A systematic review of non-clinician trauma-based interventions for school-age children and young people

Exposure to adverse childhood experiences (ACEs) is increasingly recognised as a risk factor for health problems in later life. Awareness of ACEs and associated trauma is increasing in schools and educational settings, as well as demand for supportive services to deal with needs. However, there is a lack of clear evidence for effective interventions which can be delivered by non-clinicians (e.g., the school staff themselves). For this review, we conducted a search across five electronic databases for studies published since January 2013. These studies assessed the efficacy of non-clinician delivered interventions for supporting trauma recovery or improvements in mental health in school age youth (4-18 years) who have experienced ACEs. Out of the 4097 studies identified through the search, 326 were retrieved for full text screening and 25 were included in the final review. There was considerable heterogeneity in study design, outcome measures and the intervention being studied. The majority of studies were assessed to be of weak quality due to convenience sampling of participants and potential bias, indicating there is a lack of high quality research evidence to inform non-clinician delivered trauma-informed interventions for improving mental health outcomes in school-age young people. Cognitive Behavioural Therapy (CBT)-based approaches are tentatively suggested as a suitable target for future rigorous evaluations of interventions addressing ACE-related trauma recovery and mental health improvement in school-age young people.