Mediators of Outcome in Trauma-Focused Psychotherapy with Youth: A Systematic Review

Sonja Protić, Lutz Wittmann, Svenja Taubner, Sonia Conejo-Cerón, Yianna Ioannou, Erkki Heinonen, Andrea Saliba, Patricia Moreno-Peral, Jana Volkert, Rasa Barkauskiene, Stefanie Julia Schmidt, Margarida Isabel Rangel Santos Henriques, Catarina Pinheiro Mota, Célia M.D. Sales, Jan Ivar Røssberg, Asta Adler, Dina Di Giacomo, Filipa Mucha Vieira, Nikola Drndarević, Randi UlbergTjasa Stepisnik Perdih, Jose M. Mestre

    Research output: Contribution to journalReview articlepeer-review

    Abstract

    This article aimed to provide a systematic narrative synthesis of existing studies on the mediators of change in psychotherapy with adolescents (10–19 years) and transition age youth (TAY) (20–29 years) who have experienced trauma-related symptoms or posttraumatic disorder. Additionally, we were interested in identifying psychotherapy-, trauma type-, and clients’ age- and gender-specific mediators of treatment outcome. Following the preferred reporting items for systematic reviews and meta-analyses, a total of 3,723 studies published in PubMed and PsycINFO databases were screened against inclusion criteria, revealing 15 eligible studies. No studies with only TAY were found; therefore, all results were limited to therapy with adolescents. Cognitive mediators were tested in 66% of selected studies, followed by parents/family-related, mental-health-related, therapy-related, and behavioral mediators. Moderate evidence was found for posttraumatic cognitions, whereas therapeutic alliance seemed to be a promising candidate for future research. Striking absence of non-cognitive-behavioral therapy interventions, emotional and adolescent-specific mediators, as well as studies with males and in non-Western societies was evident. Future original studies would benefit from applying methodological rigor in respect to mediation testing.

    Original languageEnglish
    JournalTrauma, Violence, and Abuse
    DOIs
    Publication statusAccepted/In press - 2024

    Keywords

    • adolescents and transition age youth
    • mediators
    • psychotherapy
    • systematic review
    • trauma

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