Table 114Summary strength of evidence KQ 1 and KQ 2

TypeIntervention (G1)Comparison (G2)Outcomen Trials, ParticipantsStrength of Evidence; Magnitude of Effect
Parenting InterventionsAttachment and Biobehavioral Catch-upActive controlaMental and behavioral health277,78,82,83; 213Low; NR
Healthy caregiver-child relationship279,81; 166Low; NR
Healthy development185; 37Low; NR
Wait listMental and behavioral health180; 58Low; medium (Partial eta squared=0.436 or 0.511)
Healthy caregiver-child relationship180; 58Low; medium or large (Partial eta squared=0.59 or 0.791)
Attachment-based InterventionUsual careMental and behavioral health186; 79Insufficient
Healthy caregiver-child relationship186; 79Low; small to medium (d=0.47, r=0.36 or 0.37)
Child-Parent PsychotherapybActive controlaHealthy caregiver-child relationship287,88; 159Insufficient
Usual careHealthy caregiver-child relationship287,88; 141Low; medium to large (h=0.64 to 1.34)
Incredible Years CoParenting AdaptationUsual careMental and behavioral health189; 64Insufficient
Healthy caregiver-child relationship189; 64Low; small to medium (d=0.40 or 0.59)
Keeping Foster and Kinship Parents Trained and SupportedUsual careMental and behavioral health191; 700Moderate; small (d=0.26)
Healthy caregiver-child relationship191; 700Moderate; small (d=0.29)
Placement stability191; 700Insufficient
Permanency191; 700Moderate; NR
Nurse-Home Visitation InterventionUsual careMental and behavioral health193; 163Insufficient
Healthy caregiver-child relationship193; 163Insufficient
Safety193; 163Insufficient
PCIT Adaptation PackagePCIT Adaptation Package enhancedcSafety196; 75Insufficient
Usual careSafety295,96; 153Low; NRd
PCIT Adaptation Package enhancedcUsual careSafety196; 88Insufficient
SafeCareUsual careSafety1100; 2,175Moderate; HR=0.74 to 0.83
Videotape InterventionControl videotapeMental and behavioral health1101; 30Insufficient
Healthy caregiver-child relationship1101; 30Insufficient
Trauma-Focused TreatmentsCombined Parent-Child Cognitive Behavioral TherapyActive controlaMental and behavioral health1107; 75Low; medium (d=0.61)
Healthy caregiver-child relationship1107; 75Insufficient
Eye Movement Desensitization and ReprocessingActive controlaMental and behavioral health1112; 14Insufficient
Group Psychotherapy for Sexually Abused GirlsActive controleMental and behavioral health1113; 71Low (G1<G2); small to medium (d=0.36 to 0.79)
Group Treatment Program for Sexual AbuseInactive controlMental and behavioral health1114; 30Low; NR
Trauma-Focused Cognitive Behavioral TherapyActive controlfMental and behavioral health2108,115; 315Low; small to medium (d=0.30 to 0.70)
Healthy caregiver-child relationship1108; 229Low; small to medium (d=0.38 or 0.57)
Trauma-Focused Cognitive Behavioral Therapy Group AdaptationActive controleMental and behavioral Health1116; 44Insufficient
Healthy caregiver-child relationship1116; 44Insufficient
Enhanced Foster Care InterventionsBucharest Early Intervention ProjectUsual care (institutional care in Romania)Mental health and behavior1118,120,123,125,129; 136Low; Odds ratio 2.8 [95%CI 1.2 to 6.4]
Healthy caregiver-child relationship1121,125,127; 136Low; NR
Healthy development1117,119,121,122,124,126,128; 136Low; effect sizeg =0.47 or 0.62
Fostering Healthy FuturesInactive controlMental and behavioral health1131; 156Low; small to medium (d=0.30 to 0.51)
Placement stability1132; 110Low; OR=0.18 to 0.56
Permanency1132;110Low; OR=5.14
Middle School SuccessUsual careMental health and behavior1136,137; 100Low; small to medium (d=0.35 to 0.57)
Placement stability1136; 100Low; medium (d=0.50)
Multi-dimensional Treatment Foster Care for PreschoolersUsual careMental health and behavior1142,179; 117Low; medium (d=0.64 to 0.68)
Healthy caregiver-child relationship1139,141; 117Low; NR
Healthy development1138; 23Low; NR
Permanency1140,143; 90Low; NR
New Orleans InterventionUsual careSafety1130; 255Low; RRR=0.67 to 0.75
Permanency1130; 240Low (G1<G2); NR

Active comparator is an approach derived from an intervention wherein the degree to which core components of the original model are implemented is unclear and/or core components are omitted or substantively modified.


Intervention is a variant of relationship-based dyadic psychotherapy as developed and manualized by Cicchetti and colleagues.87,88


”Enhanced” refers to the provision of individualized services to the parents.


Chaffin et al. (2011) report a hazard ratio, but it is not statistically significant (i.e., reported as a trend).


Active comparator is an approach representative of a conventional practice in the field.


One comparator is a conventional approach; the other a derived approach.


Effect size measure is not specified; therefore, we did not classify the magnitude of effect as small, medium, or large.

Note: Table is organized alphabetically by intervention name. All results are G1>G2 unless otherwise noted. For estimation of the magnitude of effect, we include only the statistically significant (p<0.05) effect sizes provided by study authors and do not calculate effect sizes as part of our analysis. Interpretation of the effect size as small, medium, or large is defined as follows: Cohen’s d=0.20, 0.50, and 0.80; Cohen’s h=0.20, 0.50, and 0.80; and correlation coefficient r=0.10, 0.30, and 0.50.176 When authors use Eta or partial eta squared effect sizes we use the interpretation that the authors provide.80,177 We include an effect size range when more than two effect sizes are reported.

Abbreviations: G = group; HR = hazard ratio; KQ = key question; n = number; NR = not reported; OR = odds ratio; RRR = relative risk reduction.

From: Discussion

Cover of Child Exposure to Trauma: Comparative Effectiveness of Interventions Addressing Maltreatment
Child Exposure to Trauma: Comparative Effectiveness of Interventions Addressing Maltreatment [Internet].
Comparative Effectiveness Reviews, No. 89.
Fraser JG, Lloyd SW, Murphy RA, et al.

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