Fractured Systems, Compounded Trauma: A Systematic Review and Meta-Aggregation of Crisis Service Experiences After...

Area of Science:

• Childhood trauma and intervention science
• Qualitative research synthesis
• Public health and social services

Background:

• The period immediately following child sexual assault (CSA) is critical for intervention effectiveness.
• Existing research lacks a synthesis of qualitative data on stakeholder experiences with crisis services.
• Understanding these experiences is vital for improving trauma mitigation and support.

Purpose of the Study:

• To systematically review and synthesize qualitative findings on the experiences of children, young people (CYP), parents/carers, and service providers with crisis responses to CSA.
• To identify systemic challenges and effective approaches within crisis interventions for CSA.
• To inform the development of trauma-informed care systems.

Main Methods:

• A systematic review and meta-aggregation of qualitative studies were conducted.
• Databases searched included MEDLINE, PsycINFO, Embase, CINAHL, and ProQuest Social Science.
• Data from 22 studies were synthesized using the Joanna Briggs Institute meta-aggregation approach.

Main Results:

• Children and young people (CYP) experienced compounded trauma from fragmented care but benefited from empathetic, child-centered approaches.
• Parents/carers found services disjointed and retraumatizing, advocating for proactive family support.
• Service providers faced interagency conflicts, resource limitations, and moral distress, hindering trauma-informed care.

Conclusions:

• Systemic reforms are needed in post-CSA crisis care, including standardized multidisciplinary protocols and dedicated family support.
• Enhanced provider training and supervision are crucial for mitigating secondary trauma and delivering effective care.
• Implementing trauma-informed systems is essential to prevent further harm during this vulnerable period.