Practice Elements in Targeted and Universal Child Mass Trauma Interventions

Many child mass trauma interventions are a composite of multiple practice elements which commonly are not well identified or assessed in the treatment outcome research. Understanding the practice elements used for targeted (samples of children with direct exposure, intense experiences, and/or serious reactions) and universal (general samples without consideration of exposure or reactions) populations can help clarify future directions for intervention development and delivery. A systematic review of 84 randomized controlled trials (RCTs) and cluster RCTs identified 131 psychosocial interventions addressing mass trauma. The current analysis compared frequently used elements delivered to targeted and universal populations and examined the populations served across context (country income), event types (including the COVID-19 epidemic), delivery modes, and delivery settings. Reflecting the importance of accessible interventions for those with the greatest need, most child mass trauma interventions overall were administered to targeted populations in group applications delivered in schools or other community settings. Psychoeducation for the child, affect modulation, and relaxation were the most frequently offered elements for both targeted and universal populations. Exposure, narrative, and psychoeducation for the caregiver were administered more often in targeted than universal populations while social skills training, mindfulness, self-praise, and communication skills training were administered more often in universal populations. Future evaluation research should identify, describe, and evaluate specific practice elements included in interventions in the two populations and should address concerns related to certain groups of children receiving interventions and to aspects of intervention delivery.