The feasibility and acceptability of delivering a group trauma-focused intervention to children in care

Rebecca S. Davis; John Devaney; Sarah L. Halligan; Richard Meiser-Stedman; Paula Oliveira; Patrick Smith; Paul Stallard; Rebecca Kandiyali; Alice Phillips; Aalia John; Rachel M. Hiller

doi:10.1111/bjc.12494

The feasibility and acceptability of delivering a group trauma-focused intervention to children in care

Rebecca S. Davis, John Devaney, Sarah L. Halligan, Richard Meiser-Stedman, Paula Oliveira, Patrick Smith, Paul Stallard, Rebecca Kandiyali, Alice Phillips, Aalia John, Rachel M. Hiller

Research output: Contribution to journal › Article › peer-review

2 Citations (SciVal)

Abstract

Objective: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable – particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial.

Methods: Participants were 34 10–17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews.

Results: Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs.

Conclusion: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).

Original language	English
Pages (from-to)	86-109
Number of pages	24
Journal	British Journal of Clinical Psychology
Volume	64
Issue number	1
Early online date	25 Jul 2024
DOIs	https://doi.org/10.1111/bjc.12494
Publication status	Published - 31 Mar 2025

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions

Funding

This project was funded by a National Institute for Health and Care Research (NIHR), Research for Patients Benefit (RfPB) grant, awarded to RMH. The views expressed here do not necessarily reflect the views of the NIHR. We are very grateful to the young people and caregivers involved in this work. The authors also sincerely thank the local authority and NHS team involved in this research, for their commitment and openness to improving practice through research. We also thank our trial steering committee: Tim Dalgleish, Bill Yule, Jo Essex, Heather Ottoway. Their guidance was much appreciated. We would also like to dedicate this research to Prof Bill Yule and Aisha Hamzat, who have both had a profound influence on our ongoing research in this area.

Funders	Funder number
National Institute for Health and Care Research
Research for Patient Benefit Programme
Aisha Hamzat

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

PTSD
complex trauma
feasibility
foster care
group treatment

ASJC Scopus subject areas

Clinical Psychology

Access to Document

10.1111/bjc.12494Licence: CC BY

Cite this

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title = "The feasibility and acceptability of delivering a group trauma-focused intervention to children in care",

abstract = "Objective: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable – particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial. Methods: Participants were 34 10–17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews. Results: Of the 34 participants allocated to the intervention, 27 (80\%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50\%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs. Conclusion: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).",

keywords = "PTSD, complex trauma, feasibility, foster care, group treatment",

author = "Davis, \{Rebecca S.\} and John Devaney and Halligan, \{Sarah L.\} and Richard Meiser-Stedman and Paula Oliveira and Patrick Smith and Paul Stallard and Rebecca Kandiyali and Alice Phillips and Aalia John and Hiller, \{Rachel M.\}",

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T1 - The feasibility and acceptability of delivering a group trauma-focused intervention to children in care

AU - Davis, Rebecca S.

AU - Devaney, John

AU - Halligan, Sarah L.

AU - Meiser-Stedman, Richard

AU - Oliveira, Paula

AU - Smith, Patrick

AU - Stallard, Paul

AU - Kandiyali, Rebecca

AU - Phillips, Alice

AU - John, Aalia

AU - Hiller, Rachel M.

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N2 - Objective: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable – particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial. Methods: Participants were 34 10–17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews. Results: Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs. Conclusion: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).

AB - Objective: Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable – particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial. Methods: Participants were 34 10–17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews. Results: Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs. Conclusion: The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).

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KW - foster care

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SN - 0144-6657

VL - 64

SP - 86

EP - 109

JO - British Journal of Clinical Psychology

JF - British Journal of Clinical Psychology

IS - 1

ER -

The feasibility and acceptability of delivering a group trauma-focused intervention to children in care

Abstract

Data Availability Statement

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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