Trauma informed interventions: A systematic review.

<h4>Background</h4>Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as es...

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Autores principales:	Hae-Ra Han, Hailey N Miller, Manka Nkimbeng, Chakra Budhathoki, Tanya Mikhael, Emerald Rivers, Ja'Lynn Gray, Kristen Trimble, Sotera Chow, Patty Wilson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b6d0331813274891859e1c37a881ee9d
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spelling	oai:doaj.org-article:b6d0331813274891859e1c37a881ee9d2021-12-02T20:07:05ZTrauma informed interventions: A systematic review.1932-620310.1371/journal.pone.0252747https://doaj.org/article/b6d0331813274891859e1c37a881ee9d2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252747https://doaj.org/toc/1932-6203<h4>Background</h4>Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes.<h4>Methods</h4>We performed database searches- PubMed, Embase, CINAHL, SCOPUS and PsycINFO-to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria.<h4>Results</h4>More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5).<h4>Conclusions</h4>There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.Hae-Ra HanHailey N MillerManka NkimbengChakra BudhathokiTanya MikhaelEmerald RiversJa'Lynn GrayKristen TrimbleSotera ChowPatty WilsonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252747 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hae-Ra Han Hailey N Miller Manka Nkimbeng Chakra Budhathoki Tanya Mikhael Emerald Rivers Ja'Lynn Gray Kristen Trimble Sotera Chow Patty Wilson Trauma informed interventions: A systematic review.
description	<h4>Background</h4>Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes.<h4>Methods</h4>We performed database searches- PubMed, Embase, CINAHL, SCOPUS and PsycINFO-to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria.<h4>Results</h4>More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5).<h4>Conclusions</h4>There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.
format	article
author	Hae-Ra Han Hailey N Miller Manka Nkimbeng Chakra Budhathoki Tanya Mikhael Emerald Rivers Ja'Lynn Gray Kristen Trimble Sotera Chow Patty Wilson
author_facet	Hae-Ra Han Hailey N Miller Manka Nkimbeng Chakra Budhathoki Tanya Mikhael Emerald Rivers Ja'Lynn Gray Kristen Trimble Sotera Chow Patty Wilson
author_sort	Hae-Ra Han
title	Trauma informed interventions: A systematic review.
title_short	Trauma informed interventions: A systematic review.
title_full	Trauma informed interventions: A systematic review.
title_fullStr	Trauma informed interventions: A systematic review.
title_full_unstemmed	Trauma informed interventions: A systematic review.
title_sort	trauma informed interventions: a systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b6d0331813274891859e1c37a881ee9d
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Trauma informed interventions: A systematic review.

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