The Effectiveness of Psychological Interventions on the Impact of Trauma Exposure in Foster Care: A Meta-Analysis

Due to prevalent exposure to trauma in the biological family, children in foster care often experience post-traumatic stress symptoms, difficulties in forming secure attachments with the caregivers, and can present a complex range of symptoms and impairments across several areas of development. Therefore, there is an increased necessity for interventions on the effects of trauma exposure in foster care. This is the first meta-analysis to investigate the effectiveness of interventions on the effects of trauma exposure in foster care against control groups. Twelve randomized controlled trials on interventions for children with trauma-related diagnoses or with other mental health problems that are a result of complex trauma were included. A random-effects model was used for pooling the effect sizes, which were calculated for trauma-related outcomes at posttreatment and follow-up. Several potential moderator variables were analyzed. The results showed that participants receiving the intervention on trauma-related problems reported significantly better outcomes than those in the control conditions at posttreatment, after the exclusion of one outlier (g = 0.39; 95% CI [0.18 to 0.62]). The effect size was smaller at follow-up (g = 0.24; 95% CI [0.03 to 0.46]), but significant. Clinical diversity, methodological diversity, as well as other limitations were identified and discussed. Overall, the findings highlight the potential of interventions for trauma-related problems in foster care. These findings bring important contributions to the child welfare system in their efforts to develop and adapt suitable interventions for children with mental health problems due to trauma.