A scalable psychological intervention designed to help children in resource poor settings following conflict and emergencies. TRT is delivered by trained non-specialist practitioners to groups of children and young people (8-18 years old). Five group sessions, delivered weekly, teach skills to manage trauma-related difficulties such as: upsetting memories; distress and physiological arousal; and avoidance. Skills are based on cognitive behavioural therapy (CBT) techniques. Parallel groups for carers help them to support their children.
Access to the intervention manual: Full open access (https://www.childrenandwar.org/manuals)
Access to training: Other (https://www.childrenandwar.org/trainings)
Intended users/ Implementers: Trained and supervised non-specialist provider
Therapeutic strategies: Cognitive Behavioural Therapy (CBT) based therapeutic strategies including psycho-education, normalising, memory focused work (talking, drawing, writing), imagery techniques, relaxation, sleep hygiene, self-monitoring, graded exposure, behavioural activation.
Intervention format: Weekly group sessions
Target population: Children and adolescents 8 - 18 years old
Key innovative or differentiating features of this intervention: The intervention components (skills taught) are based on well-established psychological techniques. The intervention can be delivered by non-specialists who have attended a 4-day experimental training workshop
Summary of Evidence: 6 published RCTs. A recent meta analysis found that TRT significantly reduced PTSD symptoms (https://doi.org/10.1016/j.jaac.2023.02.013). Another systematic review also concluded that TRT has positive effect https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293248
Different populations where the intervention has been used: Child survivors of war and war-like situations; child survivors of large scale disasters such as earthquakes
Restrictions or requirements for its use: We recommend training, but the manual is made freely available regardless of training
Requirements / qualifications for trainers and supervisors: Trainers should have attended a "training the trainers" workshop offered by the Children and War Foundation
Examples of implementation outside of RCT contexts: TRT has been used in Ukraine and is for example described by Yavna et al., 2024, where 3123 children and adolescents received TRT; and 68% reported reduced symptoms, the rate increasing the more experienced the TRT facilitators became. TRT has also been evaluated in Sweden (Sakardi et al 2018) when used with 13-18 year old unaccompanied refugee minors, who showed significant improvements in PTSD and depression symptoms after the intervention. More general experiences are described by Heltne et al (2023) on training non-specialists in teaching recovery techniques (TRT) to help traumatised children in humanitarian settings: a qualitative analysis of experiences gained from 20 years of practice.
Information provided Patrick Smith on 5 April 2024. He is the co-author of TRT.