What is the effectiveness and cost-effectiveness of interventions in reducing the harms for children and young people who have been exposed to domestic violence or abuse: a rapid review

Children and young people witnessing domestic violence and abuse (DVA) can be affected negatively in terms of their psychological, emotional, and social development. Adverse events in childhood are known to be harmful to a young persons development and influence their life course, and therefore is a significant public health issue. The aim of this rapid review is to highlight the evidence on effective interventions (and any relevant cost-effectiveness evidence) focusing on reducing the harms for children and young people who have been exposed to DVA. Twenty-five studies were identified along with three guidance documents from the Welsh Government and the National Institute for Health and Care Excellence (NICE) in the UK. Twenty papers from nineteen studies reported the effectiveness of a wide range of interventions to support children and young people who have witnessed DVA. Most studies found meaningful differences in behaviour following an intervention. However, some studies did not find any differences between the intervention and control groups following an intervention to reduce the negative effects of witnessing DVA. An included cost-effectiveness analysis suggested that for behavioural outcomes, a psychoeducational intervention delivered to parent and child in parallel is likely to be cost-effective among the interventions they compared. Two further full economic evaluation studies determined the cost-effectiveness of cognitive behavioural therapy interventions to support children and young people who have been exposed to DVA. Policy and practice implications: Economic evaluations have found preliminary evidence that cognitive therapy is a cost-effective intervention to treat children and adolescents with PTSD. Future interventions should be co-produced with relevant stakeholders and patient and public members (including children and young people). There is a need for larger, well conducted, pragmatic randomised controlled trials with longer follow-up periods.