Authors' objectives: Traumatic experiences are a predictor of ill mental health, primarily posttraumatic stress disorder (PTSD), depression and anxiety. The Children and War Foundation has developed a group-based trauma-focused cognitive behavioural therapy (TF-CBT) – the Teaching Recovery Techniques (TRT) – for children and adolescents exposed to war, violence, and displacement. TRT is a programme designed for health promotion and prevention in low-resource settings and is facilitated by trained laypersons, often from the same cultural background as the participants.

Authors' results and conclusions: Results: A systematic literature search identified 12 empirical studies: seven randomised controlled trials (RCTs) and five before–after case series, with over 1,800 participants. Across studies, TRT was generally found to reduce PTSD symptoms, with CRIES-8 or CRIES-13 scores improving between 3- and 14 points post-intervention, and up to 12 points at follow-up (3–6 months). Evidence for reductions in psychological distress and depressive symptoms (measured via SDQ and DSRS) was mixed and less consistent. Improvements in well-being (Cantril Ladder) and depression severity (PHQ-9) were observed in some studies. The analysis of the Austrian TRT programme is based on data from 372 participants, children and adolescents (aged 6–18) with post-traumatic stress disorder (PTSD): CRIES-8 data was collected before and after the intervention from children identified by teachers. The analysis revealed significant reductions in PTSD symptoms post-intervention, especially among unaccompanied minors and children with high baseline scores. The programme demonstrated strong feasibility, cultural adaptability, and acceptability. The average cost per participant was € 678. Conclusion: The results show consistent effects across studies. The evidence supports the TRT programme as an effective, scalable and low cost intervention for reducing trauma symptoms among refugee children and adolescents.

Authors' recommendations: Future research should aim to strengthen the evidence base with longer-term outcomes, explore moderators, and enhance inclusion of underrepresented groups such as girls.

Authors' methods: A systematic review of published studies (RCTs and case series) was conducted based on a systematic search in three databases (Medline via Pubmed, INAHTA, Cochrane Library). Additionally, a descriptive analysis of the data from the Austrian TRT programme at AFYA, operated since 2018 in school settings, was carried out.

Project Status: Completed

Year Published: 2025

URL for published report: https://eprints.aihta.at/1563/1/HTA-Projektbericht_Nr.165.pdf

URL for additional information: https://eprints.aihta.at/1563/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Austria

Organisation Name: Austrian Institute for Health Technology Assessment

Contact Address: Josefstaedter Strasse 39, A-1080 Vienna, Austria

Contact Name: office@aihta.at

Contact Email: office@aihta.at