Seven randomised controlled trials (RCTs) were included (516 participants). Three RCTs reported their randomisation method. About half the RCTs used blinded assessment, none blinded participants, most gave details of attrition rates and three reported using ITT analysis.
There was a statistically significant benefit for the intervention group at post-test in internalising symptoms (ES: 0.41, 95% CI: 0.21 to 0.61, six RCTs), externalising symptoms (ES: 0.32, 95% CI: 0.13 to 0.52, six RCTs), child sexual behaviours (ES: 0.31, 95% CI: 0.10 to 0.52, four RCTs), and PTSD outcomes (ES: 0.37, 95% CI: 0.14 to 0.55, five RCTs); and in child sexual behaviours at follow-up (ES: 0.45, 95% CI: 0.15 to 0.74, one RCT). These findings suggested small treatment effects.
No statistically significant difference between the groups was found at follow-up for internalising symptoms (two RCTs), externalising symptoms (three RCTs) or PTSD outcomes (three RCTs).
These are fixed-effect data, as no significant statistical heterogeneity was found for any outcome. The fail-safe N for statistically significant results ranged from four to 16. There were insufficient studies for moderator analysis.