A Meta Analysis of Randomised Controlled Trials on Psychological Interventions for PTSD and Depression in Adolescent Victims of Sexual Abuse

Adolescent sexual abuse (ASA) is a complex, multifactorial, less researched, and challenging issue leading to an enormous immediate and long-term adverse multidimensional impacts. And as these impacts could be unique and different than child sexual abuse (CSA), the treatment plans require special attention. While 2/3rd of the global sexual abuse literature is focused on CSA, the remaining studies focus on miscellaneous issues pertaining sexual abuse. Especially, there is a dearth of literature on ASA focused interventions to guide and provide directions to clinicians for treatment plans. This is the first meta-analysis to analyse the efficacy of randomised controlled studies (RCTs) on the psychotherapy interventions for adolescents experienced penetrative sexual abuse. An electronic search was performed using PubMed, PsycINFO, and ERIC from June 1995 to June 2025. Following PRISMA guidelines, the search yielded 29 potentially relevant studies out of which 4 studies met inclusion/exclusion criteria. Analyses mainly focused on the commonly reported mental health impacts (PTSD and depression) of ASA. Results indicated pooled effect size for post-traumatic stress disorder (PTSD) to be −1.07 with a 95% confidence interval (CI) of −2.8989; −0.2223, p < 0.05. The pooled effect size for depression was −1.57 (with a 95% confidence interval of −4.7587; 1.6183, p > 0.05). It was difficult to ascertain the effects of other variables (abuse related distress, anxiety or behavioural problems) on PTSD and depression due to inadequate information. Since, I² value 72.8% showed substantial heterogeneity across studies, the findings on random effects of interventions are discussed and heterogeneity is explained by appropriate clinical or methodological differences. Except one study, all three studies included at least one parent session. TF-CBT without involving parents showed the largest effect size for ASA which should be compared specifically with TF-CBT involving parents.

Plain Language Summary

Adolescent sexual abuse is a serious and complex issue that can have both immediate and long-term effects on mental health. Teenagers who experience sexual abuse often struggle with difficulties such as post-traumatic stress disorder (PTSD) and depression. While there is a large amount of research on child sexual abuse, much less is known about how best to support adolescents, whose experiences and needs may be different. This study examined how effective psychological therapies are for adolescents who have experienced penetrative sexual abuse. We reviewed research studies known as randomised controlled trials, which are considered a reliable way to test how well treatments work. We searched major databases and identified four studies that met the inclusion criteria. Our findings suggest that psychological therapies can significantly reduce symptoms of PTSD in adolescents. However, the evidence for reducing depression was not strong enough to draw clear conclusions. The studies included in the review varied widely in their methods and reporting, making it difficult to compare results and understand what factors may influence treatment outcomes. Among the therapies studied, Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) showed particularly promising results, especially when delivered without involving parents. However, more research is needed to better understand this finding and to compare it with approaches that include parental involvement. Overall, this study highlights the need for more focused research on adolescents to guide effective treatment planning and improve mental health outcomes for survivors of sexual abuse.