A systematic review and meta-analysis of medical and psychosocial care procedures for children and adolescents after (online) sexual abuse.

BACKGROUND AND

OBJECTIVE

Child sexual abuse (CSA) and online child sexual abuse (OCSA) continue to pose an increasing challenge. Although structured interventions exist for CSA, no established framework currently addresses OCSA, and research on effective care procedures is scarce. Initially focused on OCSA, this review expanded to include CSA due to the absence of OCSA-specific studies, enabling a more comprehensive synthesis. The review outlines medical and psychosocial care procedures after CSA and provides recommendations for OCSA.

METHODS AND

RESULTS

53 studies published between 1995 and 2022 identified medical and psychosocial interventions for children and adolescents up to 17.11 years old who have experienced CSA. 17 studies with a medical focus tend to follow a common thread after CSA, although some focus on different procedural steps. Psychosocial interventions (36 articles) showed a high degree of diversity, with trauma-focused cognitive behavioral therapy (TF-CBT), adapted forms of cognitive behavioral therapy (CBT), group therapy and individual settings proving particularly effective. A subgroup meta-analysis of 31 psychosocial studies yielded a weighted mean effect size of 1.14 [0.98; 1.29], indicating the effectiveness of all psychotherapeutic interventions, with a high heterogeneity of I2 = 82 %.

CONCLUSIONS

The review reveals a research gap, the lack of studies on interventions and their effectiveness in OCSA, which urgently needs to be addressed. It highlights the need for comprehensive, interdisciplinary medical and psychosocial interventions after CSA, whereby adapted interventions for OCSA are needed. This study is limited by the absence of OCSA-specific interventions, constraints on subgroup analyses due to limited data, and the high heterogeneity of included psychosocial studies. Further research on procedures specific to OCSA and training for professionals dealing with it are strongly indicated.