The effectiveness of trauma-based therapies for Aboriginal and non-Aboriginal children and adolescents in out-of-home care

<h2>Abstract</h2><h3>Purpose</h3> Aboriginal and Torres Strait Islander children are more likely to enter out-of-home care (OOHC) in New South Wales (NSW), Australia, than non-Aboriginal children. In response to recommendations (Tune 2015) that asserted the need for culturally responsive programs designed to meet the cultural needs of children and adolescents in OOHC, the NSW government initiated a pilot project across two regions in NSW, Australia. The LINKS Trauma Healing Service was established to provide multidisciplinary services to children and adolescents in OOHC. The service has a particular focus on culturally responsive effectiveness of therapies delivered to Aboriginal and Torres Strait Islander children, adolescents and their families. Three earlier evaluations of the LINKS program have highlighted positive trends in outcomes for children and their families in NSW OOHC. This study aimed to further investigate the effectiveness of culturally responsive therapies for both Aboriginal and Torres Strait Islander and non-Aboriginal children and adolescents in OOHC in NSW, Australia. <h3>Methods</h3> An analysis was conducted on the LINKS data collected from 144 children and adolescents (70 Aboriginal/Torres Strait Islander children and 74 non-Aboriginal children) aged 3 to 16 years. Data were analysed using mixed measures analysis of variance (ANOVA), to investigate effectiveness of culturally adapted trauma therapies for Aboriginal and Torres Strait Islander children participating in the LINKS program. Data were analysed in unison with outcomes for non-Aboriginal children and young people. <h3>Main findings</h3> Data supported statistically significant reductions in difficulties and trauma symptoms for both Aboriginal/Torres Strait Islander and non-Aboriginal children and adolescents. Eye movement desensitisation and reprocessing and parent–child interaction therapy treatments were found to be most beneficial in reducing trauma symptoms overall. The results further indicate no significant differences in outcomes between Aboriginal and non-Aboriginal children, with comparable rates of improvement for both groups. <h3>Principal conclusions</h3> Trauma treatments utilised within the LINKS service show effectiveness in reducing difficulties and trauma symptoms for Aboriginal/Torres Strait Islander and non-Aboriginal children/adolescents in OOHC. This study provides some support for embedding culturally responsive approaches into mental health services delivered to children/adolescents in OOHC. It highlights the necessity for clinicians to align service delivery with the cultural values and needs of communities. Future research should address clinician cultural parity and incorporate control groups to strengthen the evidence base.