Korean Clinical Psychology Association
[ Review Article ]
Korean Journal of Clinical Psychology - Vol. 39, No. 2, pp.164-185
ISSN: 1229-0335 (Print) 2733-4538 (Online)
Print publication date 30 May 2020
Received 03 Jan 2020 Revised 09 Feb 2020 Accepted 27 Feb 2020
DOI: https://doi.org/10.15842/kjcp.2020.39.2.007

The Efficacy of Psychological Interventions for Complex Trauma: A Systematic Review and Meta-Analysis

Hyunjung Choi1, ; Wooyeol Lee1 ; Simyang Heo2 ; Jahye Kim2
1Department of Psychology, Chungbuk National University, Cheongju, Korea
2Traumahealing Center Human Hearts, Seoul, Korea

Correspondence to: Hyunjung Choi, Department of Psychology, Chungbuk National University, 1 Chung-daero, Suwon-gu, Cheongju, Korea; E-mail: hchoi@chungbuk.ac.kr

© 2020 Korean Clinical Psychology Association


This study meta-analyzed interventions for symptom constructs of complex posttraumatic stress disorder related to complex trauma, such as child abuse, multiple interpersonal trauma, and organized violence. From 42 randomized controlled studies, 164 effect sizes were calculated comprising various treatment comparisons and outcomes. Cognitive processing therapy/cognitive therapy (CPT/CT), narrative exposure therapy (NET), phase-based trauma-focused cognitive behavior therapy (phased TF-CBT), single-phased TF-CBT (single TF-CBT), prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and present-centered therapy (PCT) each showed moderate to large effect sizes on PTSD. For depression, CPT/CT, phased TF-CBT, single TF-CBT, NET, and PE showed moderate to large effect sizes. Meta regression revealed that efficacy on PTSD and depression was greater with trauma-focused than with present-centered interventions. Limited evidence made it impossible to compare phased treatments and single-phase treatments. Outcomes of disturbance in self organization (DSO) were relatively scarce; however, among those, CPT/CT, PE, and PCT showed large to moderate effect sizes on negative self-concept. For emotion regulation and interpersonal problems, phased TF-CBT seemed to be promising. Treatment completion rates were similar between trauma-focused and present-centered. Population and study characteristics did not affect efficacy; however, we discussed related clinical issues.


complex trauma, evidence-based interventions, posttraumatic stress disorder, complex posttraumatic stress disorder, meta-analysis


This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2017S1A5B5A07062178).


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