Psychological counseling does seem to help heal the scars of child abuse and neglect, though the extent to which family therapy prevents future abuse is unclear, according to a research review.

Although there are numerous forms of psychological therapy for child maltreatment - for both children and parents - their effectiveness has been unclear. In particular, researchers have so far failed to find good evidence that family therapy can put a stop to abuse and neglect.

The new study, a review of 21 previous studies, found that, in general, children who underwent some form of therapy fared better than those who did not, showing fewer symptoms of anxiety, depression and low self-esteem.

There was also evidence that therapy improved abusive parents’ attitudes and behavior.

The findings are encouraging, according to study co-author Dr. Elizabeth A. Skowron of Pennsylvania State University in University Park. “This is the first definitive evidence that, collectively, these interventions are pretty effective,” she told Reuters Health.

Still unanswered, however, is the question of whether the benefits last, and whether therapy actually ends the abuse, Skowron said.

Among the studies she and colleague Dawn H.S. Reinemann reviewed, a few did follow families for longer periods - with one showing that treatment gains could last up to 12 years.

However, with so few data to go on, those results should be “viewed cautiously,” the researchers report in the journal Psychotherapy: Theory, Research, Practice and Training.

Though psychological therapies for child maltreatment have been available since the 1970s, their effectiveness has been hard to gauge for several reasons. For one, Skowron explained, many abused children - perhaps three-quarters - suffer several types of abuse and neglect, which is a therapeutic challenge.

“The nature of child maltreatment is complex,” she said.

In addition, long-term follow-up of families who enter therapy requires resources. The positive findings of this study, according to Skowron, point to the importance of funding research to find out whether psychological therapy has lasting benefits for children and parents - as well as to answer questions such as why various types of therapy work, and for whom they work best.

More funding, Skowron added, is also needed to make treatment available to families through social services.

“It would be a mistake,” she said, “to think that these therapies are widely available to families.”

SOURCE: Psychotherapy: Theory, Research, Practice and Training; Spring 2005.