What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review
Highlights
- Eye Movement Desensitisation and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT) are the most studied and effective treatments for trauma-related distress, with Prolonged Exposure and Narrative Exposure Therapy showing promise but requiring more research.
- Alternative psychotherapies, including psychodynamic approaches, demonstrate effectiveness in complex trauma cases (e.g., intimate partner violence, child loss) where EMDR and CBT may be less effective, though these remain understudied.
- Clinicians should consider a broader range of therapeutic options beyond CBT and EMDR, selecting interventions based on clients’ individual needs, cultural context, and trauma complexity rather than defaulting to the most studied approaches.
- The identified evidence gaps highlight the need for further research into alternative therapies and emerging approaches, like the Walters Method, which may offer accessible options for clients who find traditional evidence-based treatments challenging.
Abstract
1. Introduction
2. Aims and Review Questions
3. Materials and Methods
- Defining and aligning the objective/s and question/s.
- Developing and aligning the inclusion criteria with the objective/s and question/s.
- Describing the planned approach to evidence searching, selection, data extraction, and presentation of the evidence.
- Searching for the evidence.
- Selecting the evidence.
- Extracting the evidence.
- Quality appraisal (now recommended in JBI scoping reviews).
- Analysis of the evidence.
- Presentation of the results.
- Summarising the evidence in relation to the purpose of the review, making conclusions and noting any implications of the findings.
3.1. Inclusion Criteria
3.1.1. Population
3.1.2. Concept
3.1.3. Context
3.2. Search Strategy
- MEDLINE: OVID;
- Scopus: Elsevier;
- Web of Science: Clarivate;
- CINAHL Ultimate: EBSCOhost;
- APA PsycNet.
3.3. Study/Source of Evidence Selection
3.4. Data Extraction
3.5. Quality Appraisal
4. Results
5. Discussion
Major Research Gaps and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| TWM | The Walters Method |
| CBT | Cognitive Behavioural Therapy |
| EMDR | Eye Movement Desensitisation and Reprocessing |
| NET | Narrative Exposure Therapy |
| CPT | Cognitive Processing Therapy |
| CT-PTSD | Cognitive Therapy for PTSD |
| PE | Prolonged Exposure |
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| Ref ID | First Author | Year | Appraisal |
|---|---|---|---|
| [7] | Belli | 2025 | Moderately High Quality |
| [8] | Bongaerts | 2022 | Moderately High Quality |
| [9] | Bryant | 2013 | Moderately High Quality |
| [10] | Colosetti | 2000 | Moderately High Quality |
| [11] | Brom | 1989 | Low Quality |
| [12] | Doherty | 2025 | Moderately High Quality |
| [13] | Edmond | 2004 | Moderately High Quality |
| [14] | Ellenbroek | 2024 | Moderately High Quality |
| [15] | Fan | 2021 | Moderately High Quality |
| [16] | Feingold | 2018 | Moderately High Quality |
| [17] | Forbes | 1994 | Moderately High Quality |
| [18] | Kehle-Forbes | 2025 | High Quality |
| [19] | Khan | 2025 | Moderate Quality |
| [20] | Kitchiner | 2004 | High Quality |
| [21] | Köhler | 2017 | Moderately High Quality |
| [22] | Krüger-Gottschalk | 2025 | Moderately High Quality |
| [23] | Lazrove | 1998 | Moderately High Quality |
| [24] | Melegkovits | 2022 | Moderately High Quality |
| [25] | Zepeda Méndez | 2018 | Moderately High Quality |
| [26] | Moghadam | 2020 | Moderate Quality |
| [27] | Mørkved | 2018 | High Quality |
| [28] | Motoziuk | 2024 | Moderate Quality |
| [29] | Mueser | 2008 | Moderately High Quality |
| [30] | Sandström | 2006 | Very Low Quality |
| [31] | Schubert | 2016 | Moderately High Quality |
| [32] | Susanty | 2022 | Moderately High Quality |
| [33] | Tarquinio | 2012 | Very Low Quality |
| [34] | Turrini | 2021 | The paper is not a primary study, thus cannot be appraised using the MMAT. |
| [35] | Wakusawa | 2023 | Moderate Quality |
| [36] | Van Woudenberg | 2018 | Moderately High Quality |
| [37] | Yu | 2022 | High Quality |
| [38] | Zinfandel | 2024 | High Quality |
| [39] | Lian | 2024 | Moderately High Quality |
| Article Characteristics | N/33 | Article Characteristics | N/32 |
|---|---|---|---|
| Type of evidence source | Sample size | ||
| Primary research article | 32 | <10 | 7 |
| Secondary research article | 1 | 10–30 | 6 |
| Methodology used | 31–50 | 3 | |
| Qualitative | 5 | 51–70 | 4 |
| Quantitative | 23 | 71–100 | 6 |
| Mixed Methods | 4 | >100 | 7 |
| Methods of data collection | Region | ||
| Multiple methods | 4 | UK and Ireland | 4 |
| Interviews | 5 | Europe | 12 |
| Surveys/questionaries | 0 | USA | 6 |
| Other | 24 | Asia | 8 |
| Not applicable | 1 | Australia | 2 |
| Multiple | 1 |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Shiel, E.V.; Connor, Z.; Downes, M.; Bailey-Shaw, A.; Hemingway, S.; Walters, C.; Kola-Palmer, S. What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review. Healthcare 2025, 13, 3180. https://doi.org/10.3390/healthcare13233180
Shiel EV, Connor Z, Downes M, Bailey-Shaw A, Hemingway S, Walters C, Kola-Palmer S. What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review. Healthcare. 2025; 13(23):3180. https://doi.org/10.3390/healthcare13233180
Chicago/Turabian StyleShiel, Emma Victoria, Zoe Connor, Megan Downes, Abigail Bailey-Shaw, Steve Hemingway, Clare Walters, and Susanna Kola-Palmer. 2025. "What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review" Healthcare 13, no. 23: 3180. https://doi.org/10.3390/healthcare13233180
APA StyleShiel, E. V., Connor, Z., Downes, M., Bailey-Shaw, A., Hemingway, S., Walters, C., & Kola-Palmer, S. (2025). What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review. Healthcare, 13(23), 3180. https://doi.org/10.3390/healthcare13233180

