Therapeutic interventions after abuse and neglect

A quick guide for practitioners and managers supporting children, young people and families

Abuse and neglect can have a long-lasting impact on the health and wellbeing of children and young people.

It is important to know how to respond, and the evidence suggests that the following interventions may be effective for children and young people. If possible, offer a choice and explain what each intervention will involve and how you think it may help. Not all interventions will suit everyone, and the choice should be informed by a detailed assessment.

You can help and support abused and neglected children, young people and their families - but only if you know what works.

Interventions after physical abuse, emotional abuse and neglect

Age 0 to 5

Attachment-based intervention:

For example, Attachment and Biobehavioural Catch-up.

after neglect or physical abuse
for parents or carers and their children
at least 10 sessions in parent or carer’s home.

Aims to:

Improve nurturing; help parent understand the child’s behaviour; respond positively to the child’s feelings and manage their own feelings.

Child-parent psychotherapy:

(Based on Cicchetti and Toth model.)

after physical or emotional abuse, neglect or domestic violence
for parents or carers and their children
weekly sessions over 1 year in parent or carer’s home.

Aims to:

Explore parent’s understanding of the child’s behaviour, explore relationship between parents’ emotional reactions and perceptions of the child and their own childhood experiences.

An illustration of a woman and child holding hands

Attachment-based intervention (foster carers):

after abuse or neglect
for foster carers, adoptive parents, those providing permanence and their children.

Aims to:

Improve nurturing; help foster carer/adoptive parent to understand the child’s behaviour; respond positively to the child’s feelings; manage their own feelings and behave in ways that will not frighten the child.

Age 0 to 12

Parenting intervention:

For example, SafeCare.

after physical or emotional abuse or neglect
for parents or carers and their children
weekly home visits lasting at least 6 months from a trained professional.

Aims to:

Address parent-child interactions; structures and routines; parental stress; home safety.

Parent-child interaction therapy:

after physical abuse or neglect
for parents or carers and their children
group sessions for parents or carers, combined with individual child-parent sessions.

Aims to:

Develop child-centred interaction and discipline skills.

Parent training intervention:

For example, KEEP.

after abuse or neglect, where the child is showing problematic behaviours
for foster carers of children aged 5–12
groups of 8–10 for at least 16 weeks.

Aims to:

Develop strategies to manage behaviour and discipline positively; include video, role play and homework practice.

Age 10 to 17

Multi-systemic therapy for child abuse and neglect:

after abuse or neglect
for the whole family, including the parent or carer
4-6 months duration.

Aims to:

Address multiple factors contributing to the problem; include round-the-clock on-call service to provide support in crises.

Trauma-informed group parenting intervention:

after abuse or neglect
for foster carers, adoptive parents and those providing permanence for children and young people aged 5–17 (parents only)
at least 4 day-long sessions.

Aims to:

Help foster carers to develop the child/young person’s capacity for selfregulation; build trusting relationships; develop proactive and reactive strategies for managing behaviour.

Interventions after sexual abuse

Up to age 17

Trauma-focused cognitive behavioural therapy:

for children and young people showing symptoms of anxiety, sexualised behaviour or post-traumatic stress disorder
12–16 sessions
separate sessions for the non-abusing parent or carer.

Discuss fully with child or young person; be clear that there are other options if they prefer.

Provide separate sessions for non-abusing parent or carer.

Age 8 to 17

Therapeutic programme:

For example, Letting the Future In.

for children and young people
up to 20 sessions, extending to 30 as needed
up to 8 parallel sessions for non-abusing parent or carer.

Therapeutic relationship crucial.

Tailored support; range of approaches including counselling, socio-educative and creative (for example, drama or art).

Age 6 to 14

Group psychotherapeutic and psychoeducational sessions or individual psychoanalytic therapy:

for girls showing emotional or behavioural disturbance
up to 18 group sessions or 30 individual sessions
separate support sessions for non-abusing parent or carer.

Provide separate sessions for non-abusing parent or carer to help them support their child’s attendance and address issues in the family.

Working with children and young people after abuse and neglect

The following principles were identified as particularly important by children and young people who have experienced abuse and neglect:

Finding the right way to communicate, taking into account their age, communication needs and any disabilities.
Explaining about confidentiality - when you might need to share information and with whom.
Asking permission if you need to touch them and explaining what you are going to do.
Making sure they know how to contact you and checking how you can contact them.
Working closely with other organisations so they don't need to keep re-telling their story.
Giving them a choice of different therapies and support.
Sharing reports and plans with them, as appropriate to their age and understanding.
Developing good working relationships with their parents and carers.
Making a record of your conversations with them and asking them to sign it.
Involving them in decisions about their life.

Useful links

NICE guideline: Child abuse and neglect (NG76). Additional information about therapeutic interventions is included in the 'Terms used in this guideline' section
Department for Education: Working together to safeguard children
NICE guideline: Children’s attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care (NG26).

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NICE's social care quick guide to therapeutic interventions after abuse and neglect. (PDF)

This content has been co-produced by NICE and the Social Care Institute for Excellence (SCIE). It is based on NICE’s guideline on child abuse and neglect.