INVITED REVIEW Therapy for child psychological maltreatment FIONA LEESON & REGINALD D. V. NIXON School of Psychology, Flinders University, Adelaide, South Australia, Australia Abstract Research of childhood psychological maltreatment has documented a range of severe and long-lasting difficulties for children who experience this type of abuse. Consequences can include but are not limited to emotional and behavioural problems, low self-esteem, and relationship difficulties. Accordingly, the development of therapy programs to assist children’s recovery is imperative. Despite this, there are currently no empirically validated therapy programs designed specifically to target the effects of psychological maltreatment. There is, however, a growing literature on the effectiveness of therapies for other types of maltreatment, in particular sexual abuse. The present paper summarises the literature on treatments for childhood trauma including sexual and physical abuse. The application of these treatments to target outcomes secondary to psychological maltreatment is discussed and future research directions identified. Keywords: Child and adolescent psychopathology, clinical/counselling psychology, emotional disorders, psychological disorders, child abuse, psychological maltreatment, child and adolescent psychopathology Overview of the review and aims The current review summarises our knowledge to date regarding interventions for children who experience psychological maltreatment. This is an area of research that is still in its infancy, and at present, there are currently no empirically-tested interventions aimed specifically at treating psycholo- gical maltreatment as the core presenting problem. However, treatment for some of the negative out- comes of other forms of maltreatment has been subjected to methodologically rigorous evaluation, for example posttraumatic stress disorder (PTSD) secondary to sexual abuse (Silverman et al., 2008). We would argue that the literature for other types of maltreatment, as well as trauma in general, may be used to guide the development of therapies specific to psychological maltreatment. Current gaps in the research literature will be discussed with a view to identifying future research directions. What is psychological maltreatment and why is it a problem? Childhood maltreatment is one of the most serious and costly problems faced by modern society. For the child and families, it can lead to a range of severe and long-lasting difficulties including both internalising (Bolger, Patterson, & Kupersmidt, 1998; Flisher et al., 1997; Kaplan et al., 1998; Kim & Cicchetti, 2004; Manly, Kim, Rogosch, & Cicchetti, 2001) and externalising (Briere & Runtz, 1990; Flisher et al., 1997; Kaplan et al., 1998; Kim & Cicchetti, 2004; Manly et al., 2001) problems, and has been reported to explain a significant amount of variance in child onset disorders (e.g., 5–13% in one New Zealand cohort study, Fergusson, Boden, & Horwood, 2008). For the community, the cost is also high. In Australia alone in 2007 it was estimated that child maltreat- ment cost the nation somewhere between $10.7 and $30.1 billion in terms of health services, responding to associated crime, educational expenditure and care and protection (Taylor et al., 2008). Between 2007 and 2008, there were 55,120 substantiated cases of child abuse and neglect in Australia (Australian Institue of Health and Welfare [AIHW], 2009), a dramatic increase from previous decades. However, prevalence rates should be inter- preted with caution because of difficulties in defining and measuring maltreatment (AIHW, 2009), the secret nature of some types of maltreatment (Na- tional Research Council, 1993) and differences in Correspondence: Dr Reginald D. V. Nixon, School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia. Tel: þ61 8 8201 2748. Fax: þ61 8 8201 3877. E-mail: reg.nixon@flinders.edu.au Clinical Psychologist, Vol. 14, No. 2, July 2010, pp. 30–38. ISSN 1328-4207 print/ISSN 1742-9552 online ª The Australian Psychological Society Ltd Published by Taylor & Francis DOI: 10.1080/13284207.2010.500311