Engaging with children and adolescents in mental health settings who are exhibiting behaviours that challenge can often result in the use of seclusion, restraint and coercive practices. It is recognised that more therapeutic ways to engage this population are needed, adopting trauma informed interventions may provide a solution. The aim of this systematic review is to synthesize the evidence in relation to the effect of trauma-informed interventions on coercive practices in child and adolescent residential settings. The review is guided by elements of the Cochrane Handbook for Systematic Reviews of Interventions and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. Results were synthesized and reported narratively. Nine studies met the eligibility criteria for this review. There was a lack of homogeneity amongst the studies. The trauma-informed interventions used were typically multi-faceted, underpinned by a variety of approaches and sought to bring about changes to clinical practice. Most studies (n = 8) reported significant reductions in the use of restrictive practices following the implementation of a trauma informed approach. The use of a trauma-informed approach, underpinned by an organisational change or implementation strategy, have the potential to reduce coercive practices with children and adolescents. However, the included interventions were insufficiently described to draw strong conclusions.

Mental health disorders among primary school children remain a crucial issue. Early health promotion interventions can positively affect and prevent the onset of mental disorders. Promising digital mental health methods have been implemented for adolescents and youths with scarce evidence among younger ages. Therefore, the aim of the current systematic review was to identify health promotion interventions on mental health and wellbeing, with the use of digital methods, delivered in primary school settings. Six digital interventions have been identified, three of which were targeting teachers and the others students. Regardless of the limited number of studies, the effectiveness of the web-based interventions upon teachers’ knowledge and attitudes and the positive impact on children’s behavioral improvements has been documented. The lack of adequate evidence highlights the need for further research in the field. The current review provides information for professionals working in primary schools useful for the design and implementation of effective mental health and wellbeing interventions.

Background: Trauma-informed care (TIC) is a framework that embeds safety, trust, choice, collaboration, and empowerment into practice. Although training improves TIC attitudes, implementation in European residential child and adolescent settings remains inconsistent, and immersive technologies such as virtual reality (VR) are underevaluated for this purpose. Objective: This study aims to evaluate whether a VR-enhanced training program improves TIC attitudes among staff and trainees in residential child and adolescent care across European sites and to examine site-level heterogeneity. Methods: We conducted a multisite pre-post evaluation within the European Union–co-funded Safe4Child project. Participants completed a standardized online TIC module followed by a mentor-facilitated VR simulation. Attitudes were measured using the ARTIC-10 (10-item version of the Attitudes Related to Trauma-Informed Care; 7-point) scale immediately before the online module and immediately after the VR simulation; the design, therefore, evaluates the combined program rather than VR in isolation. Analyses included Wilcoxon signed-rank tests, multivariable regression, and Bayesian models with skeptical priors. Results: Among 79 matched participants from Bulgaria, Finland, and Germany, mean (SD) ARTIC-10 scores increased from 5.33 (1.05) to 5.57 (1.20; P <.001; Cohen d =0.22). Effects varied by site. Germany showed significant improvement (Cohen d =0.56), whereas Bulgaria and Finland did not reach significance. Bayesian estimation yielded a mean change of 0.24 points (95% CI 0.11‐0.37) with P ( Δ >0) ≈ 1.00. Prior trauma-related training showed a probable but uncertain additional benefit. Conclusions: The VR-enhanced TIC program produced a small overall improvement in attitudes, with a moderate effect in Germany, suggesting that immersive training can strengthen TIC learning when aligned with local contexts. The absence of a control group precludes attributing effects specifically to VR. Larger comparative trials are needed to determine whether VR confers advantages over conventional training approaches.