A/HRC/43/39 95. The report by WHO and others entitled INSPIRE: Seven Strategies for Ending Violence against Children is a resource that highlights a select group of strategies based on the best available evidence to help countries and communities intensify their focus on the prevention programmes and services with the greatest potential to reduce violence against children. With respect to response and support services that support the mental health of child victims, the report highlights important evidence on the effectiveness of traumafocused cognitive behavioural therapy for individuals and groups in reducing trauma symptoms and long-term negative psychological and emotional outcomes in children and adolescents who have experienced violence – reducing them by up to 37 per cent for individuals and 56 per cent for group participants. 96. For example, in Lusaka, 257 boys and girls aged 5 to 18, who had experienced at least one traumatic incident (including abuse and exploitation) and reported significant trauma-related symptoms (such as post-traumatic stress disorder) were recruited from five communities. The children were randomly assigned either to an intervention group where they received between 10 and 16 sessions of trauma-focused cognitive behavioural therapy, or to a comparison group where they received the “treatment as usual” offered to orphaned and vulnerable children. Treatment as usual included psychosocial counselling, peer education, support groups and testing for and treatment of HIV/AIDS. Importantly, the trauma-focused cognitive behavioural therapy was delivered by trained and supervised lay counsellors rather than specialist mental health providers. The study found that trauma symptoms were reduced by 82 per cent in the intervention group compared to a 21 per cent reduction in the group receiving treatment as usual. Functional impairment was reduced by 89 per cent by the therapy intervention compared to a 68 per cent reduction from treatment as usual. Trauma-focused cognitive behavioural therapy was significantly more effective than treatment as usual. Those findings are especially important given that there are unlikely to be sufficient resources in most low-income settings to recruit specialist mental health-care providers or train lay workers in more than one approach to dealing with the effects of trauma.74 97. The report entitled Promising Programmes to Prevent and Respond to Child Sexual Abuse and Exploitation, commissioned by UNICEF, has also drawn attention to the increasing focus by mental health professionals on evidenced-based practices for the treatment of child abuse and trauma. In high-income countries trauma-focused cognitive behavioural therapy, creative therapies, eye-movement desensitization and reprocessing and counselling are recognized as potential models of intervention for sexually abused children and young people. Creative therapies such as play, dance or music offer children an alternative for healing and restoration, and there are examples of this approach being used in low- and middle-income countries. A meta-analysis of play therapy for children in highincome countries found positive impact across modalities, settings, age and gender, with the most significant impact seen with humanistic, non-directive play therapy approaches. 98. The Know Violence in Childhood global learning initiative has also highlighted important evidence to inform action on violence prevention, including: (a) The potential of parenting programmes to both prevent and reduce the risk of child maltreatment and to act as an entry point to address vulnerabilities and risks within home environments; (b) Opportunities for greater synergies between intimate partner violence and child maltreatment programmes; (c) The importance of coordinated and multisectoral responses to reduce the likelihood of children being separated from their families; (d) The value of investing in changing social norms and linking initiatives to end violence against children with those aimed at ending violence against women; 74 See WHO and others, INSPIRE: Seven Strategies for Ending Violence against Children (2016). 17