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Cognitive Behavioral Intervention for Trauma in Schools
The Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a collaborative project with the Los Angeles School District (LAUSD), provides mental health screening and a standardized brief cognitive behavioral therapy treatment in schools for students who have been exposed to violence. Researchers from UCLA and RAND have been engaging in a participatory research partnership with the LAUSD mental health staff in order to develop a program that is relevant and appropriate for students, their families, and their schools.
Key aims: To understand the level of violence exposure and mental health symptoms of students attending the participating schools. To develop a trauma program that could be delivered in schools by school clinicians. To evaluate the effectiveness of the program. Methods: In the CBITS pilot study, conducted between January through June 2000, 1,004 recent immigrant school children (aged 8-15) were surveyed about their prior exposure to violence and symptoms of PTSD and depression. 198 Latino students who reported significant community violence exposure and trauma-related Depression and/or Posttraumatic Stress Disorder symptoms in this pilot study were evaluated. When possible, students were randomized to receive the intervention immediately or be placed on a waitlist to receive the intervention later in the school year. The intervention consisted of a brief manualized group cognitive behavioral therapy (CBT) (CBITS, Jaycox, 2003) delivered in Spanish by bilingual, bicultural school social workers. The program also includes 4 parent sessions and 1 teacher psychoeducation session. Following this pilot study, a randomized controlled trial was conducted to evaluate the effectiveness of this school-based program. Participants included 126 general population sixth-grade students at two large middle schools in Los Angeles who reported violence exposure and had clinical levels of post-traumatic stress symptoms. Students were randomly assigned to CBITS (n=61) or to a wait-list control group (n=65). Significance: The pilot study showed that students reported high levels of violence exposure over the previous year, with only 12% reporting no violence exposure. Thirty-two percent of students reported PTSD symptoms in the clinical range, and 16% reported clinical levels of depressive symptoms. The pilot study demonstrated that this program could be implemented in the public school system and showed that PTSD and Depression symptoms improved with the CBITS treatment. In the follow-up study, compared to the control group, students randomly assigned to the intervention had significantly lower post-traumatic stress and depressive symptoms as reported by students and lower psychosocial dysfunction as reported by parents. There was no significant difference in teacher-reported behavior. Impact: CBITS is an effective early intervention program that can be delivered on school campuses by school based clinicians. This program provides an evidence-based treatment for the many traumatized children who frequently do not receive mental health services. Current status: We are now beginning a new phase of the project, and exploring ways to disseminate the program to a wide range of communities and school districts across the country. |
Principal Investigators: Marleen Wong (PI); Bradley Stein, MD, MPH; Lisa Jaycox, PhD; Sheryl Kataoka, MD Sponsored by: |
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Last updated on 8/10/2009 |