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Helping Kids Cope with the Effects of Trauma

Previous Features » CBITS: Helping Kids Cope with the Effects of Trauma

Figure 1
Post-Traumatic Stress Symptoms at Baseline, Three Months, and Six Months

Figure 2
Depressive Symptoms at Baseline, Three Months, and Six Months

SOURCE: Stein BD, Jaycox LH, Kataoka SH, Wong M, Tu W, Elliott MN, Fink A. A Mental Health Intervention for School Children Exposed to Violence, Journal of the American Medical Association, Vol. 290, No. 6, August 6, 2003, pp. 603-611. Copyright © 2003, American Medical Association. All rights reserved.

Somewhere between 20 and 50 percent of children in the United States are affected by exposure to violence, and more are affected by traumatic events such as natural disasters. Children exposed to trauma may experience post-traumatic stress disorder (PTSD), depression, and anxiety. These conditions can interfere with performance in school and disrupt relationships with friends and family.

To help children cope with the effects of trauma, RAND in partnership with the Los Angeles Unified School District and UCLA, developed a school-based group intervention aimed at relieving symptoms of PTSD, depression, and anxiety among children exposed to trauma. Known as CBITS (which stands for Cognitive-Behavioral Intervention for Trauma in Schools), the program has been proven effective. In 2001-2002, LAUSD conducted a randomized controlled trial of the program in partnership with RAND, involving an early intervention group and a second group that received the intervention after a period of observation.

Students in the early intervention group showed less severe PTSD symptoms than would have been expected without the intervention (figure 1);
Students in the early intervention group also showed less severe symptoms of depression than would have been expected without the intervention (figure 2);
In addition, parents of students in the early intervention group reported that their children were functioning significantly better.

Since this trial was conducted, CBITS has been implemented in school districts in several states, including New Jersey, Maryland, Missouri, Wisconsin, Louisiana, and Montana, as well as other districts in California. In addition, the CBITS team has added several research and community partners through their work within the National Child Traumatic Stress Network, a collaboration of over 70 academic and community-based service centers whose mission is to raise the standard of care and increase access to services for traumatized children and their families.

The CBITS partners have now developed a program and manual that can be delivered in schools by nonclinicians. This new intervention is being pilot-tested to determine how it performs in alleviating children's distress following trauma.