RAND Toolkit Identifies Programs for Long-Term Recovery Among Children Exposed to Significant Traumatic Events
October 24, 2006
The RAND Corporation today issued the first guide that shows how to provide school-based mental health programs for students exposed to violence, natural disasters and other traumatic events.
The guide, called a toolkit, was developed by RAND Health for the RAND Gulf States Policy Institute (RGSPI) to enable schools to help students displaced by natural disasters like Hurricanes Katrina and Rita.
“We found that following Hurricanes Katrina and Rita, schools were in a unique position to help the displaced students they enrolled, but had limited information about how to help,” said Lisa Jaycox, a RAND senior behavioral scientist who is the lead author of the guide. “This toolkit should be used as a step toward closing the information gap.”
“Ensuring that children receive long-lasting help for the emotional effects of traumatic events requires critical planning ahead of time,” Jaycox added. “If this waits until a large-scale disaster strikes, there are few resources for developing new programs or training staff. It is essential that schools know what is out there, so that they can choose the program that best fits their students' needs and for which they have the appropriate resources.”
Titled “How Schools Can Help Students Recover From Traumatic Experiences: A Tool-Kit for Supporting Long-Term Recovery,” the guide moves beyond the short-term responses typically taken by schools after disasters strikes.
Although schools have developed good capacity as “early responders” to support communities in the aftermath of disasters or crises, they have much less experience in how to support the longer term mental health issues of students and staff members.
Originally developed a few months after the hurricanes, the toolkit has now been expanded to include national and international mental health programs for treating other experiences such as sexual abuse and assault, the sudden death of family members, terrorism incidents, and trauma experienced by refugees.
The guide was issued as RAND President and CEO James A. Thomson and RGSPI Director George Penick were meeting with leaders in business and government in Mississippi and in Louisiana this week to discuss rebuilding in the Gulf States.
“The RAND Gulf States Policy Institute will play an important part in helping Gulf Coast states and communities find effective solutions to many of the problems they face,” Thomson said.
RGSPI works to develop a long-term vision and strategy to help build a better future for Louisiana, Mississippi and Alabama in the wake of Hurricanes Katrina and Rita.
RAND, a nonprofit research organization, joined with seven universities to create RGSPI in late 2005. The seven are: Jackson State University and the University of Southern Mississippi in Mississippi; Tulane University, the University of New Orleans and Xavier University in Louisiana; and Tuskegee University and the University of South Alabama in Alabama.
RGSPI seeks funding from nonprofit institutions, other donors, government and the private sector to conduct a broad range of studies. It is the first organization of its kind in the region to conduct a full spectrum of policy research on pressing challenges facing the three states, including problems that existed even before the hurricanes struck.
The toolkit compares 24 trauma-focused programs that have been developed and used by schools across the United States and countries that have experienced ongoing wars and acts of terror. The guide assesses these programs based upon the potential needs of students and provides school officials with estimates of the time, funding, training, and other resources needed to put the programs into place.
Researchers note that exposure to traumatic events can have significant long-term consequences, leading to reactions of anxiety and depression and causing some students to act out in school, at home and among their peers.
Trauma-focused programs that have been developed specifically for use in schools can reduce emotional and behavioral problems while also fostering students' resilience for future events.
Among the programs that the report describes are:
- A program by RAND, the University of California at Los Angeles (UCLA), and the Los Angeles Unified School District called Cognitive-Behavior Intervention for Trauma in Schools (CBITS), which was developed to treat students exposed to multiple acts of violence. Students showed emotional and behavioral improvements six months following initial therapy. The program has since been implemented in other states including Maryland, Wisconsin and Illinois.
- The UCLA Trauma/Grief Program for Adolescents, which has been used in New York City schools following the World Trade Center attacks of Sept. 11, 2001 and in schools in post-war Bosnia. The program targets middle and high school students following terrorism incidents, community violence, man-made disasters and war. Program participants have displayed reductions in depression and improvements in academic performance and classroom behavior.
- The Friends & New Places program, which has been used to help 1,100 K-12 students who were displaced to the Dallas Independent School District following Hurricane Katrina. Results have not been formally evaluated, but the program is designed to reframe how displaced children think about their traumatic experiences in relation to their new environment and emphasizes making treatment for traumatic events culturally acceptable.
In addition to evaluating programs for schools to choose from, the toolkit also includes funding options for securing program materials and training staff. However, RAND researchers note that information on funding resources can change rapidly and schools should thoroughly investigate which resources are available in their district.
Plans are underway to make the toolkit available as an Internet-based search tool. Schools will be able to determine which program best meets their needs based on a series of search criteria – including the age of their students, the trauma experienced and the related symptoms.
Development of the toolkit and selection of the programs were guided by work from the National Child Traumatic Stress Network (NCTSN). NCTSN is funded by the Substance Abuse Mental Health Services Administration.
Other authors on the report include Lindsey Morse, Terri Tanielian, and Bradley Stein of RAND.
As part of a partnership with Mercy Family Center in News Orleans and Allegheny General Hospital in Pittsburgh, the report authors are working on a study of children exposed to community level disasters like Hurricane Katrina and will develop a risk profile of which children are most in need of mental health treatment.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and delivery, among other topics.
Copies of “How Schools Can Help Students Recover From Traumatic Experiences: A Tool-Kit for Supporting Long-Term Recovery” (ISBN: 0-8330-4037-5) can be ordered from RAND's Distribution Services (email@example.com or call toll-free in the U.S. 1-877-584-8642) or downloaded from the RAND Gulf States Policy Institute at www.rand.org/rgspi.