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Effects of Trauma on Students: Early Intervention Through the Cognitive Behavioral Intervention for Trauma in Schools

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Handbook of School Mental Health

Abstract

The potential negative consequences of exposure to traumatic events on the academic success and mental health of children and adolescents are well documented, particularly the development of posttraumatic stress disorder. Providing school-based interventions for students who are experiencing trauma symptoms has great potential to meet unmet mental health needs, build resilience, and support students’ academic success. The current chapter provides an overview of the effect of trauma on students, and describes the development and core components of the Cognitive Behavioral Intervention for Trauma in Schools (CBITS. The chapter also summarizes the research evidence and implementation experiences with CBITS, and highlights future directions for research and practice for supporting students exposed to traumatic events.

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References

  • Beers, S. R., & De Bellis, M. D. (2002). Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. The American Journal of Psychiatry, 159(3), 483–486.

    Article  PubMed  Google Scholar 

  • Bowen, N., & Bowen, G. (1999). Effects of crime and violence in neighborhoods and schools on the school behavior and performance of adolescents. Journal of Adolescent Research, 14(3), 319–342.

    Article  Google Scholar 

  • Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.

    Article  PubMed  Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., et al. (1995). Children’s mental health service use across service sectors. Health Affairs, 14(3), 147–159.

    Article  PubMed  Google Scholar 

  • Cichetti, C. (2011). CBITS implementation in Chicago: Funding flows from public policy. Presentation at the 3rd Annual CBITS Summit, Los Angeles.

    Google Scholar 

  • Cohen, J. A., Deblinger, E., Mannarino, A., & Steer, R. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 393–402.

    Article  PubMed  Google Scholar 

  • Cohen, J. A., Jaycox, L. H., Walker, D. W., Mannarino, A. P., Langley, A. K., & DuClos, J. L. (2009). Treating traumatized children after Hurricane Katrina: Project Fleur-de lis. Clinical Child and Family Psychology Review, 12(1), 55–64.

    Article  PubMed  Google Scholar 

  • Cooley-Quille, M., Boyd, R. C., Frantz, E., & Walsh, J. (2001). Emotional and behavioral impact of exposure to community violence in inner-city adolescents. Journal of Clinical Child Psychology, 30(2), 199–206.

    Article  PubMed  Google Scholar 

  • Dean, K. L., Langley, A. K., Kataoka, S. H., Jaycox, L. H., Wong, M., & Stein, B. D. (2008). School-based disaster mental health services: Clinical, policy, and community challenges. Professional Psychology: Research and Practice, 39(1), 52–57.

    Article  Google Scholar 

  • Delaney-Black, V., Covington, C., Ondersma, S. J., Nordstrom-Klee, B., Templin, T., Ager, J., et al. (2002). Violence exposure, trauma, and IQ and/or reading deficits among urban children. Archives of Pediatrics & Adolescent Medicine, 156(3), 280–285.

    Article  Google Scholar 

  • Domitrovich, C. E., Bradshaw, C. P., Poduska, J. M., Hoagwood, K., Buckley, J. A., Olin, S., et al. (2008). Maximizing the implementation quality of evidence-based preventive interventions in schools: A conceptual framework. Advances in School Mental Health Promotion, 1(3), 6–27.

    Article  Google Scholar 

  • Feldstein, A. C., & Glasgow, R. E. (2008). A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Joint Commission Journal on Quality and Patient Safety, 34(4), 228–243.

    PubMed  Google Scholar 

  • Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433–1441.

    Article  PubMed  Google Scholar 

  • Finkelhor, D. (1995). The victimization of children: A developmental perspective. The American Journal of Orthopsychiatry, 65(2), 177–193.

    Article  PubMed  Google Scholar 

  • Finkelhor, D., Turner, H., Ormrod, R., & Hamby, S. L. (2009). Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics, 124(5), 1411–1423.

    Article  PubMed  Google Scholar 

  • Fixsen, D. L., Naoom, S. F., Blasé, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.

    Google Scholar 

  • Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., Meadows, E. A., & Street, G. P. (1999). A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67(2), 194–200.

    Article  PubMed  Google Scholar 

  • Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. (2001). The Child PTSD symptom scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30, 376–384.

    Article  PubMed  Google Scholar 

  • Fowler, P. J., Tompsett, C. J., Braciszewski, J. M., Jacques-Tiura, A. J., & Baltes, B. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21(1), 227–259.

    Article  PubMed  Google Scholar 

  • Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590–595.

    Article  PubMed  Google Scholar 

  • Garbarino, J., & Kostelny, K. (1992). Child maltreatment as a community problem. Child Abuse & Neglect, 16(4), 455–464.

    Article  Google Scholar 

  • Garrison, E. G., Roy, I. S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based services. Clinical Psychology Review, 19(2), 199–219.

    Article  PubMed  Google Scholar 

  • Goodkind, J. R., Lanoue, M. D., & Milford, J. (2010). Adaptation and implementation of cognitive behavioral intervention for trauma in schools with American Indian youth. Journal of Clinical Child and Adolescent Psychology, 39(6), 858–872.

    Article  PubMed  Google Scholar 

  • Greenhalgh, T., Robert, G., MacFarland, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629.

    Article  PubMed  Google Scholar 

  • Grogger, J. (1997). Local violence and educational attainment. The Journal of Human Resources, 32(4), 659–682.

    Article  Google Scholar 

  • Guerra, N. G., Huesmann, L. R., & Spindler, A. (2003). Community violence exposure, social cognition, and aggression among urban elementary school children. Child Development, 74(5), 1561–1576.

    Article  PubMed  Google Scholar 

  • Hurt, H., Malmud, E., Brodsky, N. L., & Giannetta, J. (2001). Exposure to violence: Psychological and academic correlates in child witnesses. Archives of Pediatrics & Adolescent Medicine, 155(12), 1351–1356.

    Article  Google Scholar 

  • Jaycox, L. H. (2003). Cognitive-behavioral intervention for trauma in schools. Longmont, CO: Sopris West Educational Services.

    Google Scholar 

  • Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., et al. (2010). Children’s mental health care following Hurricane Katrina: A field trial of trauma-focused psychotherapies. Journal of Traumatic Stress, 23(2), 223–231.

    PubMed  Google Scholar 

  • Jaycox, L. H., Kataoka, S. H., Stein, B. D., Wong, M., & Langley, A. (2005). Responding to the needs of the community: A stepped care approach to implementing trauma-focused interventions in schools. Report on Emotional and Behavioral Disorders in Youth, 5(4), 85–88. 100–103.

    Google Scholar 

  • Jaycox, L. H., Langley, A., & Dean, K. L. (2012). Support for students exposed to Trauma (Japanese translation). Santa Monica, CA: RAND Corporation. http://www.rand.org/pubs/technical_reports/TR675z1.html

  • Jaycox, L. H., Langley, A. K., Stein, B. D., Wong, M., Sharma, P., Scott, M., et al. (2009). Support for students exposed to trauma: A pilot study. School Mental Health, 1(2), 49–60.

    Article  PubMed  Google Scholar 

  • Jaycox, L. H., Stein, B. D., Kataoka, S. H., Wong, M., Fink, A., Escudero, P., et al. (2002). Violence exposure, posttraumatic stress disorder, and depressive symptoms among recent immigrant schoolchildren. Journal of the American Academy of Child and Adolescent Psychiatry, 41(9), 1104–1110.

    Article  PubMed  Google Scholar 

  • Kataoka, S. H., Fuentes, S., O'Donoghue, V. P., Castillo-Campos, P., Bonilla, A., Halsey, K., et al. (2006). A community participatory research partnership: The development of a faith-based intervention for children exposed to violence. Ethnicity & Disease, 16(Suppl. 1), S89–S97.

    Google Scholar 

  • Kataoka, S. H., Jaycox, L. H., Wong, M., Nadeem, E., Langley, A., Tang, L., et al. (2011). Effects on school outcomes in low-income minority youth: Preliminary findings from a community-partnered study of a school trauma intervention. Ethnicity & Disease, 21(3), 71.

    Google Scholar 

  • Kataoka, S., Langley, A. K., Wong, M., Baweja, S., & Stein, B. D. (2012). Responding to students with posttraumatic stress disorder in schools. Child and Adolescent Psychiatric Clinics of North America, 21(1), 119–133. x.

    Article  PubMed  Google Scholar 

  • Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., et al. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 311–318.

    Article  PubMed  Google Scholar 

  • Kataoka, S., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among US children: Variation by ethnicity and insurance status. The American Journal of Psychiatry, 159(9), 1548–1555.

    Article  PubMed  Google Scholar 

  • Kearney, C. A. (2003). Bridging the gap among professionals who address youths with school absenteeism: Overview and suggestions for consensus. Professional Psychology: Research and Practice, 34(1), 57–65.

    Article  Google Scholar 

  • Kennedy, A. C., Bybee, D., Sullivan, C. M., & Greeson, M. (2009). The effects of community and family violence exposure on anxiety trajectories during middle childhood: The role of family social support as a moderator. Journal of Clinical Child and Adolescent Psychology, 38(3), 365–379.

    Article  PubMed  Google Scholar 

  • Kliewer, W., Lepore, S. J., Oskin, D., & Johnson, P. D. (1998). The role of social and cognitive processes in children’s adjustment to community violence. Journal of Consulting and Clinical Psychology, 66(1), 199–209.

    Article  PubMed  Google Scholar 

  • Ko, S. J. F., Julian, D., Kassam-Adams, N., Berkowitz, S. J., Wilson, C., Wong, M., et al. (2008). Creating trauma-informed systems: Child welfare, education, first responders, health care, juvenile justice. Professional Psychology: Research and Practice, 39(4), 396–404.

    Article  Google Scholar 

  • Langley, A. K., Bergman, R. L., McCracken, J., & Piacentini, J. C. (2004). Impairment in childhood anxiety disorders: Preliminary examination of the child anxiety impact scale-parent version. Journal of Child and Adolescent Psychopharmacology, 14(1), 105–114.

    Article  PubMed  Google Scholar 

  • Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2(3), 105–113.

    Article  PubMed  Google Scholar 

  • Last, C. G., & Strauss, C. C. (1990). School refusal in anxiety-disordered children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 31–35.

    Article  PubMed  Google Scholar 

  • March, J. S., Amaya-Jackson, L., Murray, M. C., & Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. Journal of the American Academy of Child and Adolescent Psychiatry, 37(6), 585–593.

    Article  PubMed  Google Scholar 

  • McMiller, W. P., & Weisz, J. R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child and Adolescent Psychiatry, 35(8), 1086–1094.

    Article  PubMed  Google Scholar 

  • Morsette, A., Swaney, G., Stolle, D., Schuldberg, D., van den Pol, R., & Young, M. (2009). Cognitive Behavioral Intervention for Trauma in Schools (CBITS): School-based treatment on a rural American Indian reservation. Journal of Behavior Therapy and Experimental Psychiatry, 40(1), 169–178.

    Article  PubMed  Google Scholar 

  • Nadeem, E., Jaycox, L., Kataoka, S. H., Langley, A. K., & Stein, B. D. (2011). Going to scale: Experiences implementing a school-based trauma intervention. School Psychology Review, 40(4), 549–568.

    Google Scholar 

  • Ngo, V., Langley, A., Kataoka, S. H., Nadeem, E., Escudero, P., & Stein, B. D. (2008). Providing evidence-based practice to ethnically diverse youths: Examples from the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 858–862.

    Article  PubMed  Google Scholar 

  • Overstreet, S. (2000). Exposure to community violence: Defining the problem and understanding the consequences. Journal of Child and Family Studies, 9(1), 7–25.

    Article  Google Scholar 

  • Reschly, D. J., & Bergstrom, M. K. (2009). Response to intervention. In T. B. Gutkin & C. R. Reynolds (Eds.), The handbook of school psychology. New York: Wiley.

    Google Scholar 

  • Rew, L., Resnick, M. D., & Blum, R. W. (1997). An exploration of help-seeking behaviors in female Hispanic adolescents. Family & Community Health, 20(3), 1–15.

    Article  Google Scholar 

  • Saigh, P. A., Mroueh, M., & Bremner, J. D. (1997). Scholastic impairments among traumatized adolescents. Behaviour Research and Therapy, 35(5), 429–436.

    Article  PubMed  Google Scholar 

  • Schreiber, M., Gurwitch, R., & Wong, M. (2008). Listen, protect, connect—model & teach: Psychological first aid (PFA) for students and teachers. Folsom, CA: US Department of Education, Technical Assistance Center.

    Google Scholar 

  • Schultz, D., Barnes-Proby, D., Chandra, A., Jaycox, L. H., Maher, E., & Pecora, P. (2010). Toolkit for Adapting Cognitive Behavioral Intervention for Trauma in Schools (CBITS) or Supporting Students Exposed to Trauma (SSET) for Implementation with Youth in Foster Care. Santa Monica, CA: RAND.

    Google Scholar 

  • Schwab-Stone, M. E., Ayers, T. S., Kasprow, W., Voyce, C., Barone, C., Shriver, T., et al. (1995). No safe haven: A study of violence exposure in an urban community. Journal of the American Academy of Child and Adolescent Psychiatry, 34(10), 1343–1352.

    Article  PubMed  Google Scholar 

  • Schwab-Stone, M., Chuansheng, C., Greenberger, E., Silver, D., Lichtman, J., & Voyce, C. (1999). No safe haven II: The effects of violence exposure on urban youth. Journal of the American Academy of Child and Adolescent Psychiatry, 38(4), 359–367.

    Article  PubMed  Google Scholar 

  • Schwartz, D. G., & Hopmeyer, A. (2003). Community violence exposure and children’s academic functioning. Journal of Educational Psychology, 95(1), 163–173.

    Article  Google Scholar 

  • Schwartz, D., & Proctor, L. J. (2000). Community violence exposure and children’s social adjustment in the school peer group: The mediating roles of emotion regulation and social cognition. Journal of Consulting and Clinical Psychology, 68(4), 670–683.

    Article  PubMed  Google Scholar 

  • Singer, M. I., Anglin, T. M., Song, L., & Lunghofer, L. (1995). Adolescents’ exposure to violence and associated symptoms of psychological trauma. JAMA: The Journal of the American Medical Association, 273(6), 477–482.

    Article  Google Scholar 

  • Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliott, M. N., et al. (2003). A mental health intervention for schoolchildren exposed to violence: A randomized controlled trial. JAMA: The Journal of the American Medical Association, 290(5), 603–611.

    Article  Google Scholar 

  • Stein, B. D., Kataoka, S. H., Jaycox, L. H., Steiger, E. M., Wong, M., Fink, A., et al. (2003). The mental health for immigrants program: Program design and participatory research in the real world. In M. D. Weist (Ed.), Handbook of school mental health: Advancing practice and research (Issues in clinical child psychology, pp. 179–190). New York: Kluwer Academic/Plenum.

    Google Scholar 

  • Stein, B. D., Kataoka, S. H., Jaycox, L. H., Wong, M., Fink, A., Escudero, P., et al. (2002). Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: a collaborative research partnership. The Journal of Behavioral Health Services & Research, 29(3), 318–326.

    Article  Google Scholar 

  • Stein, B. D., Zima, B. T., Elliott, M. N., Burnam, M. A., Shahinfar, A., Fox, N. A., et al. (2001). Violence exposure among school-age children in foster care: Relationship to distress symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 40(5), 588–594.

    Article  PubMed  Google Scholar 

  • Stoiber, K. C., & Kratochwill, T. R. (2000). Empirically supported interventions and school psychology: Rationale and methodological issues–Part I. School Psychology Quarterly, 15(1), 75–105.

    Article  Google Scholar 

  • Sugai, G., & Horner, R. R. (2006). A promising approach for expanding and sustaining school-wide positive behavior support. School Psychology Review, 35(2), 2450259.

    Google Scholar 

  • Turner, H. A., Finkelhor, D., & Ormrod, R. (2010). The effects of adolescent victimization on self-concept and depressive symptoms. Child Maltreatment, 15(1), 76–90.

    Article  PubMed  Google Scholar 

  • Walker, D. W. (2008). A school-based mental health service model for youth exposed to disasters: Project Fleur-de-lis. The Prevention Researcher, 15(3), 11–13.

    Google Scholar 

  • Wong, M. (2006). Commentary: Building partnerships between schools and academic partners to achieve a health-related research agenda. Ethnicity & Disease, 16(Suppl. 1), 149–153.

    Google Scholar 

  • Wong, M., Rosemond, M., Stein, B. D., Langley, A. K., Kataoka, S. H., & Nadeem, E. (2007). School-based intervention for adolescents exposed to violence. The Prevention Researcher, 14(1), 17–20.

    Google Scholar 

  • Wood, J. J., Lynne-Landsman, S. D., Langer, D. A., Wood, P. A., Clark, S. L., Mark Eddy, J., et al. (2012). School attendance problems and youth psychopathology: Structural cross-lagged regression models in three longitudinal data sets. Child Development, 83(1), 351–366.

    Article  PubMed  Google Scholar 

  • Yule, W. (2001). Post-traumatic stress disorder in children and adolescents. International Review of Psychiatry, 13(3), 194–200.

    Article  Google Scholar 

  • Zinzow, H. M., Ruggiero, K. J., Resnick, H., Hanson, R., Smith, D., Saunders, B., et al. (2009). Prevalence and mental health correlates of witnessed parental and community violence in a national sample of adolescents. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 50(4), 441–450.

    Article  PubMed  Google Scholar 

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Nadeem, E., Jaycox, L.H., Langley, A.K., Wong, M., Kataoka, S.H., Stein, B.D. (2014). Effects of Trauma on Students: Early Intervention Through the Cognitive Behavioral Intervention for Trauma in Schools. In: Weist, M., Lever, N., Bradshaw, C., Owens, J. (eds) Handbook of School Mental Health. Issues in Clinical Child Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-7624-5_11

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