Abstract
The present study is a pilot study to examine the initial effectiveness of the Support for Students Exposed to Trauma (SSET) program (Jaycox et al. in Support for Students Exposed to Trauma: the SSET program. Lesson plans, worksheets, and materials. TR-675, RAND, Santa Monica, CA, 2009) in reducing PTSD symptoms and building resilience and social support among children living in flood-affected rural areas of Southern Punjab, Pakistan. One hundred and ninety-three children were screened for symptoms of post-traumatic stress, and 38% met eligibility criteria. Children were then randomly assigned into experimental (n = 38) and control (n = 37) groups. The findings of the study showed a significant reduction in PTSD symptoms, and improvement in resilience, and perceived social support in the experimental group. The result of the study demonstrates that SSET, delivered by a clinically trained provider, may be an effective intervention for treating traumatic stress symptoms among children affected by natural disasters like flooding, particularly in under-resourced contexts. This pilot lays the initial groundwork for SSET in this context, which may ultimately be implemented by non-clinicians to address trauma-related psychological issues.
Similar content being viewed by others
References
Abbasi, S., & Shaukat, B. (2012). Psychological problems caused by the flood induced displacements; A study of the victims of 2010 flood in Khyber Phukhtoonkhwa, Pakistan. World Applied Sciences Journal, 19, 1244–1250.
Alston, M., Hazeleger, T., & Hargreaves, D. (2019). Social work and disasters: A handbook for practice. New York: Routledge.
American Psychological Association. (2015). The road to resilience. Washington, DC 20002-424. Retrieved April 12, 2016 from http://www.apa.org/helpcenter/road-resilience.aspx.
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.
Bhamani, A., Sobani, Z. A., Baqir, M., Bham, N. S., Beg, M. A., & Fistein, E. (2012). Mental health in the wake of flooding in Pakistan: An ongoing humanitarian crisis. Journal of the College of Physicians and Surgeons–Pakistan, 22(1), 66–68.
Bishop, S. (2015). The impact of attachment and social support on parents of children with autism. Long Beach: California State University.
Centre for Research on the Epidemiology of Disasters. (2019). Natural disaster 2018: An opportunity to prepare. EM-DAT The International Disaster Database-CERD.
Chmitorz, A., Kunzler, A., Helmreich, I., Tüscher, O., Kalisch, R., Kubiak, T., et al. (2018). Intervention studies to foster resilience—a systematic review and proposal for a resilience framework in future intervention studies. Clinical Psychology Review, 59, 78–100.
Cicchetti, D. (2013). Annual research review: Resilient functioning in maltreated children–past, present, and future perspectives. Journal of Child Psychology and Psychiatry, 54(4), 402–422.
Cohen, J. A., Mannarino, A. P., Zhitova, A. C., & Capone, M. E. (2003). Treating child abuse-related posttraumatic stress and comorbid substance abuse in adolescents. Child Abuse and Neglect, 27(12), 1345–1365.
Darling-Hammond, L., & Bransford, J. (Eds.). (2007). Preparing teachers for a changing world: What teachers should learn and be able to do. New York: Wiley.
Deeba, F., Rapee, R. M., & Prvan, T. (2014). Psychometric properties of the children’s revised impact of events scale (CRIES) with Bangladeshi children and adolescents. PeerJ, 2, e536.
Evans, G. W., Li, D., & Whipple, S. S. (2013). Cumulative risk and child development. Psychological Bulletin, 139(6), 1342.
Federal Flood Commission. (2012). Annual flood report, 2012. Islamabad: Ministry of Water and Power, Government of Pakistan. Retrieved October 4, 2019 from http://www.ffc.gov.pk/download/Annual%20Flood%20Report%202012.pdf.
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(3), 376–384. https://doi.org/10.1207/S15374424JCCP3003_9.
Fu, Y., Chen, Y., Wang, J., Tang, X., He, J., Jiao, M., et al. (2013). Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake. Child and adolescent psychiatry and mental health, 7(1), 1.
Garrett, A. L., Grant, R., Madrid, P., Brito, A., Abramson, D., & Redlener, I. (2007). Children and mega disasters: Lessons learned in the new millennium. Advances in Paediatrics, 54(1), 189–214.
Ghous, M., Khan, K., & Basit, A. (2015). An assessment of household coping response of the vulnerable population of flood affected areas of KotAddu, District Muzaffargarh. Science International, 27(2), 1373–1380.
Hagan, M. J., Sulik, M. J., & Lieberman, A. F. (2016). Traumatic life events and psychopathology in a high risk, ethnically diverse sample of young children: A person-centered approach. Journal of Abnormal Child Psychology, 44(5), 833–844.
Harandi, T. F., Taghinasab, M. M., & Nayeri, T. D. (2017). The correlation of social support with mental health: A meta-analysis. Electronic Physician, 9(9), 5212.
Henderson, S. E., & Elsass, P. (2015). Predictors of trauma and distress in Sri Lanka five years after the Indian Ocean tsunami: A cross-sectional study. International Journal of Disaster Risk Reduction, 14, 438–444. https://doi.org/10.1016/j.ijdrr.2015.09.010.
Hitchcock, C., Ellis, A. A., Williamson, P., & Nixon, R. D. V. (2015). The prospective role of cognitive appraisals and social support in predicting children’s posttraumatic stress. Journal of Abnormal Child Psychology, 43(8), 1485–1492.
Howell, E., & McFeeters, J. (2008). Children’s mental health care: Differences by race/ethnicity in urban/rural areas. Journal of Health Care for the Poor and Underserved, 19(1), 237–247.
Iqbal, K. (2015). Translation and validation of Child PTSD symptoms Scale-V into Urdu Language. Unpublished dissertation
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.
Jaycox, L. H., Langley, A. K., & Dean, K. L. (2009). Support for Students Exposed to Trauma: The SSET program. Lesson plans, worksheets, and materials. TR-675. Santa Monica, CA: RAND.
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.
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.
Jennings, P. A. (2019). Teaching in trauma sensitive classroom: What educators can do to support students. Retrieved September 28, 2019 from https://www.aft.org/ae/summer2019/jennings.
Jones, S. M., & Bouffard, S. M. (2012). Social and emotional learning in schools: From programs to strategies and commentaries. Social Policy Report, 26(4), 1–33.
Kalisch, R., Baker, D. G., Basten, U., Boks, M. P., Bonanno, G. A., Brummelman, E., et al. (2017). The resilience framework as a strategy to combat stress-related disorders. Nature Human Behaviour, 1(11), 784–790.
Kar, N., Mohapatra, P. K., Nayak, K. C., Pattanaik, P., Swain, S. P., & Kar, H. C. (2007). Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: Exploring cross-cultural validity and vulnerability factors. BMC Psychiatry, 7(1), 8.
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, 21(1), 119–133.
Kataoka, S. H., Nadeem, E., Wong, M., Langley, A. K., Jaycox, L. H., Stein, B. D., et al. (2009). Improving disaster mental health care in schools: A community-partnered approach. American Journal of Preventive Medicine, 37(6), S225–S229.
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.
Khuwaja, A. A. (2010). Impact of flood on children. The Express Tribune. Retrieved August 29, 2016 from http://tribune.com.pk/story/60119/impact-of-flood-on-children/.
Komal, S. (2016). Translation and validation child impact of event scale-13. Unpublished dissertation
Kousky, C. (2016). Impacts of natural disasters on children. The Future of Children, 16(1), 73–92.
Lagana, M. T. (2004). Protective factors for inner-city adolescents at risk of school dropout: Family factors and social support. Children & Schools, 26(4), 211–220. https://doi.org/10.1093/cs/26.4.211.
Lai, B. S., Kelley, M. L., Harrison, K. M., Thompson, J. E., & Self-Brown, S. (2015). Posttraumatic stress, anxiety, and depression symptoms among children after Hurricane Katrina: A latent profile analysis. Journal of Child and Family Studies, 24(5), 1262–1270.
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.
Larson, K., & Halfon, N. (2010). Family income gradients in the health and health care access of US children. Maternal and Child Health Journal, 14(3), 332–342.
Liebenberg, L., Ungar, M., & LeBlanc, J. C. (2013). The CYRM-12: A brief measure of resilience. Canadian Journal of Public Health, 104(2), e131–e135.
Liebenberg, L., Ungar, M., & Vijver, F. V. D. (2012). Validation of the child and youth resilience measure-28 (CYRM-28) among Canadian youth. Research on Social Work Practice, 22(2), 219–226.
Lieberman, A. F., & DeMartino, R. (Eds.). (2006). Interventions for children exposed to violence. New York: Johnson & Johnson Pediatric Institute.
Luthar, S. S. (2006). Resilience in development: A synthesis of research across five decades. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Risk, disorder, and adaptation (pp. 739–795). New York: Wiley.
Malecki, C. K., Demaray, M. K., Elliott, S. N., & Nolten, P. W. (1999). The child and adolescent social support scale. DeKalb, IL: Northern Illinois University.
Masten, A. S. (1999). Resilience comes of age reflections on the past and outlook for the next generation of research. In M. D. Glantz & J. Jhonson (Eds.), Resilience and development: Positive life adaptations (pp. 281–296). New York: Plenum.
Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227.
Masten, A. S. (2013). Risk and resilience in development. In P. D. Zelazo (Ed.), Oxford handbook of developmental psychology (pp. 579–607). New York: Oxford University Press.
Masten, A. S., & Osofsky, J. D. (2010). Disasters and their impact on child development: Introduction to the special section. Child Development, 81(4), 1029–1039.
Mustafa, D., & Wrathall, D. (2011). Indus basin floods of 2010: Souring of a Faustian bargain? Water Alternatives, 4(1), 72–85.
Nadeem, E., Jaycox, L. H., 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.
Nadeem, E., & Ringle, V. A. (2016). De-adoption of an evidence-based trauma intervention in schools: A retrospective report from an urban school district. School Mental Health: A Multidisciplinary Research and Practice Journal, 8(1), 132–143. https://doi.org/10.1007/s12310-016-9179-y.
Nadeem, E., Santiago, C. D., Kataoka, S. H., Chang, V. Y., & Stein, B. D. (2016). School personnel experiences in notifying parents about their child’s risk for suicide: Lessons learned. Journal of School Health, 86(1), 3–10.
National Commission on Children and Disasters. (2010). Report to the president and congress. Rockville, MD: Agency for Healthcare Research and Quality; 2010. AHRQ Publication 10-M037. Retrieved October 4, 2019 from archive.ahrq.gov/prep/nccdreport/.
National Disaster Management Authority NMDA. (2014). Flood Affects overall Punjab, KPK and Sindh. Government of Pakistan. Retrieved February 10, 2017 from http://www.ndma.gov.pk/new/newsroom/news2015.php.
Neria, Y., Nandi, A., & Galea, S. (2008). Post-traumatic stress disorder following disasters: A systematic review. Psychological Medicine, 38(4), 467–480.
Pakistan Economic Survey. (2014–2015). Pakistan: Flood impact assessment report. Economic Adviser’s Wing, Finance Division, Government of Pakistan, Islamabad
Pallant, J. (2007). SPSS survival manual: A step by step guide to data analysis using SPSS for windows. Maidenhead: Open University Press.
Panter-Brick, C., Goodman, A., Tol, W., & Eggerman, M. (2011). Mental health and childhood adversities: a longitudinal study in Kabul, Afghanistan. Journal of the American Academy of Child and Adolescent Psychiatry, 50(4), 349–363.
Parvin, G., Shimi, A., Shaw, R., & Biswas, C. (2016). Flood in a changing climate: The impact on livelihood and how the rural poor cope in Bangladesh. Climate, 4(4), 60.
Perrin, S., Meiser-Stedman, R., & Smith, P. (2005). The Children’s Revised Impact of Event Scale (CRIES): Validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33, 487–498.
Pervaiz, M., & Naz, M. A. (2013). Translation and adaptation of child and youth resiliency measure. Unpublished dissertation
Roche, H. (2015). Floods in Pakistan. Construction of a school unit in flood affected area of Pakistan. Retrieved November 18, 2016 from http://www.roche.com.pk/home/corporate-responsibility/floods-inpakistan.html/.
Rutter, M. (2000). Resilience reconsidered: Conceptual considerations, empirical findings, and policy implications. In J. P. Shonkoff & S. J. Meisels (Eds.), Handbook of early childhood intervention (pp. 651–682). New York, NY: Cambridge University Press.
Self-Brown, S., Lai, B. S., Thompson, J. E., McGill, T., & Kelley, M. L. (2013). Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth. Journal of Affective Disorders, 147(1–3), 198–204.
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, 290(5), 603–611.
Tabachnick, G. G., & Fidell, L. S. (2007). Using a multivariate statistics. Boston, MA: Pearson Inc.
Tang, B., Deng, Q., Glik, D., Dong, J., & Zhang, L. (2017). A meta-analysis of risk factors for post-traumatic stress disorder (PTSD) in adults and children after earthquakes. International Journal of Environmental Research and Public Health, 14(12), 1537.
Ungar, M. (2008). Resilience across cultures. The British Journal of Social Work, 38(2), 218–235.
Ungar, M. (2011). Community resilience for youth and families: Facilitative physical and social capital in contexts of adversity. Children and Youth Services Review, 33(9), 1742–1748.
Ungar, M., & Liebenberg, L. (2009). Cross-cultural consultation leading to the development of a valid measure of youth resilience: The International Resilience Project. Studia Psychological, 51(2–3), 259–268.
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), 11–14.
Wallemacq, P., Herden, C., & House, R. (2015). The human cost of natural disasters 2015: A global perspective. Technical report, Centre for Research on the Epidemiology of Disasters.
Weems, C. F., Russell, J. D., Neill, E. L., & McCurdy, B. H. (2019). Annual research review: Pediatric posttraumatic stress disorder from a neurodevelopmental network perspective. Journal of Child Psychology and Psychiatry, 60(4), 395–408.
Weissbecker, I., Sephton, S. E., Martin, M. B., & Simpson, D. M. (2008). Psychological and physiological correlates of stress in children exposed to disaster: Current research and recommendations for intervention. Children Youth and Environments, 18(1), 30–70.
Yager, Z. (2011). Health education in teacher education: Evaluation of learning design with embedded personal wellness learning and assessment focus. Australian Journal of Teacher Education, 36(10), 8.
Ziaaddini, H., Nakhaee, N., & Behzadi, K. (2009). Prevalence and correlates of PTSD among high school students after the earthquake disaster in the city of Bam, Iran. American Journal of Applied Sciences, 6(1), 130–132.
Zuberi, M. A. (2014). Floods: A fateful, familiar story. Pakistan premier financial daily. Retrieved April 4, 2016 from http://www.brecorder.com/br-research/44:miscellaneous/4741:floods-a-fateful-familiar-story/.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Amin, R., Nadeem, E., Iqbal, K. et al. Support for Students Exposed to Trauma (SSET) Program: An Approach for Building Resilience and Social Support Among Flood-Impacted Children. School Mental Health 12, 493–506 (2020). https://doi.org/10.1007/s12310-020-09373-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12310-020-09373-y