This article reports on an evaluation of the effectiveness of a collaboratively designed school-based intervention for reducing children's symptoms of posttraumatic stress disorder (PTSD) and depression resulting from exposure to violence.
A randomized controlled trial conducted during the 2001-2002 academic year involved sixth-grade students at two large middle schools in Los Angeles who reported exposure to violence and had clinical levels of PTSD symptoms. These students were randomly assigned to a 10-session standardized cognitive-behavioral therapy (the Cognitive-Behavioral Intervention for Trauma in Schools) early intervention group (n = 61) or to a wait-list delayed intervention comparison group (n = 65). The intervention program was conducted by trained school mental health clinicians. Students were assessed before and 3 months after the intervention. The assessment addressed 1) child-reported symptoms of PTSD, 2) depression, 3) parent-reported psychosocial dysfunction, and 4) teacher-reported classroom problems. Compared with the wait-list delayed intervention group (no intervention) after 3 months of intervention, students who were randomly assigned to the early intervention group had significantly lower scores on symptoms of PTSD, depression, and psychosocial dysfunction. Adjusted mean differences between the two groups at 3 months did not show significant differences for teacher-reported classroom problems in acting out, shyness/anxiousness, and learning. At 6 months after both groups had received the intervention, the differences between the two groups were not significantly different for symptoms of PTSD and depression; showed similar ratings for psychosocial function; and teachers did not report significant differences in classroom behaviors. The study concluded that a standardized 10-session cognitive-behavioral group intervention can significantly decrease symptoms of PTSD and depression in students who are exposed to violence and can be effectively delivered on school campuses by trained school-based mental health clinicians. 69 references (publisher abstract modified)