Academic journal article Education & Treatment of Children

Matching Interventions to Children's Mental Health Needs: Feasibility and Acceptability of a Pilot School-Based Trauma Intervention Program

Academic journal article Education & Treatment of Children

Matching Interventions to Children's Mental Health Needs: Feasibility and Acceptability of a Pilot School-Based Trauma Intervention Program

Article excerpt

Abstract

The primary goal was to develop and implement a school-based, trauma-specific intervention program for inner-city children exposed to the World Trade Center attacks on September 11th, 2001. The feasibility and acceptability of the program, and its research component, were examined. The efficacy of the program was evaluated in a pilot study. Sixty-three children were assessed using measures of posttraumatic stress disorder (PTSD), generalized anxiety, depression, and externalizing symptoms, and provided a 10-session, skill-based classroom intervention. Following the classroom intervention, children were re-assessed and those who continued to meet criteria for PTSD were offered an individualized intervention. The assessment was repeated following the individualized intervention. The differential influence of the classroom and individual interventions suggest that each intervention may target a separate group of symptoms. Study limitations are discussed and future directions are proposed.

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Multicultural, inner-city youth are more likely to be exposed to traumatic events, but less likely to receive mental health services (Brown, Jannes, Braunstein, & Gonzalez, 2005). The World Trade Center attack on September 11th increased the public's awareness of and interest in implementing interventions for posttraumatic stress disorder (PTSD) and other mental health correlates of trauma exposure. In fact, private and public organizations allocated funding for the assessment and treatment of New York City youth. The Prevention of Adverse Reactions To Negative Events and Related Stress (PARTNERS) Program was approached by the leadership of a charter school in East Harlem who received such funding to provide trauma-specific interventions for their students. The goal was to implement a trauma-specific intervention for students in the third to eighth grades who, having lived and/or been schooled in Manhattan, were exposed to the events of September 11th, 2001. This paper is a description of the school-based trauma program, highlighting the feasibility, acceptability, pilot research findings, and challenges to implementing and limitations of the program.

Mental Health Correlates of Youth Exposed to Disasters

The mental health problems in youth exposed to disasters vary and may be severe (Brown, 2002, May). The most commonly researched phenomenon is PTSD, found among survivors of war, natural disasters, human-induced accidents, school shootings, and terrorism (c.f., Hoven, Duarte, & Mandell, 2003). Rates of severe PTSD within one year of these traumas range from 10% to 90%. Even if they do not meet full criteria for PTSD, the majority of children exposed to trauma report some disabling symptoms of re-experiencing, avoidance, and physical arousal (Berliner, 1997). Severe depressive reactions also are common responses to disasters and often co-occur with PTSD (La Greca, Silverman, & Wasserstein, 1998; March, Amaya-Jackson, Robert, & Costanzo, 1997). Other mental health correlates include: separation fears, generalized anxiety, externalizing behavior problems, and social skills deficits (La Greca et al., 1998; March et al., 1997). Years after the trauma, children may continue to exhibit high rates of PTSD (26%-95%) and depressive disorder (28%-76%) (Goenjian et al., 1995).

Inner-City Youth's Vulnerability to Trauma-Related Mental Health Problems

One of the strongest predictors of having mental health problems following trauma exposure is prior exposure to trauma and psychiatric symptoms (Brown, 2002, May; Fletcher, 2003). Children who live and/or are schooled in inner-city environments are particularly vulnerable to experiencing high rates of poverty, crime, drug use, and community violence (Stein et al., 2003). Horowitz, Weine, and Jekel (1995) found that inner-city adolescents' repeated and prolonged exposure to multiple traumatic events was associated with high levels of all three PTSD symptom clusters: re-experiencing, avoidance, and hyper-arousal. …

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