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Promising Program Seal

Cognitive Behavioral Intervention for Trauma in Schools (CBITS)

Blueprints Program Rating: Promising

A 10-session group intervention provided by mental health professionals to reduce children's post-traumatic stress disorder (PTSD), depression and anxiety resulting from exposure to violence. Also included are 1-3 individual child sessions, 2 optional parent sessions, and a teacher educational session.

Program Outcomes

  • Depression
  • Post Traumatic Stress Disorder

Program Type

  • Counseling and Social Work
  • School - Individual Strategies
  • Skills Training

Program Setting

  • School

Continuum of Intervention

  • Indicated Prevention (Early Symptoms of Problem)

Age

  • Early Adolescence (12-14) - Middle School

Gender

  • Male and Female

Race/Ethnicity

  • All Race/Ethnicity

Endorsements

  • Blueprints: Promising
  • Crime Solutions: Effective
  • OJJDP Model Programs: Effective
  • SAMHSA: 3.0-3.4

Program Information Contact

Lisa H. Jaycox
Rand Corporation
1200 South Hayes Street
Arlington, VA 22202
jaycox@rand.org

Program Developer/Owner

  • Lisa H. Jaycox, Ph.D.
  • Rand Corporation

Brief Description of the Program

Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is designed to reduce posttraumatic stress disorder (PTSD), depression, and anxiety among children with symptoms of PTSD. The 10-session school-based intervention teaches cognitive behavioral skills in a group format, led by mental health professionals, with 6-8 students per group, using a mixture of didactic presentation, examples, and games to solidify concepts. Some components of the program include: relaxation training, combating negative thoughts, reducing avoidance, developing a trauma narrative, and building social problem solving skills. The program also includes 1-3 individual child sessions, 2 optional parent sessions, and a teacher inservice session.

See: Full Description

Outcomes

(Stein et al., 2003)

  • Decrease in self-reported PTSD and depression, relative to a waitlisted control group, at 3 month followup.
  • Intervention parents reported their children to be functioning significantly better than did the parents of children in the delayed intervention group.
  • Teachers reported no significant difference in classroom behavior between intervention and waitlisted control students at 3 months.
  • At 6 months, after the delayed intervention group had received the CBITS intervention, there were no longer significant self- or parent-reported differences between the two groups.

CBITS used in New Orleans after Hurricane Katrina (Jaycox et al., 2010)

  • At 10 month follow-up of a treatment/alternative treatment comparison, PTSD scores improved in both interventions including all students who began treatment, compared with baseline scores.
  • Changes in depressive symptoms improved for both groups, but the improvement was only statistically significant for the CBITS group, with mean depression scores moving to the normal range for both groups.

Race/Ethnicity/Gender Details

All, but designed for multi-cultural schools.

Risk and Protective Factors

Risk Factors
  • Individual: Stress*
  • Family: Family conflict/violence
Protective Factors
  • Individual: Coping Skills, Problem solving skills

*Risk/Protective Factor was significantly impacted by the program.

Training and Technical Assistance

$4,000 for two days of onsite training for up to 15 trainees.

Training Certification Process

An intensive two-day training and consultation is available through the Los Angeles Unified School District (LAUSD) Trauma Services Adaptation Center for Schools and Communities. Before taking the CBITS training course, please download or purchase the CBITS manual. The CBITS manual for the entire course is available as a FREE download, or you can purchase the paperback manual.

www.rand.org/pubs/commercial_books/CB209.html#download

Brief Evaluation Methodology

The original CBITS program has been evaluated in one randomized control trial in The Los Angeles Unified School District (LAUSD), and a second randomized control trial in New Orleans. Modifications of the program have been piloted to allow for its implementation by non-clinically trained school personnel (renamed Support for Students Exposed to Trauma) in Los Angeles. The original version of the program used with immigrant populations was named Mental Health for Immigrants.

References

Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., Scott, M., & Schonlau, M.  (2010). Children's mental health care following Hurricane Katrina:  A field trial of trauma-focused psychotherapies. Journal of Traumatic Stress, 23, 223-231.

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

Stein, B., Jaycox, L., Kataoka, S., Wong, M., Tu, W., Elliott, M., & Fink, A. (2003). A mental health intervention for school children exposed to violence: A randomized controlled trial. Journal of the American Medical Association, 290, 603-611.

Mental Health for Immigrants:
Kataoka, S.H., Stein B.D., Jaycox, L.H., Wong, M., Escudero, P., Tu, W., Zaragoza, C., & Fink, A. 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.