Efficacy Study of the Cognitive Behavioral Intervention Program (CBITS): Helping Students Suffering the Effects of Exposure to Trauma

Introduction: There is a compelling need for school-based interventions to ameliorate the behavioral and academic challenges of the growing number of students who experience acute or chronic trauma; however, rigorous evidence supporting the use of trauma-focused interventions is still emerging. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program, recognized in SAMHSA’s National Registry of Evidence-based Programs and Practices, is a school-based intervention for students who experienced acute or chronic trauma.

The CBITS program, a structured symptom-focused therapy, was developed for use with diverse groups of school children (ages 11 through 15) who have experienced significant trauma and suffer from related emotional or behavioral problems (Jaycox 2004). It is designed to be implemented by school-based mental health clinicians in a typical school setting through 10 group therapy sessions and one individual session.

Methods: We are currently conducting a randomized controlled trial of CBITS in an urban school district. Participants include sixth-grade students who have experienced significant trauma and are suffering from elevated levels of distress. Approximately 300 students over 4 years in 12 middle schools are participating, with half randomly assigned to the intervention condition, and half to the comparison “services-as-usual” condition.

We are assessing student outcomes across three domains: (1) trauma symptoms and problem behaviors, (2) academic outcomes, and (3) coping and social skills. We are administering outcome measures at baseline, posttest, and at 1-year follow-up. Additionally, dosage, adherence, quality of implementation, and social validity are being assessed.

Results: At the time of the SPR conference in May, 2015 we will have completed our 4^th year of data collection which will include pre and post assessments for over 300 participating students and one year follow up data for over 220 students. We will measure the impact of the CBITS program within a hierarchical linear model (HLM) framework testing the impact of the CBITS intervention on student outcomes (trauma symptoms, problem behavior, academics, coping skills, and social skills). Preliminary results from logistic regressions show significant reductions in internalizing symptoms (depression, anxiety, somatic complaints, thought problems), problem behaviors, and social problems as well as a significant increase in several academic outcomes (academic engagement, applied problems, and letter-word identification).

Conclusions: Results from the study will strengthen the knowledge base regarding “what works” in ameliorating the behavioral and academic challenges of middle school students who have been exposed to acute or chronic trauma.