Session: Youth at Risk for Trauma-Related Mental Health Problems: Three RCTs of Selective and Indicated Prevention Interventions (Society for Prevention Research 26th Annual Meeting)

A large and growing body of research has documented the physiological, social, behavioral, and mental health issues associated with trauma exposure during childhood and adolescence. Short- and long-term impacts include aggression, substance use, academic problems, depression, anxiety, and school dropout. This line of research, together with recent, high-profile violent events (e.g., mass shootings, hate-based violence) has increased interest in the use of trauma-informed prevention approaches in schools; these models carefully attend to potential impacts of violence and other forms of trauma exposure. Yet such approaches, along with more traditional selective and indicated preventive interventions for youth exposed to violence, are often challenging for school personnel to implement, given the sensitive nature of traumatic experiences and the discomfort often experienced by school staff in addressing these issues. This panel presents findings from a set of three randomized controlled trials (RCTs) testing different models of school-based selective and indicated prevention interventions aimed at supporting youth at risk for trauma-related behavioral and mental health problems. The three trials span elementary through high school and each use a screening approach for identifying at risk youth. The first RCT focuses on elementary school aged youth participating in a structured, selective group prevention program designed to improve social-emotional skills, reduce bullying, and ameliorate the devastating effects of trauma. The second trial is implemented in elementary, middle, and high schools with the goal of testing a comprehensive, indicated preventive intervention which addresses student emotional and behavioral health needs. The third trial tests an indicated preventive intervention in urban high schools and aims to promote effective coping skills and reduce aggressive behavior through programming for youth, parents, teachers, and school police. All three programs aim to preventing student emotional and behavioral health problems using evidence-based, culturally competent, trauma-informed strategies. Implications for high fidelity implementation of preventive interventions in urban settings will be discussed with particular attention to issues associated with conducting school-based screening for trauma-related risk and symptomology in youth. Challenges related to recruitment, consent, and participant retention will also be considered, along with developmentally and culturally sensitive approaches for assessing behavioral and mental health outcomes of the programs. An expert discussant will provide insight regarding issues of transportability and sustainability of these three approaches, and identify cross-cutting themes from the presentations.