Statewide Implementation of an Evidence-Based Trauma Intervention in Schools

• Published in: School psychology quarterly Vol. 33; no. 1; pp. 44 - 53
• Main Authors: Hoover, Sharon A, Sapere, Heather, Lang, Jason M, Nadeem, Erum, Dean, Kristin L, Vona, Pamela
• Format: Journal Article
• Language: English
• Published: United States American Psychological Association 01.03.2018
• Subjects: Elementary School Students; Evidence Based Practice; Intervention; Mental Health; Middle School Students; Posttraumatic Stress Disorder; Program Implementation; Secondary School Students; Trauma; Connecticut
• ISSN: 1045-3830; 1939-1560
• DOI: 10.1037/spq0000248

The goal of the current article is to describe the implementation and outcomes of an innovative statewide dissemination approach of the evidence-based trauma intervention "Cognitive Behavioral Intervention for Trauma in Schools (CBITS)". In the context of a 2-year statewide learning collaborative effort, 73 CBITS groups led by 20 clinicians from 5 different school-based mental health provider organizations served a total of 350 racially and ethnically diverse (66.9% Hispanic, 26.2% Black/African American, 43.7% White, and 30.1% Other), majority female (61%) children, averaging 12.2 years (SD = 2.4, range 8-19). Of the 350 children who began CBITS, 316 (90.3%) successfully completed treatment. Children demonstrated significant reductions in child posttraumatic stress disorder (PTSD) symptoms (42% reduction, d = 0.879) and problem severity (25% reduction, d = 0.396), and increases in child functioning, t(287) = -3.75, p < 0.001 (5% increase, d = 0.223). Findings point to the need, feasibility, and positive impact of implementing and scaling up school-based interventions for students suffering from posttraumatic stress. Impact and Implications: In addition to demonstrating the positive impact of a school-based trauma intervention on students' psychosocial and academic functioning, the current study tested the implementation of an adapted learning collaborative model to support statewide implementation of trauma interventions in schools. This successful scaling up of a school-based trauma intervention offers a framework for other states on leveraging implementation drivers that promote adoption of evidence-based practices in schools. Implementation strategies included organizational and state leadership engagement, expert clinical consultation, measurement feedback data systems, and cross-site sharing and accountability.