Trauma / Grief-Focused Intervention for Adolescents Exposed to Community Violence : Results of a School-Based Screening and Group Treatment Protocol

Recent studies document high levels of community violence exposure among adolescents and link violence exposure to psychological distress and impaired academic achievement. This study assessed the prevalence of trauma exposure among middle school students and evaluated the effectiveness of a school-based, trauma/grief-focused group psychotherapy protocol in treating a sub-group of students with severe exposure, posttraumatic stress disorder (PTSD) and functional impairment. Using a stratified screening procedure, 812 students completed a screening survey, 58 students (7.1% of those surveyed) met criteria for group treatment, and 26 students participated in the group. Group participation was associated with improvements in posttraumatic stress and complicated grief symptoms, and in academic performance. Results suggest that students who are exposed to severe levels of community violence may not be typically identified or treated. The findings also suggest that severe PTSD in adolescence may be associated with impaired school functioning, and that a reduction in PTSD symptoms may be related to academic remediation.

[1]  A. Steinberg,et al.  A developmental model of childhood traumatic stress. , 1995 .

[2]  S. Bruce,et al.  Impact of exposure to community violence on violent behavior and emotional distress among urban adolescents. , 1997, Journal of clinical child psychology.

[3]  W. Yule,et al.  The treatment of post traumatic stress disorder in children and adolescents , 1994 .

[4]  L. Fairbanks,et al.  Outcome of psychotherapy among early adolescents after trauma. , 1997, The American journal of psychiatry.

[5]  E. Costello,et al.  Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues. , 1993, The American journal of psychiatry.

[6]  A. Steinberg,et al.  A public mental health approach to the postdisaster treatment of children and adolescents. , 1998, Child and adolescent psychiatric clinics of North America.

[7]  C. M. Parkes.  Traumatic Grief: Diagnosis, Treatment and Prevention , 2000, British Journal of Psychiatry.

[8]  A. Cavaiola,et al.  Behavioral sequelae of physical and/or sexual abuse in adolescents. , 1988, Child abuse & neglect.

[9]  R. Yehuda.  POST-TRAUMATIC STRESS DISORDER , 1985, The Lancet.

[10]  Mph Robert S Pynoos.  Grief and Trauma in Children and Adolescents , 1992 .

[11]  E. Foa,et al.  Psychosocial treatments for posttraumatic stress disorder: a critical review. , 1997, Annual review of psychology.

[12]  Melissa Sickmund.  Juvenile offenders and victims , 1997 .

[13]  J. March,et al.  Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[14]  D. J. Hansen,et al.  Long-term consequences of childhood physical abuse. , 1993, Psychological bulletin.

[15]  C. Bell,et al.  Community violence and children on Chicago's southside. , 1993, Psychiatry.

[16]  A. Steinberg,et al.  Traumatic stress in childhood and adolescence: Recent developments and current controversies. , 1996 .

[17]  G. Gardner.  Aggression and violence--the enemies of precision learning in children. , 1971, The American journal of psychiatry.

[18]  J. J. Collins,et al.  Traumatic stress disorder and violent behavior , 1990 .

[19]  J. Bremner,et al.  Scholastic impairments among traumatized adolescents. , 1997, Behaviour research and therapy.

[20]  Therese A. Rando,et al.  Treatment of complicated mourning , 1993 .

[21]  K. Christoffel.  Violent death and injury in US children and adolescents. , 1990, American journal of diseases of children.

[22]  E. Uehara,et al.  African American Youth Encounters With Violence , 1996 .

[23]  M. Seligman,et al.  The effectiveness of psychotherapy. The Consumer Reports study. , 1995, The American psychologist.

[24]  N. Garmezy.  Children in poverty: resilience despite risk. , 1993, Psychiatry.

[25]  J. Dyson.  The effect of family violence on children's academic performance and behavior. , 1990, Journal of the National Medical Association.

[26]  J. Osofsky,et al.  The effects of exposure to violence on young children. , 1995, The American psychologist.

[27]  J. Osofsky,et al.  Chronic community violence: what is happening to our children? , 1993, Psychiatry.

[28]  L. Fairbanks,et al.  Moral development and psychopathological interference in conscience functioning among adolescents after trauma. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[29]  L. Sherr,et al.  Are researchers bound by child abuse reporting laws? , 1999, Child abuse & neglect.

[30]  A. Beck,et al.  Depression: Causes and Treatment , 1967 .

[31]  J. Richters.  The NIMH community violence project , 1993 .

[32]  M. O’Keefe.  Adolescents' exposure to community and school violence: prevalence and behavioral correlates. , 1997, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[33]  L. Fairbanks,et al.  Post-traumatic Stress Reactions in Children After the 1988 Armenian Earthquake , 1993, British Journal of Psychiatry.

[34]  M. Fristad,et al.  Depression in recently bereaved prepubertal children. , 1991, The American journal of psychiatry.

[35]  D G Kilpatrick,et al.  Risk factors for adolescent substance abuse and dependence: data from a national sample. , 2000, Journal of consulting and clinical psychology.