A Mental Health Intervention for Schoolchildren Exposed to Violence

Abstract

N THE LAST DECADE, THERE HAS BEEN heightened awareness of the extent to which children personally witness or experience violence. [1][2][3] Public health officials have responded by identifying violence as one of the most significant US public health issues. [4][5][6] Large numbers of US children experience such violence, and an even greater number may experience symptoms of distress after personally witnessing violence directed at others. 2,7-9 For many children, personally experiencing or directly witnessing multiple incidents of violence is the norm. 3,10,11 Violence affects all racial, ethnic, and socioeconomic groups, but its burden falls disproportionately on urban, 5,12 poor, and minority populations. 13,14 Several studies have found that the majority of children exposed to violence, defined as personally witnessing or directly experiencing a violent event, display symptoms of posttraumatic stress disorder (PTSD), 15,16 and a substantial minority develop clinically significant PTSD. [17][18][19] However, the harmful effects of violence extend beyond symptoms of PTSD. Exposure to violence is associated with depression 20 and behav-Author Affilations are listed at the end of this article.

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

“…Fewer studies have been published on the effectiveness of cognitive behavioural treatment for children with PTSD (e.g. Cohen, Deblinger, Mannorino, & Steer, 2004;Cohen, Mannarino, & Staron, 2006;Deblinger, Lippman, & Steer, 1996;King et al, 2000;Smith et al, 2007;Stein et al, 2003; for review see Silverman et al, 2008). These studies show that cognitive behavioural treatment is more effective than a waitlist control condition, community treatment, supportive therapy or child-centred therapy on short-and long-term outcome measures.…”

“…Most treatment studies included children displaying traumatic symptoms after being exposed to one specifi c type of trauma, such as sexual assault (e.g. Cohen et al, 2004;Deblinger et al, 1996;King et al, 2000; for review see Silverman et al, 2008), violence (Stein et al, 2003), or the death of a parent or loved one .…”

Psychosocial Treatment of Children in Foster Care: A Review

“…Trauma-focused CBT has been shown with randomized controlled trials (RCT) to be effective in treating PTSD in sexually abused children and adolescents (Celano & Rothbaum, 2002;Cohen, Deblinger, Mannarino, & Steer, 2004;King, Tonge, Mullen, Myerson, Heyne, Rollings, et al, 2000;Pine & Cohen, 2002). Another RCT has shown CBT effectiveness as a group intervention for schoolchildren exposed to violence (Stein, Jaycox, Kataoka, Wong, Tu, Elliot, et al, 2003), while a similar study demonstrated the efficacy of group CBT for treating PTSD in Latino immigrant children exposed to community violence (Kataoka, Stein, Jaycox, Wong, Escudero, Tu, et al, 2003).…”

Cognitive behavioral therapy for the treatment of PTSD

“…CBITS has been applied to two major studies in children exposed to violence in the community. In the study by Stein et al (2003), CBITS was superior to the waiting list in reducing PTSD and depression cases.Several other CBT protocols have been found, embodying promising practices that could facilitate the application of CBT to special populations of different origins and specificities in symptomatology. For example, UCLA Τrauma and Grief Component Therapy has been primarily provided in schools, showing a benefit to teenagers exposed to war, community violence or even terrorist acts.…”

“…CBITS has been applied to two major studies in children exposed to violence in the community. In the study by Stein et al (2003), CBITS was superior to the waiting list in reducing PTSD and depression cases.…”