Prevention and treatment of posttraumatic stress disorder in the school setting

A case study addressing trauma needs during COVID-19 remote learning from an ecological systems theory framework

Mental health conditions related to trauma among American children are a concern, particularly because of the impacts of the COVID-19 pandemic. Children, as students, carry the trauma they encounter with them into the classroom. Students impacted by trauma learn differently due to effects on the brain that relate to several impairments, causing them to perform poorly in school. However, teachers may not always understand this issue. This case study shows how certain dynamics within the EST layers impacted one school during the pandemic. The purpose of this study was to examine how teachers at the school experienced a trauma-informed online PD and SEL program intended to improve student outcomes, teacher perceptions, and teacher–student relationships. The six participants included teachers in a K-8 low-income, minority population charter school. The assessment tools used were the Teacher–Student Relationship Scale, Teacher Perception Scale, and Student Outcomes Survey. The teachers’ outlook on SEL improved, particularly online. This improvement helped the teachers implement community circles and SEL infused with mindfulness in their online classrooms, which may have helped them maintain their relationships with the students and may have helped the students with academic and stress outcomes. During unprecedented times, the maintenance, rather than the deterioration, of student outcomes and teacher–student relationships is an accomplishment and an area that necessitates further research.

A Brief School-Based Cognitive-Behavioral Intervention for Japanese Adolescents With Severe Posttraumatic Stress

This pilot study investigated the efficacy of a brief school-based cognitive-behavioral intervention program for Japanese adolescents exposed to the Great East Japan Earthquake in 2011. The participants were 22 adolescents with severe posttraumatic stress symptoms at the time of the study in March 2014. They completed a single-session 4-step intervention program based on Ehlers and Clark's (2000) model at their school. Symptom status was assessed at 3 time points (preintervention, postintervention, and 4-month follow-up) using the Impact of Event Scale-Revised (Weiss, 2004) and Center for Epidemiologic Studies Depression Scale (Radloff, 1977). The results showed significant improvements in all posttraumatic stress symptoms at postintervention (d = 0.81), and the effects were maintained throughout the 4-month follow-up period (d = 1.10). However, no improvement in depressive symptoms was shown. Results from this pilot study suggest that school-based cognitive-behavioral intervention programs are feasible and show promise for Japanese adolescents with posttraumatic stress symptoms regardless of cross-cultural differences, but that additional research examining effectiveness is needed. Despite the preliminary nature of the findings of this pilot study, the strengths of our intervention were that it was driven by a well-tested theoretical model and required only a single session to administer.

School-based intervention programs for PTSD symptoms: a review and meta-analysis

This is a review and meta-analysis of school-based intervention programs targeted at reducing symptoms of posttraumatic stress disorder (PTSD). Nineteen studies conducted in 9 different countries satisfied the inclusionary criteria. The studies dealt with various kinds of type I and type II trauma exposure. Sixteen studies used cognitive-behavioral therapy methods; the others used play/art, eye movement desensitization and reprocessing, and mind-body techniques. The overall effect size for the 19 studies was d = 0.68 (SD = 0.41), indicating a medium-large effect in relation to reducing symptoms of PTSD. The authors' findings suggest that intervention provided within the school setting can be effective in helping children and adolescents following traumatic events.

Risikofaktoren der Posttraumatischen Belastungsstörung nach Trauma-Typ-I bei Kindern und Jugendlichen

Es wird ein Überblick zu Risikofaktoren einer Posttraumatischen Belastungsstörung (PTB) nach einem einmaligen traumatischen Ereignis in Kindheit und Jugend gegeben. Dazu wurde eine umfangreiche Literaturrecherche durchgeführt, als deren Ergebnis 55 Einzelstudien identifiziert werden konnten. Die berücksichtigten Studien sollten sowohl eine quantitative Erfassung der posttraumatischen Symptomatik als auch der Prädiktoren beinhalten. Prädiktoren wurden in prä-, peri- und posttraumatische Faktoren eingeteilt, wobei sich die folgenden als besonders vielversprechend herausstellten: Prätraumatische psychische Morbidität, Stressorschwere, Lebensgefahr, Ressourcenverlust und peritraumatische emotionale Reaktion, sowie eine Akute Belastungsstörung bzw. PTB nach dem Ereignis, Komorbidität, weitere kritische Lebensereignisse und mangelnde soziale Unterstützung.

Young children's reactions to war-related stress: a survey and assessment of an innovative intervention

OBJECTIVE

The goal was to assess stress reactions in young children during and after war and the effects of a new brief intervention.

METHODS

Two separate studies were conducted. In study I, we assessed war exposure and stress reactions of 74 children (2-7 years of age) in a sheltered camp during the second Israel-Lebanon war (July to August 2006). Their exposure to war experiences and their stress reactions were assessed through parental reports during the last week of the war. In addition to standard care, 35 children received a brief intervention (Huggy-Puppy intervention) aimed at encouraging them to care for a needy Huggy-Puppy doll that was given to them as a gift. The effects of the Huggy-Puppy intervention were assessed in a follow-up interview 3 weeks after the war. Study II assessed the efficacy of group administration of the Huggy-Puppy intervention to 191 young children, compared with 101 control subjects. The effects of the intervention on stress-related symptoms after the war were assessed in telephone interviews with the parents.

RESULTS

Study I indicated that, during the war, most children had significant exposure to war-related experiences and had severe stress reactions. The Huggy-Puppy intervention was associated with significant reductions in stress reactions in the postwar assessment. A higher level of attachment and involvement with the doll was associated with better outcomes. The results of study II indicated that group administration of the Huggy-Puppy intervention was associated with significant reductions in stress reactions.

CONCLUSION

These studies suggest that the Huggy-Puppy intervention may offer pediatricians and other child health care professionals a promising, cost-effective intervention for children during stressful times.