Abstract
Objective
Many Latino youth are often unable to access mental health services and support following exposure to traumatic and stressful events. This study assesses the benefits and effectiveness of utilizing Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a school based intervention, with Spanish speaking, Latino youth residing in New Orleans, Louisiana, in effort to address presenting symptoms of trauma and depression.
Method
Twenty three children and adolescents ages 10 to 14, in fifth, sixth and seventh grades, presenting with symptoms of trauma and depression, participated in a 10 week program of CBITS which was primarily conducted in Spanish.
Results
Children who participated in CBITS reported significantly fewer symptoms of trauma and depression following the intervention; however, no differences were noted between genders. Significant differences were observed between older boys and girls (12–14), as they were more likely to report higher levels of exposure to trauma than younger boys and girls (10–11). The effect sizes for the intervention were large.
Conclusions
Findings of this study suggest that CBITS is a practical and effective school based intervention available to mental health providers as a resource to be used with Spanish speaking, Latino youth who have been exposed to different forms of stress and trauma.
Similar content being viewed by others
References
Alegria, M., & Green, J. G. (2015). Disparities in child and adolescent mental health services in the U.S. Retrieved September 22, 2016 from http://www.mamh.org/Portals/0/Uploads/Documents/Public/Disparities%20in%20Child%20and%20Adolescent%20Mental%20Health.pdf.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn.). Arlington, VA: American Psychiatric Publishing.
Andrews, A., Jobe-Shields, R., Lopez, L., Metzger, C., De Arellano, M., Saunders, I., & Kilpatrick, W. (2015). Polyvictimization, income, and ethnic differences in trauma-related mental health during adolescence. Social Psychiatry and Psychiatric Epidemiology, 50, 1223–1234.
Angold, A., Costello, E. J., Messer, S. C., Pickles, A., Winder, F., & Silver, D. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237–249.
Bledsoe, S. E. (2008). Barriers and promoters of mental health services utilization in Latino context: A literature review and recommendations from an Ecosystems perspective. Journal of Human Behavior and Social Environment, 18, 151–183.
Briggs-Gowan, M., Carter, A., Clark, R., Augustyn, M., Mccarthy, K., & Ford, J. (2010). Exposure to potentially traumatic events in early childhood: Differential links to emergent psychopathology: Trauma and preschool psychopathology. Journal of Child Psychology and Psychiatry, 51, 1132–1140.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn.). Hillsdale, NJ: Lawrence Earlbaum Associates.
Copeland, W., Keeler, G., Angold, A., & Costello, E. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584.
Dorsey, S., Briggs, E. C., & Woods, B. A. (2011). Cognitive-behavioral treatment for posttraumatic stress disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 20, 255–269.
Feldman, E. (2007). Implementation of the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Spanish-speaking, immigrant middle-school students: Is effective, culturally competent treatment possible within a public school setting? (Doctoral dissertation, University of Wisconsin-Madison, 2007). Dissertation Abstracts International, 68(A), 1325.
Fincham, D. S., Altes, L. K., Stein, D. J., & Seedat, S. (2009). Posttraumatic stress disorder symptoms in adolescent: Risk factors versus resilience moderation. Comprehensive Psychiatry, 50, 193–199.
Finkelhor, D., Turner, H., Shattuck, A., Hamby, S., & Kracke, K. (2015). Children’s exposure to violence, crime and abuse: An update. Office of Juvenile Justice and Deliquency Prevention. Retrieved August 10, 2016 from http://www.ojjdp.gov/pubs/248547.pdf?ed2f26df2d9c416fbddddd2330a778c6=frmvaxdfr-ffgqxggx.
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: The posttraumatic diagnostic scale. Psychological Assessment, 9, 445–451.
Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. (2001). The child PTSD symptom scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30, 376–384.
Garrison, E. L., Roy, I. S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based services. Clinical Psychology Review, 19, 199–219.
Gudino, O. G., & Rindlaub, L. A. (2014). Psychometric properties of the child PTSD symptom scale in Latino children. Journal of Traumatic Stress, 27(1), 27–34. DOI:1-0.1002/jts.
Gwadz, M. V., Nish, D., Leonard, N. R., & Strauss, S. M. (2007). Gender differences in traumatic events and rates of posttraumatic stress disorder among homeless youth. Journal of Adolescence, 30, 117–129.
Hardaway, C., Larkby, C., Cornelius, M., & Hamby, S. (2014). Socioemotional adjustment as a mediator of the association between exposure to community violence and academic performance in low-income adolescents. Psychology of Violence, 4, 281–293.
Jaycox, L. (2004). CBITS: Cognitive Behavioral Intervention for Trauma in Schools. Longmont, CO: Sopris West Educational Services.
Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., & Schonlau, M. (2010). Children’s mental health care following Hurricane Katrina: A field trial of trauma focused psychotherapies. Journal of Traumatic Stress, 23, 223–231.
Jaycox, L. H., Kataoka, S. H., Stein, B. D., Langley, A. K., & Wong, M. (2012). Cognitive behavioral intervention for trauma in schools. Journal of Applied School Psychology, 28, 239–255.
Jaycox, L. H., Stein, B. D., Kataoka, S. H., Wong, M., Fink, A., Escudero, P., & Zaragoza, C. (2002). Violence exposure, posttraumatic stress disorder, and depressive symptoms among recent immigrant school children. Journal of American Academy of Child and Adolescent Psychiatry, 41, 1104–1110.
Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., & Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of American Academy of Child and Adolescent Psychiatry, 42, 311–318.
Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. Children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.
Kliewer, W., Lepore, S. J., Oskin, D., & Johnson, P. D. (1998). The role of social and cognitive processes in children’s adjustment to community violence. Journal of Consulting and Clinical Psychology, 66, 199–209.
Langley, A., Gonzalez, A., Sugar, C., Solis, D., & Jaycox, L. (2015). Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events. Journal of Consulting and Clinical Psychology, 83, 853–865.
Langley, A., Santiago, C. D., Rodriquez, A., & Zelaya, J. (2013). Improving implementation of mental health services for trauma in multicultural elementary schools: Stakeholder perspectives on parent and educator engagement. The Journal of Behavioral Health Services and Research, 40, 247–262.
Little, S. G., Akin-Little, A., & Somerville, M. P. (2011). Response to trauma in children: An examination of effective intervention and posttraumatic growth. School Psychology International, 32, 448–463.
Margolin, G., & Gordis, E. B. (2000). The effects of family and community violence on children. Annual Review of Psychology, 51, 445–479.
Marsden, D. (2016). As a learning collaborative, New Orleans schools deal with trauma. The national form on youth prevention news. Retrieved August 6, 2016 from http://www.dsgonline.com/nf/enews/2016/2016_04_01/story2.html.
Mendelson, T., Tandon, S. D., O’Brennan, L., Leaf, P. J., & Ialongo, N. S. (2015). Brief report: Moving prevention into schools: The impact of a trauma-informed school-based intervention. The Journal of Adolescence, 43, 142–147.
National Registry of Evidence-Based Programs and Practices. (2010). Cognitive behavioral intervention for trauma in schools. Retrieved March 28, 2016 from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=153.
Ngo, V., Langley, A., Kataoka, S. H., Nadeem, E., Escudero, P., & Stein, B. D. (2008). Providing evidence-based practice to ethnically diverse youths: Examples from the cognitive behavioral intervention for trauma in schools (CBITS) program. The Journal of Behavioral Health Services and Research, 47, 858–862.
Patten, E. (2016). The nation’s Latino population as defined by its youth. Retrieved April 20, 2016 from http://www.pewhispanic.org/2016/04/20/the-nations-latino-population-is-defined-by-its-youth/.
Perriera, K. M., & Ornelas, I. (2013). Painful passages: traumatic experiences and post-traumatic stress among U.S. immigrant Latino adolescents and their primary caregivers. International Migration Review, 47, 976–1005.
Pumariega, A., Roth, E., & Pumariega, J. (2005). Mental health of immigrants and refugees. Community Mental Health Journal, 41, 581–597.
Sharp, C., Goodyer, I. M., & Croudace, T. J. (2006). The Short Mood and Feelings Questionnaire (SMFQ): A unidimensional item response theory and categorical data factor analysis of self-report rating from a community sample of 7-through 11-year-old children. Journal of Abnormal Child Psychology, 34, 79–391.
Shavers, C. A. (2013). Exposures to violence and trauma among children and adolescents. Health, 5, 298–305.
Smith, P., Yule, W., Perrin, S., Tranah, T., Dalgleish, T., & Clark, D. M. (2007). Cognitive-behavioral therapy for PTSD in children and adolescents: A preliminary randomized controlled trial. The Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1051–1061.
Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliot, M. N., & Fink, A. (2003). A mental health intervention for schoolchildren exposed to violence: A randomized controlled trial. The Journal of American Medical Association, 290, 603–611.
Stein, B. D., Kataoka, S., Jaycox, L. H., Wong, M., Fink, A., Escudera, P., & Zaragoza, C. (2002). Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: A collaborative research partnership. The Journal of Behavioral Health Services and Research, 29, 318–326.
Steward, R. W., Ebesutani, C., Drescher, C. F., & Young, J. (2015). The child PTSD symptom scale: An investigation of its psychometric properties. Journal of Interpersonal Violence, 1–20.
Suarez-Orozco, C. (2015). Intersecting inequalities: Research to reduce inequality for immigrant-origin children and youth. Retrieved September 30, 2016, from http://wtgrantfoundation.org/library/uploads/2015/09/Intersecting-Inequalities-Research-to-Reduce-Inequality-for-Immigrant-Origin-Children-and-Youth.pdf.
Turner, H. A., Finkelhor, D., & Ormrod, R. (2010). Poly-victimization in the national sample of children and youth. American Journal of Preventative Medicine, 38, 323–330.
Turner, N., Joinson, C., Peters, T. J., Wiles, N., & Lewis, G. (2014). Validity of the short mood and feelings questionnaire in late adolescence. Psychological Assessment, 26, 752–762.
Funding
The author received no financial support for the research, authorship and/or publication of this article.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author declares no conflict of interest.
Rights and permissions
About this article
Cite this article
Allison, A.C., Ferreira, R.J. Implementing Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Latino Youth. Child Adolesc Soc Work J 34, 181–189 (2017). https://doi.org/10.1007/s10560-016-0486-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10560-016-0486-9