Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is designed to reduce posttraumatic stress disorder (PTSD), depression, and anxiety among children with symptoms of PTSD. ) CBITS is intended for use in schools for children ages 10–15 who have had substantial exposure to violence or other traumatic events, and the program has three main goals: 1) to reduce symptoms related to trauma, 2) to build resilience in handling stress and trauma in the future, and 3) to increase peer and parent support. The 10-session school-based intervention teaches cognitive behavioral skills in a group format, led by mental health professionals, with 6-8 students per group, using a mixture of didactic presentation, examples, and games to solidify concepts. Some components of the program include: relaxation training, combating negative thoughts, reducing avoidance, developing a trauma narrative, and building social problem solving skills. The program addresses risk factors for developing chronic disturbances following trauma, including poor coping skills, cognitive factors, and low levels of social support. Symptom reduction is accomplished by CBT practices—reducing maladaptive thinking that can drive depressive and anxious moods, reducing anxiety directly through relaxation training, reducing anxiety through behavior therapy (exposure to anxiety-provoking stimuli and habituation of anxiety), and processing the traumatic experience to reduce both anxiety and traumatic grief. The CBITS program also includes 1-3 individual child sessions, 2 optional parent sessions, and a teacher in-service session. Several evaluations of CBITS have produced impressive short-term results, including: reductions in PTSD, depressive symptoms, and psychosocial dysfunction.
Belief in physical aggression to resolve disagreements and violent tendencies
Developmental trauma exposure
Early and persistent noncompliant behavior
Poor parental supervision (control, monitoring, and child management)
Low school attachment/bonding/motivation/commitment to school
Non-normative school transitions (i.e., changes due to residential moves or mid-year transfers)
Poor school attitude/performance; academic failure
Trouble at school
Association with antisocial/aggressive/delinquent peers; high peer delinquency
Crime Solutions: Effective
Ms. Lisa H. Jaycox
1200 South Hayes Street
Arlington, VA 22202
Phone: (703) 413-1100
E-mail: [email protected]
Kataoka, S.H., Stein, B. D., Jaycox, L.H., Wong, M., Escudero, P., Tu, W., Zaragoza, C., and Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 311–318.
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. Journal of the American Medical Association, 290, 603–611.