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The Feasibility and Acceptability of Cognitive Behavioral Intervention for Trauma in Schools (CBITS) in a Rural Community Impacted by Environmental Trauma and Covid-19

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Tanya Renn at Florida State University
Tanya Renn
Taylor Dowdy-Hazlett at University of Kentucky
Taylor Dowdy-Hazlett
Christopher Collins at Salem State University
Christopher Collins
Michael Killian
Michael Killian
Michael Killian
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Abstract and Figures

Traumatic events are becoming more prevalent in youth, especially considering the increase in disaster exposure, impacting the wellbeing and mental health of youth. Youth in rural communities are more adversely impacted due to a lack of access to available support and services. Interventions geared toward treating traumatic stress are needed for youth residing in these communities. The Cognitive-behavioral Intervention in Schools is a school-based trauma-focused group therapy intervention geared for adolescents between 5 to 12th grade who have experienced traumatic events. The aim of this study was to test the feasibility, acceptability, and preliminary effectiveness of CBITS in a rural community impacted by a natural disaster.This study utilized a non-probability sample of youth attending primary and secondary school in a rural community impacted by Hurricane Michael. Data collection occurred with youth and parents at three-time points: pre-, post- and three months post-intervention. Feasibility and acceptability were measured through count data of referrals, assents/consents, and the number of sessions attended. Outcomes explored improvement in trauma symptomology and problem-solving skills. Results showed CBITS is a feasible and acceptable intervention for youth exposed to a natural disaster. Results of the outcome measures showed significant differences between baseline and three-month follow-up and from the post-test to the three-month follow-up on the youth self-report. Parent proxy report showed a significant decrease in PTSD symptomology from the post-test to the three-month follow-up. To examine predictors of improvement at follow-up, a regression analysis was conducted. Results showed that trauma exposure and gender were significant predictors for trauma symptom follow-up scores on the youth self-report. Youth trauma experiences vary, but for youth impacted by natural disasters, CBITS may be a feasible and acceptable intervention. School-based interventions are integral for serving youth who may not receive trauma intervention otherwise, especially for those in rural communities.
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Vol.:(0123456789)
School Mental Health (2024) 16:973–982
https://doi.org/10.1007/s12310-024-09677-3
ORIGINAL PAPER
The Feasibility andAcceptability ofCognitive Behavioral Intervention
forTrauma inSchools (CBITS) inaRural Community Impacted
byEnvironmental Trauma andCovid‑19
TanyaRenn1 · TaylorDowdy‑Hazlett2 · ChristopherCollins3 · MichaelKillian1 · DeenaAlani1
Accepted: 4 June 2024 / Published online: 17 June 2024
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024
Abstract
Traumatic events are becoming more prevalent in youth, especially considering the increase in disaster exposure, impacting
the wellbeing and mental health of youth. Youth in rural communities are more adversely impacted due to a lack of access
to available support and services. Interventions geared toward treating traumatic stress are needed for youth residing in these
communities. The Cognitive-behavioral Intervention in Schools is a school-based trauma-focused group therapy intervention
geared for adolescents between 5 to 12th grade who have experienced traumatic events. The aim of this study was to test the
feasibility, acceptability, and preliminary effectiveness of CBITS in a rural community impacted by a natural disaster.This
study utilized a non-probability sample of youth attending primary and secondary school in a rural community impacted by
Hurricane Michael. Data collection occurred with youth and parents at three-time points: pre-, post- and three months post-
intervention. Feasibility and acceptability were measured through count data of referrals, assents/consents, and the number
of sessions attended. Outcomes explored improvement in trauma symptomology and problem-solving skills. Results showed
CBITS is a feasible and acceptable intervention for youth exposed to a natural disaster. Results of the outcome measures
showed significant differences between baseline and three-month follow-up and from the post-test to the three-month follow-
up on the youth self-report. Parent proxy report showed a significant decrease in PTSD symptomology from the post-test
to the three-month follow-up. To examine predictors of improvement at follow-up, a regression analysis was conducted.
Results showed that trauma exposure and gender were significant predictors for trauma symptom follow-up scores on the
youth self-report. Youth trauma experiences vary, but for youth impacted by natural disasters, CBITS may be a feasible and
acceptable intervention. School-based interventions are integral for serving youth who may not receive trauma intervention
otherwise, especially for those in rural communities.
Keywords School-based intervention; Trauma; Implementation research
Introduction
Trauma exposure among children and adolescents is com-
mon; with more than two thirds reporting at least one trau-
matic event by age 16 (Copeland etal., 2007; Lawrence-
Sidebottom etal., 2024). Vicarious trauma, or secondary
exposure to the traumatic events of others (Branson, 2019),
accounts for most of the trauma exposure among youth
(Copeland etal., 2007). Developmentally, youth are at an
increased risk for being negatively impacted by trauma expo-
sure due to higher rates of personalization when exposed
to distressing or traumatic experiences, even when that
exposure is not personally experienced (Hoffman, 2001;
Howard, 2021). Exposure to trauma increases the risk of
negative sequelae such as disruptions in emotional learning
and development (Lissek & Van Meurs, 2015; McLaughlin
etal., 2015a, 2015b), amplified emotional reactivity (Hele-
niak etal., 2016; McCrory etal., 2011; McLaughlin etal.,
2015a, 2015b; Suzuki etal., 2014), and difficulties regulat-
ing emotion (Heleniak etal., 2016; Lambert etal., 2016;
Marusak etal., 2015).
* Tanya Renn
trenn@fsu.edu
1 College ofSocial Work, Florida State University, 296
Champions Way, Tallahassee, FL32304, USA
2 College ofSocial Work, University ofKentucky, Lexington,
USA
3 School ofSocial Work, Salem State University, Salem, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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