Going to Scale: Experiences Implementing a School-Based Trauma Intervention

The authors are grateful to their collaborators and partners whose work helped to shape this article: Ruth Campbell, Laura Danna, Priscilla Petrosky, Martha Santiago, Pamela Vona, Douglas Walker, and Marleen Wong. The authors also acknowledge the editorial guidance of Elise Cappella. The writing of this article was supported by National Institute of Mental Health (NIMH) 5K01MH83694 (EN) and MH082712 (SK) and Substance Abuse and Mental Health Services Administration (SAMHSA; SM59285).

Abstract.

This article describes implementation experiences “scaling up” the Cognitive Behavioral Intervention for Trauma in Schools (CBITS)—an intervention developed using a community partnered research framework. Case studies from two sites that have successfully implemented CBITS are used to examine macro- and school-level implementation processes and strategies used to address implementation issues and create a successful implementation support system. Key elements of the implementation support system include pre-implementation work, ongoing clinical and logistical implementation supports, promotion of fidelity to the intervention's core components, tailored implementation to fit the service context, and a value on monitoring child outcomes.

Additional information

Notes on contributors

Erum Nadeem

Erum Nadeem, PhD, is an assistant professor and research scientist at New York State Psychiatric Institute, Columbia University, where she has a Career Development Award from the NIMH to use community-based participatory research methods to enhance the alignment between the goals of Cognitive Behavioral Intervention for Trauma in Schools (CBITS) and the mission and structure of the school setting. She also works on projects evaluating child mental health service initiatives through the New York State Office of Mental Health (NYSOMH), including the Evidence Based Treatment Dissemination Center, which provides training and consultation to community clinicians delivering EBTs for common childhood disorders (e.g., disruptive behavior disorders, depression, PTSD). She received her PhD in clinical psychology at the University of California, Los Angeles (UCLA) and completed her postdoctoral training in the UCLA Department of Psychiatry and Biobehavioral Sciences as part of the UCLA/RAND Health Services Research Training Program.

Lisa H. Jaycox

Lisa H. Jaycox, PhD, a clinical psychologist and senior behavioral scientist at RAND, has both clinical and research expertise in trauma and school mental health interventions, with a focus on traumatized children and adolescents. She is the developer of CBITS and the adapted form of CBITS for nonclinicians called SSET. Her work focuses on disseminating evidence-based interventions into community settings, and evaluating existing community programs to determine their effect.

Sheryl H. Kataoka

Sheryl H. Kataoka, MD, MSHS, is an associate professor in the UCLA Division of Child and Adolescent Psychiatry and training director of the UCLA Child Psychiatry Fellowship. Her clinical and research career has focused on the access to and provision of culturally appropriate mental health services, especially for poor and ethnic minority children. She is studying ways to improve the quality of trauma-related mental health services for special education students, how a community participatory partnership facilitated the implementation of CBITS in an immigrant Latino faith-based community, and implementation factors and organizational characteristics of service delivery in schools in post-Katrina New Orleans. She was recently awarded an NIMH grant to study an adaptation of the Learning Collaborative as an implementation strategy for schools. She received the 2009 Sidney Berman Award for School-Based Study and Intervention for Learning Disorders and Mental Health from the American Academy of Child and Adolescent Psychiatry.

Audra K. Langley

Audra K. Langley, PhD, is an assistant professor in the UCLA Division of Child and Adolescent Psychiatry and the director of training for the SAMHSA-funded Trauma Service Adaption Center for Schools, and serves as chair of the National Child Traumatic Stress Network (NCTSN) School Committee. She is a researcher and clinician specializing in cognitive behavioral treatment for children and adolescents with PTSD, anxiety, and related disorders. She has directed CBITS training and consultation efforts for the past nine years, working closely with clinicians and administrators serving high-risk youth in schools and NCTSN-funded sites across the country. Via her current National Institutes of Health Career Development Award, she is partnering with schools to develop and pilot an intervention for elementary school students exposed to traumatic events.

Bradley D. Stein

Bradley D. Stein, MD, PhD, is a senior natural scientist at the RAND Corporation and associate professor of child and adolescent psychiatry at the University of Pittsburgh. He has extensive experience in examining the implementation of mental health interventions in schools and other child serving settings, with a focus on school responses to trauma and violence. He was part of the original team to develop, implement, and evaluate CBITS in the Los Angeles Unified School District, and also has evaluated the implementation of school suicide prevention programs. He has been involved in the mental health response to multiple disasters, including the Oklahoma City bombing and the crash of TWA 800. He also worked as a humanitarian aid work in the former Yugoslavia for the majority of 1994. His trauma-related research includes analyses of national survey data regarding Americans' response to terrorism and an examination of health-related behaviors during the anthrax attacks in Washington, DC, in the fall of 2001. He was the recipient of the 2006 Norbert and Charlotte Rieger Service Program Award for Excellence from the American Academy of Child and Adolescent Psychiatry, which recognizes innovative programs that address prevention, diagnosis, or treatment of mental illness in children and serve as model programs to the community.