Adaptation and Implementation of Cognitive Behavioral Intervention for Trauma in Schools with American Indian Youth

Abstract

American Indian adolescents experience higher rates of suicide and psychological distress than the overall U.S. adolescent population, and research suggests that these disparities are related to higher rates of violence and trauma exposure. Despite elevated risk, there is limited empirical information to guide culturally appropriate treatment of trauma and related symptoms. We report a pilot study of an adaptation to the Cognitive Behavioral Intervention for Trauma in Schools in a sample of 24 American Indian adolescents. Participants experienced significant decreases in anxiety and posttraumatic stress disorder symptoms, and avoidant coping strategies, as well as a marginally significant decrease in depression symptoms. Improvements in anxiety and depression were maintained 6 months postintervention; improvements in posttraumatic stress disorder and avoidant coping strategies were not.

This research was supported by grants from the SAMHSA National Childhood Traumatic Stress Network through the New Mexico Alliance for Children with Traumatic Stress and as part of the Core Research Project for the UNM Prevention Research Center through a grant from the Centers for Disease Control & Prevention (Cooperative Agreement #1-U48-DP-0000061).

Grateful acknowledgment to Steve Adelsheim, Richard Hough, and Martin Kileen, who conceptualized the project; Peou Lakhana, Lynn Abeita, Gloria Blea Johnson, Charlene Poola, Eugene Tsinajinnie, Lance Freeland, Christopher Lee, and Willa Ortega, who were instrumental in adapting the intervention and implementing the research; all of the students, families, facilitators, tribal leaders, school personnel, and community members who participated in or supported the study; Deborah Bybee for statistical consultation; and Douglas Novins for his helpful feedback on the manuscript.

Notes

Note: CBITS = Cognitive Behavioral Intervention for Trauma in Schools.

Note: PTSD = posttraumatic stress disorder.

Note: N = 23 individuals, 92 observations across four time points. PTSD = posttraumatic stress disorder; NE = not estimated in “best fit” model.

^∼ p < .06. *p < .05. **p < .001.