Students Exposed to Trauma: A Study of the CBITS Program

SRI researchers, in partnership with University of California at Los Angeles and Stanford University, are conducting a study of the efficacy of the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program in the San Francisco Unified School District. The project is funded by the U.S. Department of Education’s National Center for Special Education Research in the Institute of Education Sciences.

The CBITS program is a school-based intervention for middle school and high school students who experience acute or chronic trauma; they may have witnessed or been the victim of community or school violence, accidents or injuries, physical abuse or domestic violence, or natural or man-made disasters. It is designed to reduce symptoms of post-traumatic stress disorder, depression, and behavioral problems and to improve functioning, grades and attendance, peer and parent support, and coping skills.

CBITS is delivered by mental health professionals in school settings. The program consists of 10 weekly student group sessions delivered within one class period, one individual session with the student and clinician, and two parent educational sessions.

CBITS covers six cognitive-behavioral areas:

• Education about reactions to trauma
• Relaxation training
• Cognitive therapy
• Real-life exposure
• Stress or trauma exposure
• Social problem-solving

In this randomized controlled trial, all sixth-grade students in participating San Francisco middle schools with parent consent are screened each year (for three years) to measure their exposure to trauma. Those students with elevated trauma symptoms are invited to participate in the study. Of those students who agree to participate, half are randomly selected for the CBITS group; the other half receive regular services provided by the school and information about local community resources. This design allows a comparison between students who participated in CBITS and students who received “usual care” services.

Outcome measures include students’ behavior strengths and problems, symptoms of trauma, academic performance, and coping skills. Measures are administered at baseline, immediately after the intervention, and at one-year follow-up in both groups.