EFFICACY OF SCHOOL BASED INTERVENTION IN REDUCING POST-TRAUMATIC STRESS DISORDER SYMPTOMS AND PSYCHOLOGICAL DISTRESS AMONG ADOLESCENTS EXPOSED TO TRAUMA
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Keywords
Support for Students Exposed to Trauma (SSET), Clustered Randomized Controlled Trial (cRCT), Post-traumatic Stress Disorder (PTSD)ClinicalTrials, gov Identifier: NCT05631691
Abstract
Introduction: Post-traumatic symptoms are prevalent among youth in conflict-affected areas. Individuals who have experienced accidents, abuse, neglect, violence, loss of loved ones, or disasters are at heightened risk for developing such symptoms throughout their lives. These traumatic experiences can significantly impact mental health, often leading to anxiety, depression, and PTSD. Without proper support, the effects of trauma can persist into adulthood. One promising approach to address adolescent trauma is through school-based interventions.
Objective of the current study: The current study aimed to examine the effects of the Support for Students Exposed to Trauma Program (SSET) on adolescents who have experienced traumatic events and exhibit symptoms of post-traumatic stress disorder and psychological distress.
Materials and Methods: Ethical approval was obtained before the conduction of this study(FJWU/EC/2022/45). Initially, a sample of 450 school children (aged 10-16 years) from Govt. High Schools of Muzaffarabad region completed a cross sectional survey using Child & Adolescent Trauma Screen Questionnaire (CATS) in order to screen them for the presence of subclinical levels of Posttraumatic Stress Symptoms. A total of 131 out of 450 participants met the screening criteria. In next phase Clustered Randomized Controlled Design (cRCT) was used to determine the efficacy of school based intervention in which schools were randomly assigned into four clusters i,e, intervention group (two schools; n=65) and the control group (two schools, n=66) by using excel software. A baseline assessment at time1 (pre-test) was carried out with both groups using Child & Adolescent Trauma Screen Questionnaire (CATS) and Revised Children Anxiety & Depression (RCADS). The Interventional group was given a 10 weeks SSET intervention. On the other hand, the control group received no intervention. After completion of the intervention phase, participants from both groups were reassessed at time2 (post-test) using the same measures.
Results: Paired sample t-test analysis was applied to assess the differences between Time1 and Time2 assessments. Results revealed that the participants in the interventional group showed a significant reduction in a) post-traumatic stress symptoms from time1 to time2 (t=6.40***, p<0.001, M1=27.43+ SD1=9.56; M2=17.60+SD2=8.33) with high effect size (Cohen’s d =0.80) b) psychological distress (t=5.22***, p<0.001, M1=62.90+ SD1=20.31; M2=43.63+SD2=22.74) with medium effect size (Cohen’s d=0.64). On the other hand, no significant differences were observed in the control group from the time1 to time2 on these measures. In addition, t-tests applied to assess the differences at time2 between intervention and control group. Results showed significant differences between groups at time2 on posttraumatic stress symptoms [t=-.51, p<.001, interventional group (M+SD= 17.60+8.33); control group (M+SD= 26.22+10.68)] and psychological distress [(t=-5.9, p<.001, interventional group (M+SD=43.63+22.74); control group (M+SD= 69.33+26.42)].
Conclusion and Implications: The study found that the Support for Students Exposed to Trauma Program (SSET) effectively supports school students who have experienced trauma, highlighting its potential in developing nations such as Azad Jammu & Kashmir, Pakistan, where access to counseling is limited. To enhance its impact, it is recommended to expand SSET implementation in schools, train educators to identify trauma symptoms, collaborate with mental health professionals for ongoing support, monitor the program’s effectiveness regularly, and advocate for mental health initiatives in educational policy.
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Nayyab Khurshid
Ph.D. Scholar, Department of Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi, Lecturer, University of Azad Jammu & Kashmir, Muzaffarabad AJK.
Dr. Sajida Naz
Associate Professor, Department of Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi