Coolidge had a very hard time focusing in class. He faced traumatic issues at home including depression, an alcoholic parent, illness, and the threat of homelessness. Fortunately, he was one of the thousands of sixth graders tested each year by the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program implemented and sustained by United Way. National research shows that 1 in 4 youth will experience a traumatic event by their 16th birthday, just like Coolidge. As early as 6th grade, children who have witnessed or experienced violence or trauma can be identified as “at risk.” If these children exhibit symptoms of psychological trauma but are not identified and treated by the time they get to 9th grade, there is much less chance that they can be successfully helped. They are more likely to drop out of school, get in trouble with the law, drink alcohol, abuse drugs and become pregnant.
United Way of Dane County is partnering with school districts and community agencies to identify and treat problems such as anger, anxiety, and depression in school settings through several key programs, one of those is CBITS. Personal accounts from students and their teachers tell us that these interventions are making a positive difference in their classroom experiences. A look at recent data suggests that something is happening that’s resulting in fewer students disconnecting from school through truancy or dropout. We believe that our collective focus on addressing behavioral health barriers to learning is contributing to this positive trend.
Data collected over several years consistently highlights three key findings about the scope of behavioral health concerns seen in schools:
- Middle schools deal with the highest proportion of students with behavioral health concerns.
- Anxiety/depression, attention deficit and conduct/oppositional disorders top the list of behavioral health concerns
- About 5% of students with behavioral health concerns are dealing with the impacts of trauma.
Psychological trauma is an experience that is emotionally painful, stressful, or shocking, which can result in lasting emotional and physical affects and overwhelms one’s ability to cope. It can result from a one-time event or traumatic experiences that are interpersonal, intentional, prolonged and repeated.
Trauma brings with it a range of physiological and emotional responses such as the inability to regulate emotions and control impulsive behaviors that make learning difficult. The effects of trauma experienced in childhood can be reflected in unhealthy physical and emotional behaviors in adults if a healthy recovery from the event(s) has not occurred . Fortunately, trauma can be treated effectively; the earlier the better.
The Cognitive Behavioral Intervention for Trauma in Schools program (CBITS) provides screening, early intervention and treatment for 6th graders who are experiencing trauma, anger, anxiety, and/or depression. Students with clinically-significant levels of exposure to violence/trauma, symptoms of depression benefit greatly by participating in CBITS groups where they learn skills that help them work through the trauma and manage its effects on their lives. In 2006 addressing trauma through this evidence-based program became the primary behavioral health strategy of Achievement Connections.
CBITS groups are made up of 4-8 students. Sessions are held at school once a week for 10 weeks. They are co-facilitated by a school counselor/social worker/psychologist and a trained mental health therapist from a community agency. The therapist provides 2-3 individual sessions with each CBITS participant to help them face and come to terms with the event(s) that triggered the trauma (“exposure therapy”). Teaching and consultation is also provided to teachers and parents to help them understand how trauma may underlie behaviors they see in their student/child, and how they can respond appropriately.
- CBITS has been implemented in 4 of the16 school districts in Dane County: Middleton/Cross Plains, Oregon, Madison and Sun Prairie.
- Nearly 11,000 students have been screened for anger, anxiety, and/or depression through CBITS since 2006.
- An average of 97 6th graders a year who are screened are eligible for the school-based intervention. The majority of these students participate in CBITS groups.
- Because parent consent is required, about one-third of eligible students do not participate in the CBITS groups.
Students found to have trauma exposure and participate in CBITS benefit through reduced symptoms of anger, anxiety and/or depression, becoming more available for learning, and likely having altered the trajectory of their life course in a positive direction. The screening also benefits the broader student body by identifying students who may be struggling with other behavioral health concerns during the 6th grade – a time when the school transition alone can be inherently difficult.
Coolidge’s life was changed because of CBITS. “It showed me I don’t need to worry about that stuff,” says Coolidge, “I think about the good things. That’s the past, and I should look to the future.” Tools like CBITS helps United Way advance the goal in our community’s Agenda for Change that people’s health issues are identified and treated early. Now, thanks to United Way and CBITS, Coolidge has the tools he needs to be successful in school … and in life.