The Feasibility and Acceptability of Cognitive Behavioral Intervention for Trauma in Schools (CBITS) in a Rural Community Impacted by Environmental Trauma and COVID-19

Traumatic events are becoming more prevalent in youth, especially considering the increase in disaster exposure, impacting the wellbeing and mental health of youth. Youth in rural communities are more adversely impacted due to a lack of access to available support and services. Interventions geared toward treating traumatic stress are needed for youth residing in these communities. The Cognitive-behavioral Intervention in Schools is a school-based trauma-focused group therapy intervention geared for adolescents between 5 to 12th grade who have experienced traumatic events. The aim of this study was to test the feasibility, acceptability, and preliminary effectiveness of CBITS in a rural community impacted by a natural disaster. This study utilized a non-probability sample of youth attending primary and secondary school in a rural community impacted by Hurricane Michael. Data collection occurred with youth and parents at three-time points: pre-, post- and three months post-intervention. Feasibility and acceptability were measured through count data of referrals, assents/consents, and the number of sessions attended. Outcomes explored improvement in trauma symptomology and problem-solving skills. Results showed CBITS is a feasible and acceptable intervention for youth exposed to a natural disaster. Results of the outcome measures showed significant differences between baseline and three-month follow-up and from the post-test to the three-month follow-up on the youth self-report. Parent proxy report showed a significant decrease in PTSD symptomology from the post-test to the three-month follow-up. To examine predictors of improvement at follow-up, a regression analysis was conducted. Results showed that trauma exposure and gender were significant predictors for trauma symptom follow-up scores on the youth self-report. Youth trauma experiences vary, but for youth impacted by natural disasters, CBITS may be a feasible and acceptable intervention. School-based interventions are integral for serving youth who may not receive trauma intervention otherwise, especially for those in rural communities.