Cognitive Behavioral Intervention for Trauma in Schools (CBITS)® Manual

Lisa H. Jaycox Ph.D., 2004

Author Contact Information:
Lisa H. Jaycox, Ph.D., Senior Behavioral Scientist
RAND
1200 South Hayes Street
Arlington, VA 22202
Phone: 703-413-1100, x 5118
Fax: 703-414-4726
jaycox@rand.org

Target Population. CBITS is a skills-based, group intervention that is aimed at relieving symptoms of Post Traumatic Stress Disorder (PTSD), depression, and general anxiety among children exposed to trauma. The CBITS program has been used most commonly for children in grades 6-9 (ages 10-15) who have experienced events such as witnessing or being a victim of violence, being in a natural or man-made disaster, being in an accident or house fire, or physical abuse/injury, and who are suffering from moderate to severe levels of PTSD symptoms. Preliminary versions of the CBITS program have been used in children as young as 8 years old.

Treatment Description. Children learn skills in relaxation, challenging upsetting thoughts, and social problem solving, and children work on processing traumatic memories and grief. These skills are learned through the use of drawings and through talking in both individual and group settings. The program consists of ten 1 hour group (6-8 children) sessions usually conducted once a week in a school, mental health or other office settings. The group sessions are used to teach six cognitive-behavioral techniques:

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

A step-by-step guide to each session, including scripts and examples for use by the group leader. Between-session activities help consolidate skills and allow group members to apply these skills to real life problems. In addition to the group sessions, participants receive 1-3 individual sessions (usually held before the exposure exercises), two parent education sessions and one teacher education session.

Training Requirements. The ideal person has prior training and experience with mental health and CBT. A common training approach is for trainees to read background materials and the manual, watch a training video prior to training, attend a 2-day training, and then receive ongoing supervision from a local clinician with expertise in CBT.

Manual Ordering and Training Information. Copies of the treatment manual (117 Pages) can be ordered from Sopris West Educational Services (800) 547-6747 or at www.sopriswest.com at a cost of $29.95. For more information on CBITS training opportunities, contact Audra Langley (Alangley@mednet.ucla.edu) or Lisa Jaycox (jaycox@rand.org) .

Related References:

Jaycox, L.H., Stein, B., Kataoka, S., Wong, M., Fink, A., Escudera, P. & Zaragoza, C. (2002). Violence exposure, PTSD, and depressive symptoms among recent immigrant school children. Journal of the American Academy of Child and Adolescent Psychiatry, 41(9): 1104-1110.

Kataoka, S., Stein, B. D., Jaycox, L. H., Wong, M., Escuerdo, P., Tu, W., Zaragosa, C., & Fink, A. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 311-318.

Stein, B.D., Jaycox, L.H., Kataoka, S.H., Wong, M., Tu, W., Eliot, M.N., & Fink, A. (2003). A mental health intervention for school children exposed to violence: A randomized controlled trial. Journal of the American Medical Association, 290(5), 603-611.

Stein, B.D., Elliott, M.N., Tu, W., Jaycox, L.H., Kataoka, S.H., Wong, M., & Fink, A. (2003). “School-based intervention for children exposed to violence”: Reply. Journal of the American Medical Association, 290(19): 2542.

Stein, B. D., Kataoka, S., Jaycox, L.H., Steiger, E.M., Wong, M., Fink, A., Escudero, P., Zaragoza, C. (2003). The Mental Health for Immigrants Project: Program design and participatory research in the real world. In: M.D. Weist, S. Evans, N. Lever (Eds) Handbook of School Mental Health: Advancing Practice and Research. (pp. 179-190). New York: Kluwer Academic/ Plenum Publishers.

Stein, B., Kataoka, S., Jaycox, L., Wong, M., Fink, A., Escudero, P., & Zaragoza, C. (2002). Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: A collaborative research partnership. Journal of Behavioral Health Services and Research, 29(3), 318-326.