A trauma informed intervention to improve mental health and school success for urban eighth graders

抽象的。据估计，在美国所有14-17岁的青少年中，约有一半是身体疾病的受害者 袭击；在高犯罪率的城市长大的年轻人中，慢性压力和创伤暴露尤其普遍 社区。由于压力和创伤暴露导致的情绪调节困难导致了 心理健康问题和学业失败，低收入和非裔美国青年面临的风险要高得多 比他们收入更高的白人同龄人更多。然而，为高犯罪率社区服务的学校不提供 支持学生成功的普遍创伤信息战略。说唱俱乐部是一个以学校为基础的团体 旨在改善城市高中生情绪调节和决策能力的预防方案 帮助学生提高到高中的过渡期。该计划填补了当前学校实践中的关键空白， 包括了解创伤情况的方法、向所有学生普遍提供服务而无需预先筛查、跨诊断 对内化问题和行为问题的影响，以及对高中生的关注。 我们的团队从结构化心理治疗中改编了说唱俱乐部，用于应对长期压力的青少年 (SPARCS)，一种基于经验支持的正念和认知的青少年团体治疗- 行为技术。使用一种新的交付方式，说唱俱乐部与学校心理健康共同促进 人事和青年社区成员，以促进学生参与。在我们由NIMH资助的试验中 研究表明，该项目改善了课堂行为、社会功能和学术能力。这个 该计划改善了处于不同基线苦恼水平的学生的结果-即使是低水平的-建议 它作为一种通用模式是否合适。在这项工作的基础上，拟议的R01试验将测试城市 随机分配到说唱俱乐部的八年级学生在情感、行为和学业上都有所改善 八年级和九年级的结果与分配给健康主题组的结果进行比较，健康教育对照组 一群人。干预和控制计划将分别由不同的学校人员和联合 年轻的成年社区成员的协助。这项研究将在巴尔的摩市32所公立学校进行 为暴力发生率高的城市社区提供服务的学校。我们将收集老师和学生- 关于学生自我调节、情绪功能、课堂行为和学业的报告数据 干预前后和4个月随访时的表现，以及12个月随访时的学生数据 向上。我们将收集前一年、前一年和后一年的学业指标的学校记录数据 学习参与。我们将评估与计划实施和潜在可持续性相关的因素， 包括利益相关者的观点和成本数据。创伤见多识广的说唱俱乐部模式 有可能在为全国弱势青年服务的学区广泛传播。

ABSTRACT. Approximately half of all 14-17 years olds in the U.S. are estimated to be victims of physical assault; chronic stress and trauma exposure are particularly prevalent for youth growing up in high-crime urban communities. Emotion regulation difficulties due to stress and trauma exposure contribute to disparities in mental health problems and school failure, with low-income and African American youth at much higher risk than their higher-income, White counterparts. Schools serving high-crime communities, however, do not offer universal trauma-informed strategies to support student success. RAP Club is a school-based group prevention program aimed at improving emotion regulation and decision-making in urban upper middle school students to improve their transition to high school. The program fills key gaps in current school practices, including a trauma-informed approach, universal delivery to all students without pre-screening, transdiagnostic effects on internalizing problems as well as behavioral issues, and a focus on upper middle school students. Our team adapted RAP Club from Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), a group treatment for adolescents based on empirically supported mindfulness and cognitive- behavioral techniques. Using a novel delivery method, RAP Club is co-facilitated by school mental health personnel and young adult community members to promote student engagement. In our NIMH-funded pilot research, the program improved classroom behavior, social functioning, and academic competence. The program improved outcomes for students at varying levels of baseline distress—even low levels—suggesting its appropriateness as a universal model. Building on that work, the proposed R01 trial will test whether urban eighth grade students randomly assigned to RAP Club show improved emotional, behavioral, and academic outcomes in eighth and ninth grades compared to those assigned to Healthy Topics, a health education control group. Intervention and control programs will each be delivered by different school personnel with co- facilitation by young adult community members. The research will be conducted in 32 Baltimore City Public Schools serving urban communities with high rates of violence exposure. We will collect teacher- and student- reported data on student self-regulation, emotional functioning, classroom behavior, and academic performance at pre- and post-intervention and 4-month follow up, as well as student data at 12-month follow up. We will gather school record data on academic indicators in the year before, year of, and year following study participation. We will evaluate factors relevant to program implementation and potential sustainability, including stakeholder perspectives and cost data. The RAP Club model of trauma-informed, universal support has potential for widespread dissemination in school districts serving disadvantaged youth nationwide.