Journal of the American Academy of Child & Adolescent Psychiatry
Effectiveness of a School-Based Group Psychotherapy Program for War-Exposed Adolescents: A Randomized Controlled Trial
Section snippets
Study Objectives
The purpose of this study was to evaluate, using a randomized controlled design, the comparative effectiveness of two tiers of a three-tiered school- and communitybased intervention program for adolescents exposed to severe trauma, traumatic bereavement, and adversity. The program was implemented by local school and community professionals with war-exposed adolescents attending 10 secondary schools located in postwar central Bosnia during the 2000–2001 school year. Effectiveness was evaluated
Participants
Participants were adolescent students attending 10 secondary schools located throughout Central Bosnia. The schools comprised the total set of schools implementing the UNICEF program in the Federation of B&H during that school year. The treatment condition included 66 students, approximately 63% girls and 34% boys (sex not reported for two), ranging in age from 13 to 18 years ( = 15.9, SD 1.11) and from the first to the third year of high school. The comparison condition included 61 students,
Exposure to Trauma and Severe Adversity
Approximately 73% of the students participating reported experiencing direct life threat arising from close proximity to exploding shells or rifle fire, 36% reported witnessing during the war violent death or serious injury, 12% reported witnessing torture, and 46% reported the serious injury of a person to whom they were close. Furthermore, 55% reported abandoning their homes, and 54% reported having to change schools because of the war. Moreover, 14% reported the violent death during the war
Discussion
This study compared the effectiveness of the first two tiers of a three-tiered school- and community-based mental health intervention for war-exposed adolescents, as delivered on a large scale in a war-ravaged nation by locally trained and supervised school counselors.5 The successful implementation of both the tier 1 comparison condition (composed of classroom-based psychoeducation and skills) and the tier 2 treatment condition (composed of TGCT plus the tier 1 classroom-based intervention)
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Cited by (0)
Financial support was provided by UNICEF Bosnia and Herzegovina, the Brigham Young University Family Studies Center, the David M. Kennedy Center for International Studies, the Bing Fund, and Tony Bennett. The authors thank Drs. Michael Lambert and Joseph Olsen for statistical consultation, John-Paul Legerski and Benjamin Carter for help with the literature review, and Preston Finley for manuscript preparation. The authors are also indebted to Rune Sturland, M.S., formerly of UNICEF Bosnia and Herzegovina, for his pioneering work and support.
Article Plus (online-only) materials for this article appear on the Journal's Web site:www.jaacap.com.
This article is the subject of an editorial by Dr. Judith A. Cohen in this issue.