Children who are personally exposed to violence are more likely to experience behavioral problems, symptoms of depression, and post-traumatic stress disorder (PTSD). They're also more likely to have poorer school performance, lower reading ability, lower grade-point average, and more school absences than children who are not exposed to violence. Cognitive-behavioral therapy (CBT) is sometimes used to treat depressive and post-traumatic stress disorder in adults who have experienced violence. Researchers from RAND, a nonprofit research institution in Santa Monica, California, examined whether CBT could also be beneficial and effective for children.

The study looked at 126 sixth-grade students who reported exposure to violence (such as slapping, hitting, punching, beatings, knife attacks, and shootings) and had symptoms of PTSD were randomly divided into two groups. One group received 10 sessions of cognitive-behavioral therapy right away. The CBT sessions were conducted by a trained mental health clinician. The second group, the delayed intervention group, did not receive therapy until 3 months after the study began. The therapy sessions included training in relaxation, strategies for combating negative thoughts, and social problem solving. The students were tested to measure PTSD, depressive symptoms, and social problems before the intervention began and again 3 months after therapy began. The students' teachers also answered questions about the children's classroom behavior prior to and 3 months after the intervention.

Compared to students in the delayed intervention group who had not yet received therapy, the students who received therapy had significantly lower scores on tests measuring symptoms of PTSD, depression, and social problems. Six months after the study began - after both groups had received therapy - the differences in test scores between the two groups were not significantly different.

What This Means to You: Cognitive-behavioral therapy can successfully reduce the symptoms of PTSD and depression in school students who have experienced violence. If your child has witnessed violence, be on the lookout for symptoms such as changes in sleeping and eating patterns, prolonged sadness or anxiety, intense fear, or a lack of energy. Your child's doctor can recommend a mental health professional that can help your child and your family cope with the aftermath of violence.

Source: Bradley D. Stein, MD, PhD; Lisa H. Jaycox, PhD; Sheryl H. Kataoka, MD, MSHS; Marleen Wong, MSW; Wenli Tu, MS; Marc N. Elliott, PhD; Arlene Fink, PhD; Journal of the American Medical Association, August 6, 2003

Reviewed by Steve Dowshen, MD
Date reviewed: September 2003