Skip to Content

Cognitive Behavioral Intervention for Trauma in Schools (CBITS)

Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is a school-based, group and individual intervention designed to reduce symptoms of post-traumatic stress disorder (PTSD), depression, and behavioral problems among students who have experienced significant trauma (CEBC » Cognitive Behavioral Intervention for Trauma in Schools › Program › Detailed, n.d.). This evidence-based program focuses on improving students' mental health and overall functioning in the educational environment (Jaycox et al., 2012). 

Here, we explore CBITS in detail, categorizing its core components, implementation strategies, and impact on the educational field.


Core Components

CBITS is built upon cognitive-behavioral therapy (CBT) principles, aiming to help students process and cope with trauma through a structured and supportive framework (Jaycox e al., 2012). The core components include:


Psychoeducation: Educating students about common reactions to trauma and the rationale behind cognitive-behavioral techniques. This helps normalize their experiences and reduce feelings of isolation (Jaycox et al., 2012).


Relaxation Training: Teaching relaxation techniques such as deep breathing and progressive muscle relaxation to manage physiological symptoms of anxiety (Jaycox, 2004).


Cognitive Restructuring: Helping students identify and challenge unhelpful thoughts related to the trauma and replace them with more accurate and supportive thoughts (Stein et al., 2003).


Exposure: Gradual and controlled exposure to trauma-related memories and stimuli, which helps students reduce their fear and avoidance behaviors (Kataoka et al., 2003).


Social Problem-Solving: Enhancing students' skills in solving interpersonal problems, which can be impaired by trauma (Stein et al., 2003).


Implementation Strategies

CBITS is typically implemented by trained school mental health professionals, such as school psychologists, social workers, or counselors (Allison & Ferreira, 2017). The program consists of 10 group sessions and 1-3 individual sessions, providing flexibility to meet the specific needs of students.


Group Sessions: These sessions focus on building a supportive peer environment where students can share experiences and learn coping strategies. Group settings facilitate peer support and normalization of trauma responses (Jaycox et al., 2009).


Individual Sessions: These sessions allow for personalized attention to students' specific trauma-related issues and provide a safe space for more in-depth cognitive restructuring and exposure work (Jaycox, 2004).


Parental Involvement: Engaging parents through psychoeducation sessions to support their children’s progress and reinforce coping strategies at home (Kataoka et al., 2003).


School Integration: Collaborating with teachers and school staff to integrate CBITS strategies into the broader school environment, enhancing support for trauma-affected students throughout the school day (Stein et al., 2003).


Impact on the Educational Field

The impact of CBITS on the educational field is substantial, offering a means to address the mental health needs of students within the school setting, which is where they spend a significant portion of their day.


Academic Performance: Studies have shown that students who participate in CBITS demonstrate improvements in academic performance, likely due to reduced trauma symptoms and better concentration and engagement in school activities (Jaycox et al., 2009).


Behavioral Improvements: CBITS participants often exhibit fewer behavioral problems, contributing to a more positive classroom environment and reducing the need for disciplinary actions (Stein et al., 2003).


Emotional Well-Being: The program significantly reduces symptoms of PTSD and depression, leading to improved emotional well-being and resilience among students (Kataoka et al., 2003).


Educational Field Examples

In practice, CBITS has been successfully implemented in diverse school settings. For instance, a study in Los Angeles schools found that students who participated in CBITS showed significant reductions in PTSD and depressive symptoms compared to a control group (Stein et al., 2003). Another example from the New York City school system demonstrated that CBITS could be effectively adapted for culturally diverse populations, addressing the unique needs of students from various backgrounds (Jaycox et al., 2009).


In conclusion, CBITS is a vital intervention in addressing the mental health needs of students who have experienced trauma. By integrating cognitive-behavioral techniques within the school setting, it provides students with the tools to manage their trauma symptoms, ultimately enhancing their academic and emotional well-being. The structured yet flexible nature of CBITS allows for effective implementation across diverse educational environments, making it a valuable resource for schools striving to support the mental health of their students.

What is Trauma? 

Trauma refers to an emotional response to an event or series of events that are deeply distressing or disturbing (Trauma, n.d.). This response can result from a wide range of experiences, including physical harm, emotional abuse, natural disasters, accidents, or exposure to violence (Trauma, n.d.). Trauma can significantly impact an individual's mental, emotional, and physical well-being, often leading to long-term adverse effects if not properly addressed (Reynolds, 2021).


Effects of Trauma

Trauma can have widespread and profound effects on an individual’s mental health and daily functioning:


Psychological Effects: Trauma often leads to symptoms of PTSD, including flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event (American Psychiatric Association, 2013).


Emotional Effects: Individuals may experience intense emotions such as anger, sadness, or fear, and may have difficulty regulating these emotions (Briere & Scott, 2014).


Behavioral Effects: Trauma can result in changes in behavior, including withdrawal from social interactions, increased aggression, or self-destructive actions (National Institute of Mental Health, 2022).


Physical Effects: Chronic trauma can lead to physical symptoms such as headaches, gastrointestinal issues, and a weakened immune system (Felitti et al., 1998).


Trauma in Children and Adolescents

Children and adolescents are particularly vulnerable to the impacts of trauma, which can affect their development and school performance (American Psychiatric Association, 2013).  Traumatic experiences can disrupt their sense of safety and stability, leading to difficulties in learning, behavior, and social interactions (Perry, 2006).











CBITS Implementation Process

The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program provides a structured approach to addressing the mental health needs of students who have experienced trauma (Jaycox et al., 2012). The implementation process involves several key steps to ensure the program's effectiveness and sustainability within a school setting.


Step 1: Needs Assessment

Before implementation, schools conduct a needs assessment to identify the prevalence of trauma exposure and the specific needs of their student population (Jaycox, 2003). This can involve surveys, interviews with school staff, and reviews of student records to determine the extent of trauma and related mental health issues (Jaycox, 2003).


Step 2: Staff Training

Successful CBITS implementation requires training school mental health professionals, such as psychologists, counselors, and social workers (Stein et al., 2011). Training includes an overview of trauma and its effects, detailed instruction on the CBITS curriculum, and strategies for effectively delivering the program to students (Stein et al., 2011).


Step 3: Student Identification and Screening

Identifying students who will benefit from CBITS involves a screening process. This typically includes the use of standardized tools to assess trauma symptoms and determine eligibility for the program (Jaycox et al., 2012). Parental consent is also obtained during this stage to ensure family involvement and support (Jaycox et al., 2012).


Step 4: Program Delivery

CBITS is delivered through a combination of group and individual sessions over a period of 10 weeks. The program includes:


Group Sessions: Weekly sessions with groups of 6-8 students focus on building skills such as relaxation techniques, cognitive restructuring, and social problem-solving. Group sessions provide a supportive environment where students can share experiences and learn from each other (Jaycox et al., 2012).


Individual Sessions: These sessions provide opportunities for personalized attention, allowing students to address specific trauma-related issues in a safe and confidential setting (Stein et al., 2011).


Step 5: Parent and Teacher Involvement

Involving parents and teachers is crucial for reinforcing the skills learned in CBITS. Parents are engaged through informational sessions that explain the program's goals and offer strategies to support their children. Teachers are also provided with resources to help them recognize trauma symptoms and support students in the classroom (Kataoka et al., 2003).


Step 6: Monitoring and Evaluation

Ongoing monitoring and evaluation are essential to assess the effectiveness of CBITS and make necessary adjustments. This includes collecting data on student progress, feedback from participants and staff, and evaluating outcomes such as reduced trauma symptoms and improved academic performance (Stein et al., 2003).


In conclusion, the CBITS implementation process is a comprehensive approach to addressing the mental health needs of trauma-affected students. Through careful planning, training, and involvement of the entire school community, CBITS provides students with the skills they need to cope with trauma and succeed academically and emotionally.