Online Program

Mental health interventions for children experiencing trauma and externalizing behaviors

Tuesday, November 5, 2013

Kenneth Woodson, MPH, Health Promotion and Education, School of Human Services,, University of Cincinnati, cincinnati, OH
Laura Nabors, PhD, ABPP, School of Human Services, CECH, University of Cincinnati, Cincinnati, OH
This presentation will describe play-based and cognitive –behavioral therapy techniques for assisting children with processing traumatic experiences and outcomes of trauma-based therapy in a community mental health setting. Theoretical underpinnings of the trauma interventions including cognitive behavioral therapy, non-directive play therapy, and relational cultural therapy will be described. Outcomes data, focusing on problem behaviors and child functioning also will be presented. Forty-two children between the ages of 7 to 12 years of age with PTSD and comorbid acting out behavior problems have been enrolled. At intake, the mean score for the Global Assessment of Functioning Score (DSM-IV) was 53.61, SD = 5.70, minimum = 4, maximum = 65. This indicated significant problems in maintaining normal functioning. Mean level of number of problems as rated by therapists on the Ohio Scales was 33.78, SD = 12.86, minimum = 0, maximum = 61, providing further evidence of problems in psychosocial functioning. Problem scores as rated on the Therapist forms of the Ohio Scales did not indicate significant differences by gender or primary diagnosis (PTSD, Conduct Disorder, Other) at intake, 3, and 6 months. However, GAF score at intake was significantly related to outcomes with poorer functioning on the GAF being related to continued behavior problems over time. In one preliminary analysis, females were rated by therapists as exhibiting higher numbers of problem behaviors than males. Resilience factors were increased as a result of participation in therapy, and resilience may be independent from psychosocial problems experienced in the aftermath of trauma.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe the play-based and cognitive behavioral interventions used with children by counselors in a community-based mental health center in Ohio. Explain the links between interventions used in the community center and evidence-based trauma interventions for children. Describe the theoretical underpinnings of interventions, such as relational cultural theory, client-centered play therapy, and cognitive-behavioral therapy. Discuss evaluation results and outcomes related to child progress in behavioral functioning and resilience over a 6 month period (intake, 3 and 6 month results from analyses of therapist and parent report on scales assessing child behavioral functioning). Explain interventions related to enhancement of post-traumatic growth and resilience in children receiving community-based trauma treatment.

Keyword(s): Child/Adolescent Mental Health, Child Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Kenneth Woodson has a Master's Degree in Public Health from National University in California; he is completing his doctoral program in Health Promotion and Education at the University of Cincinnati. He has presented at several conferences in the area of mental health. He will be the lead author and is working on this funded project with Dr. Laura Nabors, who is an Associate Professor in Health Promotion and Education at the University of Cincinnati.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.