Implementing Trauma- and Grief-Informed Assessment in Underserved Communities: Towards a Best Practice Assessment Model in Detroit

Children who experience death of a loved one and community violence are at increased risk for depression, suicide, substance abuse, posttraumatic stress, maladaptive grief, and various behavioral, academic, and interpersonal problems (Kaplow et al., 2010  Melhem et al., 2008; Porche et al., 2011). Detroit youth experience alarming levels of exposure to violence, death, and associated mental/behavioral health consequences. Along with these often co-occurring and serial exposures, these youth may face severe economic depression, unemployment, family separation and loss. 

This project represents an active community-academic partnership between the University of Michigan Trauma and Grief Clinic, the University of Texas Trauma and Grief Center for Youth, City Connect Detroit, the Detroit School-Based Health Collaborative, and the Michigan Institute for Clinical & Health Research. Study goals were to: 1) test feasibility of training school-based clinicians in assessment of posttraumatic stress reactions, maladaptive grief, and depression; 2) provide a needs assessment to each school-based mental health organization involved, determining rates of trauma/loss and levels of posttraumatic stress reactions, maladaptive grief, and depression among students.

Participants included 27 school-based clinicians across 16 Detroit schools; all  trained in administering three measures (Multidimensional Grief Reaction Scale, Layne, Kaplow, & Pynoos, 2011;  UCLA PTSD Reaction Index for DSM5, Pynoos & Steinberg, 2014; Short Mood and Feelings Questionnaire, Angold & Costello, 1987) with children/adolescents.  Clinicians administered measures to 278 children/adolescents.  Results demonstrate high levels of both posttraumatic stress and grief.  This study addresses the feasibility and acceptability of training and implementing a trauma- and grief-informed assessment battery in Detroit.