This study will evaluate whether a school-based counseling program, Cognitive Behavioral Intervention for Trauma in Schools (CBITS), helps reduce trauma-related symptoms and improve psychological functioning in adolescents in Pakistan who have experienced traumatic events. Students will first be screened to identify those with trauma exposure and related symptoms. Eligible students will receive the CBITS program, delivered at their school by the researcher. Researcher will measure changes in trauma-related symptoms and other psychological outcomes before and after the intervention to determine whether the program is effective for this population.
Exposure to trauma is common among adolescents in low- and middle-income countries, including Pakistan, where students may experience adverse events such as violence, natural disasters, displacement, or abuse. These experiences can lead to significant psychological distress, including symptoms of post-traumatic stress, anxiety, and depression, which may go unaddressed due to limited access to mental health services in school settings. Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is a group-based, school-delivered intervention originally developed to address trauma-related symptoms among students exposed to community violence and other traumatic events. The program uses cognitive-behavioral techniques, including psychoeducation, relaxation training, cognitive restructuring, and gradual exposure, to help students process traumatic experiences and reduce associated symptoms. This study aims to evaluate the effectiveness of CBITS among adolescents in Pakistani schools who have experienced trauma and are exhibiting trauma-related psychological symptoms. Students will be screened using standardized measures to identify eligible participants. Those who meet criteria will receive the CBITS intervention, delivered by trained facilitators in a school-based setting over a series of structured sessions. The study will assess changes in participants' psychological symptoms and functioning from baseline to post-intervention, in order to determine whether the intervention is associated with meaningful improvement in this population. Findings from this study may help inform the feasibility and cultural adaptation of trauma-focused, school-based mental health interventions in Pakistan and similar contexts.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Participants in the intervention group will receive Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a manualized, school-based group therapy program for adolescents with trauma-related symptoms. The program includes approximately 10 group sessions (45-60 minutes) covering psychoeducation, relaxation training, cognitive restructuring, trauma narrative development, and social problem-solving. Individual sessions may be included to support the trauma narrative component.
National University Of Modern Languages (NUML), Islamabad
Islamabad, Pakistan
RECRUITINGChild and Adolescent Trauma Screen 2 (Cats-2) Self-Report (7-17 Years)
The Child and Adolescent Trauma Screen 2 (CATS-2) Self-Report (7-17 Years) is used to assess trauma-related symptoms. Possible scores range from 0 to 60, with higher scores indicating more posttraumatic stress symptoms
Time frame: Baseline and 10 weeks
Depression Anxiety Stress Scales - Youth Version (DASS-Y)
The Depression Anxiety Stress Scales - Youth Version (DASS-Y) was used to assess psychological distress, with possible scores ranging from 0 to 63, where higher scores indicate greater psychological distress
Time frame: Baseline and 10 weeks
Children's Post-Traumatic Cognitions Inventory (CPTCI-S)
Children's Post-Traumatic Cognitions Inventory (CPTCI-S) was used to assess post-trauma appraisals. Possible scores range from 10 to 40, with higher scores indicating greater difficulty in post-traumatic cognitions.
Time frame: Baseline and 10 weeks
The Difficulties in Emotion Regulation Scale Short Form (DERS-SF)
The Difficulties in Emotion Regulation Scale Short Form (DERS-SF) was used to assess emotion regulation difficulties. Possible scores range from 18 to 90, with higher scores indicating greater difficulty in emotion regulation.
Time frame: Baseline and 10 weeks
Multidimensional Scale of Perceived Social Support (MSPSS)
The Multidimensional Scale of Perceived Social Support (MSPSS), was used to assess perceived social support, possible scores range from 1 to 7, high scores indicating greater perceived social support
Time frame: Baseline and 10 weeks
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