Grief and trauma intervention for children after disaster: Exploring coping skills versus trauma narration

This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6–12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed.

► There were significant decreases in PTSD, depression, traumatic grief, global distress and internalizing symptoms in both GTI-CN and GTI-C.
► Improvements were maintained over time for both GTI-CN and GTI-C.
► There were no significant time × treatment interactions, except for externalizing symptoms in the intent-to-treat analysis.
► Increases in perceived social support primarily occurred from post intervention to follow-up.
► There was a pattern of greater improvements for children in GTI-CN versus children in GTI-C.