This is a resubmission of our grant application """"""""Multimodality Trauma Treatment in Hamlet."""""""" In May, 1991, eight months after an industrial fire in Hamlet, North Carolina, killed 25 townspeople, and injured many more, we conducted a study of fire-related post-traumatic symptomatology (PTS) in students from two elementary and two junior high schools. In 1993 we repeated this study, using a new measure, the Self-reported Post-Traumatic Stress (SRPTS) scale. In these studies, rates of chronic PTS from fire and non-fire stressors ranged from ten to twenty percent, especially at higher exposure levels. Unfortunately, despite clear need, proven treatments for traumatized youth are not yet available. Under the RFA for Exploratory/Developmental Grants for Psychosocial Treatment Research (R21), we now seek to develop and empirically evaluate a multi-component treatment program for traumatized youth in the schools from our earlier studies.
Our first aim i s to develop a theoretically-based PTSD treatment protocol, multi-modality trauma treatment (MMTT), and to test the hypothesis that MMTT reduces PTSD and collateral symptoms immediately post treatment and at follow up. MMTT consists of group psychotherapy focused on anxiety-management training, anger coping, and graded exposure to traumatic material. In year one, we use a multiple-baseline single case design to maximize feedback regarding individual subjects responses to MMTT. After revising the MMTT manual, we use a randomized parallel groups design in year two to contrast MMTT to a non-PTSD specific treatment, social-skills training (SST). In year three, again using a randomized parallel groups design, we contrast MMTT alone to MMTT plus a consulting teacher intervention (MMTT/CTI) to ask whether addressing classroom pedagogic and behavioral targets adds to the efficacy of MMTT. In order to produce a customizable and exportable screening instrument to accompany MMTT, our second aim is to further develop the Self-Reported Post- Traumatic Symptomatology (SRPTS) scale. Our ultimate goal is to provide an exportable PTSD assessment and treatment protocol; further prevention intervention research is planned for a subsequent grant period.