When Do Posttraumatic Stress and Related Problems Abate During School-Based Group Therapy for Elementary Students?

The Bounce Back program (Langley et al. in J Consult Clin Psychol 83:853, 2015) effectively reduces post-traumatic stress (PTS) symptoms and internalizing problems among Elementary students (Langley et al. in J Consult Clin Psychol 83:853, 2015; Santiago et al. in School Psychol Q 33:1–9, 2018). Some school settings may modify the program to accommodate challenges such as logistic difficulties (e.g., a busy academic schedule) and clinicians’ discomfort with parts of the protocol (i.e., the trauma narrative). Thus, research is needed to answer the question, “Can we expect to observe change if we implement a modified Bounce Back program?” Our objectives were to (1) replicate treatment outcomes, (2) examine the timing of symptom reduction to determine whether symptoms abated before and/or after the trauma narrative, and (3) test whether baseline factors predicted incremental benefits of the trauma-narrative for PTS reduction. Twenty K-5 th grade students (47.4% Hispanic/Latino, 36.8% African-American, and 63.2% White; 68% boys) attending an urban Title I Elementary school completed the Bounce Back program and reported symptoms at pre, mid therapy (immediately before the trauma narrative), and post therapy (immediately following the program). Consistent with other trials of the Bounce Back program, students in the current sample experienced significantly reduced PTS symptoms, distress, internalizing problems, and externalizing problems. Significant change in PTS and distress occurred in the first part of treatment before the trauma narrative and did not occur during the second part of treatment. The full course of treatment was needed for significant change on secondary outcomes of internalizing and externalizing problems. Distress and bereavement assessed at baseline did not predict incremental benefits of the second half of treatment. Findings yield implementation implications and directions for future research.