Trauma Interventions in Schools: Assessing the Evidence Base.

Objective: Schools can play an important role in delivering trauma interventions to students. This systematic review aimed to examine the level of evidence for school-based trauma intervention models, program components across interventions, and the cost benefits of interventions.

Methods: A search of major databases, gray literature, and evidence-based registries was conducted to identify individual studies published between 2008 and 2022 that tested the effects of school-based trauma interventions on posttraumatic stress and other mental health outcomes. Using established rating criteria, the authors rated interventions as having high, moderate, or low evidence.

Results: Of the 25 different interventions identified across 39 studies, two were rated as having a high level of evidence (ERASE-Stress and Teaching Recovery Techniques), and four were rated as having moderate evidence. Cognitive-behavioral and creative-expressive techniques were common elements across most high- and moderate-evidence interventions. Cost data on school-based trauma interventions were unavailable.

Conclusions: This systematic review identified several school-based trauma interventions that show effectiveness across a variety of school settings and student populations, making them valuable resources for decision makers. Research is needed on the cost-effectiveness and cost benefits of trauma interventions implemented in school settings.