This study documents the vicarious psychological impact of the 2010 earthquake in Haiti on Haitians living in the United States. The role of coping resources-family, religious, and community support-was explored. The results highlight the importance of family and community as coping strategies to manage such trauma.Keywords: vicarious trauma, natural disaster, coping Este estudio documenta el impacto psicológico vicario que tuvo el terremoto de 2010 en Haití sobre los residentes haitianos que viven en Estados Unidos. Se explora el papel de los recursos de afrontamiento-apoyo familiar, religioso y comunitario. Lo resultados destacan la importancia de la familia y la comunidad como estrategias de afrontamiento para superar un trauma de esas características.Palabras Clave: trauma vicario, desastre natural, afrontamiento R esearch has shown that natural disasters have an impact on survivors (Benight et al., 1999) as well as those outside of the disaster zone (Shalev, Tuval-Mashiach, & Hadar, 2004). Although less is known regarding those who are not directly affected, the limited research indicates that individuals outside the disaster zone may experience trauma symptoms similar to those reported by individuals who experienced the traumatic event (Everly, Boyle, & Lating, 1999), which may be defined as vicarious trauma (VT). Our article highlights (a) the VT symptoms resulting from one such natural disaster, the 2010 earthquake in Haiti, and (b) the coping strategies used to manage such trauma by Haitians/Haitian Americans.

This article presents outcome data of the implementation of three group cognitive-behavioral therapy (GCBT) interventions for children with externalizing behavior problems, anxiety, and depression. School counselors and graduate students co-led the groups in two low-income urban schools. Data were analyzed to assess pre-treatment to post-treatment changes in diagnostic severity level. Results of the exploratory study indicated that all three GCBT protocols were effective at reducing diagnostic severity level for children who had a primary diagnosis of an externalizing disorder, anxiety disorder, or depressive disorder at the clinical or intermediate (at-risk) level. All three GCBT protocols were implemented with relatively high levels of fidelity. Data on the effectiveness of the interventions for reducing diagnostic severity level for externalizing and internalizing spectrum disorders and for specific disorders are presented. A discussion of implementation of mental health evidence-based interventions in urban schools is provided.

There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home. The purpose of this paper is to review the current state of the literature related to integrated behavioral health services in pediatric primary care. Specifically, innovative models of integrated behavioral health care are discussed.

Public schools are an ideal setting for the delivery of mental health services to children. Unfortunately, services provided in schools, and more so in urban schools, have been found to lead to little or no significant clinical improvements. Studies with urban school children seldom report on the effects of clinician training on treatment fidelity and child outcomes. This study examines the differential effects of two levels of school-based counselor training: training workshop with basic consultation (C) vs. training workshop plus enhanced consultation (C+) on treatment fidelity and child outcomes. Fourteen school staff members (counselors) were randomly assigned to C or C+. Counselors implemented a group cognitive behavioral therapy protocol (Coping Power Program, CPP) for children with or at risk for externalizing behavior disorders. Independent coders coded each CPP session for content and process fidelity. Changes in outcomes from pre to post were assessed via a parent psychiatric interview and interviewer-rated severity of illness and global impairment. Counselors in C+ delivered CPP with significantly higher levels of content and process fidelity compared to counselors in C. Both C and C+ resulted in significant improvement in interviewer-rated impairment; the conditions did not differ from each other with regard to impairment. Groups did not differ with regard to pre- to- posttreatment changes in diagnostic severity level. School-based behavioral health staff in urban schools are able to implement interventions with fidelity and clinical effectiveness when provided with ongoing consultation. Enhanced consultation resulted in higher fidelity. Enhanced consultation did not result in better student outcomes compared to basic consultation. Implications for resource allocation decisions with staff training in EBP are discussed.

This paper describes implementation (fidelity, perceived acceptability) and tier 1 and Tier 2 outcomes of school‐wide positive behavior interventions and supports approach including mental health supports at Tier 2 in two K‐8 urban schools. Interventions for Tier 2 consisted of three manualized group cognitive behavioral therapy (GCBT) protocols for externalizing behavior problems, depression, and anxiety. Tier 1 and Tier 2 interventions were implemented with fidelity but program feasibility for Tier 2 was in question because school personnel needed a great deal of external support to implement the interventions. Tier 1 interventions were associated with a decrease in office discipline referrals. Students participating in GCBT showed a significant decrease in mental health diagnostic severity at posttreatment. A discussion of perceived and actual implementation barriers and how they were addressed is provided. Implications for practice in low‐income urban schools are discussed.

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The earthquake in Haiti led to an outpouring of outreach from groups of the Haitian international community as well as to residents of the island. Thus, an understanding of the help-seeking behavior patterns of this group is necessary to make meaning of their receptivity of assistance in a time of need. This paper summarizes help-seeking behavior patterns of 150 Haitian immigrants residing in the US. The results indicate that, overall, this sample was more likely to go to their family for assistance, regardless of the nature of the problem. In contrast, they were least likely to go to professionals for help, even when in need of emotional assistance. Given the increased rate of Haitians living outside of Haiti and around the world, a more comprehensive understanding of their mental health needs, coping patterns, and barriers to seeking help from mental health professionals is warranted.

BackgroundSchools present a context with great potential for the implementation of psychosocial evidence-based practices. Cognitive behavioral therapy (CBT) is an evidence-based practice that has been found to be very effective in treating anxiety in various community settings, including schools. Friends for Life (FRIENDS) is an efficacious group CBT protocol for anxiety. Unfortunately, evidence-based practices for anxiety are seldom employed in under-resourced urban schools, because many treatment protocols are not a good fit for the urban school context or the population, existing behavioral health staff do not receive adequate training or support to allow them to implement the treatment with fidelity, or school districts do not have the resources to contract with external consultants. In our prior work, we adapted FRIENDS to create a more culturally sensitive, focused, and feasible CBT protocol for anxiety disorders (CBT for Anxiety Treatment in Schools (CATS)).Methods/designThe aim of this 5-year study is to evaluate both the effectiveness of CATS for urban public schools compared to the original FRIENDS as well as compare the implementation strategies (train-the-trainer vs. train-the-trainer + ongoing consultation) by conducting a three-arm, parallel group, type 2 hybrid effectiveness-implementation trial in 18 K-8 urban public schools. We will also assess the cost-effectiveness and the mediators and moderators of fidelity. Ninety therapists, 18 agency supervisors, and 360 children will participate. The interactive systems framework for dissemination and implementation guides the training and support procedures for therapists and supervisors.DiscussionThis study has the potential to demonstrate that agency therapists and supervisors who have had little to no prior exposure to evidence-based practices (EBPs) can implement an anxiety disorder EBP with fidelity. Comparisons of the implementation strategies would provide large urban mental health systems with data to make decisions about the adoption of EBPs.Trial registrationClinicalTrials.gov, NCT02651402