Summary: Layne CM, Pynoos RS, and Cardenas J. "Wounded adolescence: School-based group psychotherapy for adolescents who sustained or witnessed violent injury," in Shafii M and Shafii SL, School Violence: Assessment, Management, Prevention, 163-186. Washington, American Psychiatric Press. 2001.

It is estimated that 1.8 million American adolescents have suffered from posttraumatic stress disorder (PTSD) at some time during their lives. Rates of PTSD are particularly high among those who have been both witnesses to and victims of violence. School-based programs offer an opportunity to offer psychological services to these young people.

Researchers at UCLA piloted a group-counseling program to help students at a multiracial public high school in the Los Angeles area who had moderate to severe symptoms of PTSD. In many cases these students had been victims and/or witnesses of multiple extreme traumas. In addition to their PTSD symptoms, these students also displayed developmental disturbances. After their trauma their relationships with friends and family had been strained, and their academic performance had declined.

The UCLA program was designed to address the students' PTSD and also help the students get back on track educationally and developmentally. In group sessions, these young people recounted their trauma histories. It was often the case that an older trauma-especially one that involved being a witness to violence-had been the most upsetting to them. In recounting their traumas, and learning about what their peers had been through, the students came to realize that they were not alone and that their reactions to trauma and their interpersonal problems were not unique. With the guidance of a psychologist, they explored their feelings, revealed their psychological and physical scars, learned strategies for coping with their emotions, and came to trust and rely on other group members. They were encouraged to try to reconnect with friends and family, and to make plans for the future-plans that many had put on hold after their traumas.

Thirteen months later, the program's participants wrote essays on their progress and were evaluated in interviews. While one student had experienced another traumatic event and had new PTSD symptoms because of it, other group members improved at least moderately. Their depression, hopelessness, and symptoms of PTSD had diminished, and they were making plans for their futures.