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Helping Children Heal Project

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  • To be or not to be that is the question
  • In September, recognizing the pressing need and importance of providing continued education for the children of New Orleans,
  • Transcript

    • 1. Leslie E. Lawrence, M.D. Tulane University School of Medicine Department of Psychiatry and Neurology 1
    • 2. Helping Children Heal Project Introduction An innovative school-based community research developed post Hurricane Katrina Survey Type Research Medical Students, Residents, Faculty To assist in the post-disaster mental health recovery of children 2
    • 3. Helping Children Heal Project Introduction Arnold P. Gold Foundation: advances humanism in medicine Katrina Assistance Fund Grant (2005): Mark Viron, M.D. and Janet Johnson, M.D. Mercy Corps- My personal Story of Hurricanes Katrina and Rita. 3
    • 4. Helping Children Heal Project Introduction Monday, August 29, Hurricane Katrina made landfall in New Orleans metro area Levees Failed---Horrific Aftermath Submerging 80% of New Orleans One of the Greatest Tragedies in United States History 4
    • 5. Helping Children Heal Project Introduction In Louisiana alone, over 1,000 people lost their lives Countless others lost their homes, their jobs, and their way of life Katrina left the people of New Orleans scattered across the country, with many, including school-age children, now in Houston, Texas 5
    • 6. Helping Children Heal Project Introduction American Psychiatric Association and the Campaign for Mental Health Reform noted:  “For an estimated 30 % of hurricane victims and relief workers, the magnitude and duration of the traumas they are experiencing place them at great risk for developing post-traumatic stress disorder (PTSD), other anxiety disorders (e.g. panic disorder), severe depression and other mental and emotional disorders.” 6
    • 7. Helping Children Heal Project Introduction September, 2005, recognizing need and importance of providing continued education for the children of New Orleans Knowledge Is Power Program (KIPP) Teach for America Houston Independent School district 7
    • 8. Helping Children Heal Project Introduction New Orleans West College Preparatory School (NOW)  K-8 charter school in Houston exclusively for children displaced from New Orleans 8
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    • 10. Helping Children Heal Project Introduction Student Population of NOW: 100% African-American Historically impoverished areas of New Orleans Homes destroyed by Katrina 10
    • 11. Helping Children Heal Project Introduction Administrators of NOW: Structure Stability Support 11
    • 12. Helping Children Heal Project Introduction Risk Factors for Children at NOW school: Witnessed Traumatic Events Trapped Lost their homes, belonging, pets, friends and family  At the very least, all must start life over at a new school in a new city 12
    • 13. Helping Children Heal Project Introduction Problem: Increased number of behavioral and emotional problems  NOW administrators contacted Tulane University Department of Psychiatry & Neurology* Requested assistance in dealing with the psychological effects of Katrina 13
    • 14. Helping Children Heal Project Introduction NOW administrators Teachers Tulane University Dept of Psychiatry & Neurology Helping Children Heal (HCH) project. 14
    • 15. Helping Children Heal Project Research (NOW) OBJECTIVES: Determine the prevalence of PTSS among the children of a middle school in post-Katrina New Orleans Evaluate the effect of a guided-workbook intervention 15
    • 16. Helping Children Heal Project Research (NOW) METHODS: The National Child Traumatic Stress Network Custom screening Tool The University of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Children by Gilbert Kliman, et al. 16
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    • 22. Helping Children Heal Project Research (NOW) RESULTS: For grades 6-8, post-traumatic symptom level scores declined 18.75% compared with pre- assessment scores (median of 32 to 26). This was statistically significant (p=.0001). 22
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    • 27. Helping Children Heal Project Research (McDonogh #15) Same Research Different Location; New Orleans Same Administrators Different Population 27
    • 28. Helping Children Heal Project Research (McDonogh #15) Objective Methods* Community Education on PTSD Results Arnold P. Gold Foundation; Poetry Books 28
    • 29. Helping Children Heal Project Research (McDonogh #15) OBJECTIVES: Determine the prevalence of PTSS among the children of a middle school in post-Katrina New Orleans Evaluate the effect of a guided-workbook intervention 29
    • 30. Helping Children Heal Project Research (McDonogh #15) METHODS: The National Child Traumatic Stress Network Custom screening Tool The University of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Children by Gilbert Kliman, et al. 30
    • 31. Helping Children Heal Project Research (McDonogh #15) COMMUNITY EDUCATION: PTSD Types of Stressors: During the Hurricane(Trapped In Superdome) Afterwards (Living in a trailer) PTSD Treatment 31
    • 32. Helping Children Heal Project Research (McDonogh #15) RESULTS: Before the workbook, the median RI score was 24, and 54 students (46%) displayed moderate to severe PTSS. Post-workbook, 43 students (37%) displayed moderate to severe PTSS, and the median RI score decreased by 17% to 20 (p=.0096). 32
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    • 41. Helping Children Heal Project Research Conclusions Guided workbook may be a simple and effective intervention to reduce post-traumatic stress in children exposed to hurricanes Numerous confounders need to be considered Home Environment Classroom Resilience of Each Child Supportive Factors Passage of Time 41
    • 42. Helping Children Heal Project 42
    • 43. Helping Children Heal Project References  Pynoos R, Rodriguez N, Steinberg A, Stuber M, Frederick C: The UCLA PTSD Reaction Index for DSM IV (Revision 1). Los Angeles, UCLA Trauma Psychiatry Program, 1998  Kliman G, Oklan E, Wolfe H, Kliman J: My Personal Story about Hurricanes Katrina and Rita: A Guided Activity Workbook for Middle and High School Students. San Francisco, The Children's Psychological Health Center, 2005  Mishkin, AD, Viron M, Lawrence LE, Johnson JE, Samples G, Kliman G. Reducing Post-Traumatic Stress after Hurricane Katrina: A School-Based Intervention. Poster presented at the 59th Institute on Psychiatric Services Annual Meeting, New Orleans, LA, October 11-14, 2007  Lawrence LE, Viron M, Johnson JE, Hudkins A, Samples G, Kliman G: A school-based mental health recovery effort. Poster presented at the 58th Institute on Psychiatric Services Annual Meeting, New York, NY, October 5- 8, 2006 43