Leslie E. Lawrence, M.D.
Tulane University School of Medicine
Department of Psychiatry and Neurology
1
Helping Children Heal Project
Introduction
An innovative school-based community research
developed post Hurricane Katrina...
Helping Children Heal Project
Introduction
Arnold P. Gold Foundation: advances humanism in
medicine
Katrina Assistance F...
Helping Children Heal Project
Introduction
Monday, August 29, Hurricane Katrina made landfall
in New Orleans metro area
...
Helping Children Heal Project
Introduction
In Louisiana alone, over 1,000 people lost their lives
Countless others lost ...
Helping Children Heal Project
Introduction
American Psychiatric Association and the Campaign
for Mental Health Reform not...
Helping Children Heal Project
Introduction
September, 2005, recognizing need and importance
of providing continued educat...
Helping Children Heal Project
Introduction
New Orleans West College Preparatory School
(NOW)
 K-8 charter school in Hous...
9
Helping Children Heal Project
Introduction
Student Population of NOW:
100% African-American
Historically impoverished ar...
Helping Children Heal Project
Introduction
Administrators of NOW:
Structure
Stability
Support
11
Helping Children Heal Project
Introduction
Risk Factors for Children at NOW school:
Witnessed Traumatic Events
Trapped
...
Helping Children Heal Project
Introduction
Problem:
Increased number of behavioral and emotional
problems
 NOW administ...
Helping Children Heal Project
Introduction
NOW administrators
Teachers
Tulane University Dept of Psychiatry & Neurology...
Helping Children Heal Project
Research (NOW)
OBJECTIVES:
Determine the prevalence of PTSS among the
children of a middle ...
Helping Children Heal Project
Research (NOW)
METHODS:
The National Child Traumatic Stress Network
Custom screening Tool
...
17
18
19
20
21
Helping Children Heal Project
Research (NOW)
RESULTS: For grades 6-8, post-traumatic symptom
level scores declined 18.75%...
23
24
25
26
Helping Children Heal Project
Research (McDonogh #15)
Same Research
Different Location; New Orleans
Same Administrators...
Helping Children Heal Project
Research (McDonogh #15)
Objective
Methods*
Community Education on PTSD
Results
Arnold P...
Helping Children Heal Project
Research (McDonogh #15)
OBJECTIVES:
Determine the prevalence of PTSS among the
children of ...
Helping Children Heal Project
Research (McDonogh #15)
METHODS:
The National Child Traumatic Stress Network
Custom screeni...
Helping Children Heal Project
Research (McDonogh #15)
COMMUNITY EDUCATION:
PTSD
Types of Stressors:
During the Hurrica...
Helping Children Heal Project
Research (McDonogh #15)
RESULTS: Before the workbook, the median RI
score was 24, and 54 st...
33
34
35
36
37
38
39
40
Helping Children Heal Project
Research Conclusions
Guided workbook may be a simple and effective
intervention to reduce p...
Helping Children Heal Project
42
Helping Children Heal Project
References
 Pynoos R, Rodriguez N, Steinberg A, Stuber M, Frederick C: The UCLA
PTSD Reacti...
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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,
  • Helping Children Heal Project

    1. 1. Leslie E. Lawrence, M.D. Tulane University School of Medicine Department of Psychiatry and Neurology 1
    2. 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. 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. 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. 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. 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. 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. 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
    9. 9. 9
    10. 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. 11. Helping Children Heal Project Introduction Administrators of NOW: Structure Stability Support 11
    12. 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. 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. 14. Helping Children Heal Project Introduction NOW administrators Teachers Tulane University Dept of Psychiatry & Neurology Helping Children Heal (HCH) project. 14
    15. 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. 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
    17. 17. 17
    18. 18. 18
    19. 19. 19
    20. 20. 20
    21. 21. 21
    22. 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
    23. 23. 23
    24. 24. 24
    25. 25. 25
    26. 26. 26
    27. 27. Helping Children Heal Project Research (McDonogh #15) Same Research Different Location; New Orleans Same Administrators Different Population 27
    28. 28. Helping Children Heal Project Research (McDonogh #15) Objective Methods* Community Education on PTSD Results Arnold P. Gold Foundation; Poetry Books 28
    29. 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. 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. 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. 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
    33. 33. 33
    34. 34. 34
    35. 35. 35
    36. 36. 36
    37. 37. 37
    38. 38. 38
    39. 39. 39
    40. 40. 40
    41. 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. 42. Helping Children Heal Project 42
    43. 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
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