Breathe in and Breathe out: A Formative Evaluation of the Trauma-Informed Mind Matters Program for Adolescents Living in Poverty

Background: Adolescence is an ideal time to reach youth, particularly high risk, with programs aimed to build resiliency. Youth living in communities marked by poverty are exposed to heightened stress and often experience multiple adverse childhood events. When stress is prolonged and chronic, it can disrupt the development of brain circuits, increase levels of stress hormones, and cause the onset lasting physical, mental, and emotional problems. Further, a new form of trauma—COVID-19— has emerged worldwide and evokes consideration of youth challenges and outcomes. The aim of this study was to conduct a formative evaluation to assess the feasibility, acceptability, and youth’s use of skills from Mind Matters: Overcoming Adversity and Building Resilience, a newly developed program aimed to build resiliency among youth who have experienced trauma.

Methods: Just prior to the U.S. outbreak of the pandemic, the PI conducted focus groups with middle- and high-schoolers (N=14; M_age =13; 85% Hispanic) who had participated in the 12-lesson Mind Matters program in an after-school setting. Three months later (March 2020), the lead case manager conducted interviews with available youth (N=5) by phone. Youth lived in a zip code ranked among the poorest in the U.S. and having among the highest COVID-related deaths. Focus group questions solicited youth’s perspectives of the program, what they learned, and their suggestions for program improvement. Interview questions assessed what youth remembered, as well how they were utilizing the skills. Dialogue was recorded and transcribed. Focus group were coded thematically, and a flexible template was then formed by which to deductively elaborate on themes using interview data.

Results: Youth felt that the program provided a sense of community, a safe space to discuss and cope with trauma, and fostered self-discovery. Youth described the program as relatable,“...I didn’t know that all this had something to do with me, but then I’m like oh my god. I always feel this. I always do that...I’m so glad I’ve done this program”. Dialogue reflected the content and skills imparted, including emotion regulation, self-soothing, and understanding the impact of trauma. Youth described how they were utilizing the skills in home, peer, and school environments, “There was this girl. She was talking like all her mess and then I went (does deep breathing). It calmed me down like a lot.” Some youth felt that the program could be improved in that it was too complex and more time was needed to discuss each topic. One youth disclosed being triggered by an abusive home situation, “[The instructor] said something, I felt uncomfortable, and I went under the table...”. Data from follow-up interviews found that youth were still utilizing specific skills to help them cope with the pandemic.

Conclusion: There has been a dearth of research examining resiliency-building programs for youth who have experienced trauma and particularly as related to the pandemic. Findings suggest that evidence-based coping skills can be imparted in an after-school setting, and that these may continue to hold relevance to youth over time and across multiple contexts.