A Solution-Focused Group Approach for Crisis Prevention and Early Intervention Among Traumatized and Stressed Youth: A Feasibility Trial in Alternative High Schools

Background: The COVID-19 pandemic has markedly affected youth mental health with about 69% suffering from post-traumatic stress and over a third of high school students experiencing persistent sadness and hopelessness (Bhushan et al., 2022; CDC, 2020). This situation underscores an urgent need for effective crisis intervention. Traditional crisis interventions, which are mainly deficit-based, have fallen short in addressing these issues. This study investigates the development and implementation of a strengths-based, trauma-informed, solution-focused (SF) group crisis prevention and early intervention program in alternative high schools in a large Southern state. Focusing on students with high levels of stress and trauma, we assessed the program's feasibility, acceptability, and adaptability, and measured post-traumatic growth, including areas of hope, subjective well-being, solution-focused thinking, and perceived stress levels.

Methods: A single-arm design was employed to recruit high school students ages 14-21 from four alternative high schools using the adapted Child/Youth Assessment and Referral (CRAR) Tool for eligibility based on prior history of trauma or current heightened trauma symptoms. Of the 41 students screened, 18 met the inclusion criteria and participated in the six-week intervention, with 12 completing it for final analysis. Participants’ average age was 15.67, two-thirds (66.67%) identified as female and two-thirds (66.67%) identified as Hispanics/Latino. Paired-sample t-tests were used to evaluate mean changes and effect sizes pre- and post-intervention in post-traumatic growth domains. Repeated measures ANOVA (time * trauma) was used to explore time and trauma score interaction effects (Murrar & Brauer, 2018).

Results: The intervention showed promising outcomes for high-needs, traumatized youth in enhancing school connectedness (Cohen’s d = 0.41, , 95% CI [-0.46, 1.27]), joy of learning (d = 0.53, 95% CI [-0.21, 1.27]), and overall well-being (d = 0.35, 95% CI [-0.41, 1.11]). It showed feasibility and high fidelity to the Solution-Focused Brief Therapy approach with an 86.01% adherence rate. Participant satisfaction was high with the majority attending at least four sessions. Significant reductions in perceived stress levels (Cohen’s d = 0.81, 95% CI [-4.89, 0.06]) and notable improvements in hope and solution-focused skills (d = 0.70, 95% CI [-0.10, 1.49]) were observed, suggesting the intervention’s efficacy. The program's adaptability was highlighted by outcomes based on trauma history, with students from lower socioeconomic backgrounds and at risk of dropout experiencing significant benefits, underscoring its applicability and impact across diverse student populations.

Implications: Findings indicate that solution-focused crisis prevention and early intervention shows promise as a supplement to school mental health services for supporting stressed and traumatized youth. Future research should examine long-term school outcomes through follow-ups to assess the effects on active coping strategies and post-traumatic growth. Future studies should also build on culturally specific, trauma-informed solution-focused techniques and the change processes identified in this study to inform full-scale clinical trials via research-community partnerships.