Empowering Trauma-Affected Youth through DREAMs: The Developing Relational, Emotional, and Adaptive Minds Program

Background and Purpose: Recent scholarship demonstrates trauma is occurring at an epidemic level among youth in the U.S., with nearly 60% of youth experiencing substantial adversity before the age of 18. Childhood adversity can modify or interfere with fundamental cognitive, behavioral, and regulatory processes that are essential for an array of desirable developmental outcomes, such as academic achievement and positive relationships. Meanwhile, the risk of experiencing childhood adversity is not equally distributed in the U.S., where structural and interpersonal racism have resulted in Black or African-American youth being significantly more likely to experience trauma than their White peers. In addition to the increased risk, Black youth are also less likely to receive mental health care more generally. Providing accessible and trauma-responsive interventions is key for addressing the disparities in youth mental health services, and the potential effects resulting from trauma exposure. In response, the present study aims to address this need through a new school-based intervention, Developing Relational, Emotional, and Adaptive Minds (DREAMs). We hypothesized that participants receiving DREAMs will 1) show improvements in cognitive functioning, and 2) socio-emotional health.

Methods: The current study uses a pre-post design with purposive sampling. Collaboration with families, 5 Pittsburgh-area schools, and research team members, facilitated the enrollment of 41 students grades 5-8 with significant exposure to on average four Adverse Childhood Experiences. Eighty-five percent of participants were African American. The DREAMs intervention was informed by principles pulled from Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT). Principles derived from CBT include psychoeducation pertaining to the interdependent relationship between thoughts, emotions, and behaviors; cognitive restructuring; and emotion identification. Principles rooted in DBT include skills training related to distress tolerance, emotion regulation, and preemptive emotional coping. Lastly, to create greater access, DREAMs was designed as a manualized treatment to be delivered by non-licensed clinicians after completing comprehensive trainings. Eleven weekly group sessions and individual check-ins were conducted. Validated measures such as the CID-2, CALS, SDQ, DERS, PEARLS, and NIH Toolbox assessed student outcomes. Data analysis involved one-way ANOVA and two-sample t-tests to examine changes in cognitive functioning and social-emotional health.

Results: The analysis revealed significant improvements in cognitive functioning and socio-emotional health across various domains. Students exhibited reduced depressive symptoms, enhanced emotional awareness and clarity, diminished psychosomatic symptoms, and fewer peer-related issues. Cognitive assessments showed significant improvements in processing speed and gains in episodic memory recall. Feedback from participants was overwhelmingly positive; 97% would recommend DREAMs to peers and expressed interest in future participation. Additionally, 97% perceived DREAMs as a safe environment for discussing personal experiences, compared to 68% for their schools overall.

Conclusions and Implications: Given the observed socio-emotional benefits, cognitive enhancements, high program acceptability, and school-aged students’ critical need for trauma-supports, partners should streamline trauma-informed, manualized treatments that can be easily implemented in school spaces, where accessibility for youth is highest. Further, teacher training programs should emphasize the high prevalence of trauma amongst today’s youth. These efforts may mitigate adverse effects resulting from trauma and school environments being potentially triggering environments.