Examining the Effects of a Trauma-Informed School-Based Preventive Intervention on Adolescent Mental Health and Substance Use

Background and Purpose:
Adverse childhood experiences (ACEs) are strongly associated with adolescent mental health challenges and substance use. Trauma-informed approaches have gained attention as promising strategies for school-based prevention. This study evaluated Rise Above, a trauma-informed intervention designed to promote mental health and reduce substance use among children and adolescents with high rates of ACEs.

Methods:
A quasi-experimental design was used to compare students in the intervention group (n = 48) to a control group (n = 58), for a total sample of N = 106, on measures of anxiety, depression, somatization, overall psychological distress, and substance use. Data were collected using pre- and post-intervention surveys and analyzed using mixed-design ANOVAs, controlling for age and sex. The Rise Above program was delivered in small groups (5–13 students) across four public middle schools. The curriculum consisted of 16 lessons taught twice weekly for about 40 minutes.

Rise Above is a trauma-informed, group-based intervention designed specifically for 4th–8th graders. It integrates cognitive-behavioral preventive strategies into a social-emotional learning (SEL) framework to address the impacts of stressful life events, including ACEs. The program targets key risk factors such as emotion dysregulation, impulsivity, and stress sensitivity by fostering adaptive coping strategies, stress management skills, and prosocial behaviors. The intervention also targeted developmental vulnerabilities associated with ACEs, with a focus on promoting psychological resilience and enhancing drug resistance skills. It aims to build long-term resilience and support healthy development, particularly for youth exposed to adversity.

Results:
The 106 participants ranged in age from approximately 11 to 14 years (M = 13.1, SD = 0.7) and were predominantly female (61.3%). The sample was divided into a comparison group (n = 58; M age = 12.8, SD = 0.7) and an intervention group (n = 48; M age = 13.4, SD = 0.5). Most (78.0%) reported experiencing at least one ACE. Notably, 22.6% of the total sample reported experiencing five or more ACEs. Self-rated physical health was similar across groups, with a mean score of 2.5 (SD = 0.9), where lower scores indicated better perceived health. Furthermore, no significant baseline differences were observed between the groups for mental health and substance use outcomes. Compared to the control group, students in the intervention group demonstrated significant reductions in depressive symptoms (p < .01), overall psychological distress (p < .01), and willingness to use alcohol (p < .05). Modest improvements were also noted in anxiety and somatization. Effect sizes (partial η²) ranged from .024 to .039, indicating small-to-moderate intervention effects.

Conclusions and Implications:
These findings suggest that trauma-informed interventions like Rise Above can effectively improve mental health outcomes and reduce substance use risk in adolescents exposed to ACEs. Integrating such models into school-based prevention efforts represents a feasible and equity-driven strategy aligned with social work values. School-based programs that integrate trauma-informed principles and resilience-building strategies may offer a realistic and impactful social work approach to supporting youth in high-risk communities.