For children in military families, a parent's wartime deployment can be a frightening and traumatic experience. But one USC School of Social Work professor will use a $1.8 million federal grant to help prevent long-term mental-health disturbances, including post-traumatic stress disorder (PTSD), from developing in this vulnerable population.

Assistant Dean and Clinical Professor of Field Education Marleen Wong and her partners at RAND, UCLA Health Services Research Center and the Los Angeles Unified School District (LAUSD) were recently awarded funds from the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop trauma interventions for military children that can be implemented during the regular school day.

The researchers have received a total of $5.2 million in SAMHSA grants since 2002.

Wong and her colleagues, who formed the Trauma Services Adaption (TSA) Center for Resiliency, Hope and Wellness in Schools, created the Cognitive Behavioral Intervention for Trauma in Schools (CBITS). This nationally recognized, evidence-based program provides mental health screening and 10 weeks of therapy sessions in public schools to reduce symptoms related to existing traumatic experiences and build skills to handle future stress. The work is based on cognitive-behavioral therapy, recognized by the U.S. Task Force on Community Preventive Services as the only approach with strong evidence of effectiveness to back it up.

Wong, who once served as the director of mental health and crisis intervention for LAUSD, spearheaded the development of CBITS nearly a decade ago to treat thousands of LAUSD students suffering from full-blown PTSD after experiencing neighborhood, school and family violence. The intervention was soon adopted by the National Child Traumatic Stress Network and is now used in public schools across the country.

Over the next three years, CBITS will be reworked to fit the unique needs of children in military families.

But the undertaking will present a significant challenge for the group, Wong said. While the program has been geared toward healing after trauma symptoms have set in, this time around, the group will have to investigate how to prevent these symptoms from cropping up all together.

"We want to reach these kids before the symptoms of severe depression and PTSD begin – before boys start acting out aggressively and girls start withdrawing. Before school attendance starts to drop and sleep is lost," Wong said. "This is a very new challenge, and there is very little research delving into this area. And, of course, it makes it more difficult that to know we are successful, we will essentially have to prove a negative."

Wong said nearly every aspect of a parent's deployment can trigger a traumatic reaction in children, from preparing for a parent to leave for more than a year to worrying about a parent's safety oversees — something completely beyond their control. Even reuniting with a parent can be an emotionally-damaging situation.

"A reunion can be fraught with emotional minefields for children, especially if the parent comes back dealing with his or her own emotional baggage after being in a warzone," she said. "Suddenly the parent isn't acting like he did when he went away, and that can be traumatic."

One of the biggest questions the group will attempt to answer is how best to mitigate the psychological effects of multiple deployments, which have become increasingly common as some members of the military prepare for their fourth of fifth tours of duty in Iraq and Afghanistan.

"The more times a parent goes away, the less resilient their child becomes," Wong said.

The TSA plans to expand the existing CBITS program during the new grant period. Initiatives include promoting CBITS training in schools of social work, clinical psychology and child psychiatry; creating a program to educate more trainers; and developing a certificate program for new practitioners.

Clinical associate professors Steve Hydon and Jose Coll, director of the USC School of Social Work's military social work program, will join the longstanding program to add expertise to the development of evidence-based and trauma-informed internships for graduate students specializing in school social work.

The partners also plan to create a website for teachers and other adults who are not mental health professionals to recognize and work with children who have undergone traumatic experiences. Wong said trauma-related depression and PTSD look different in children than adults, and are often overlooked by teachers and parents. Males typically become disruptive and aggressive, while females often withdraw from school activities and become very quiet. Students stop attending school regularly and often appear glassy-eyed and sleep at their desks because they are up all night sick with anxiety.

"Basically, a student with PTSD looks like a failing student," she said.