Grief and Trauma Intervention (GTI) for Children
About This Program
Target Population: Children who are experiencing grief and posttraumatic stress
For children/adolescents ages: 7 – 12
For parents/caregivers of children ages: 7 – 12
Program Overview
GTI is designed for children ages 7 to 12 with posttraumatic stress due to witnessing or being a direct victim of one or more types of violence or a disaster, or due to experiencing or witnessing the death of a loved one, including death by homicide. The purpose of the intervention is to improve symptoms of posttraumatic stress, depression, and traumatic grief. The intervention is conducted with children in a group or individual format in 10 sessions of approximately 1 hour with at least one session with the parent. The techniques used in the sessions are grounded in cognitive-behavioral therapy (CBT) and narrative therapy and include narrative exposure to the trauma (through drawing, discussing, and writing), development of an in-depth, coherent narrative while eliciting the child's thoughts and feelings, development of positive coping strategies, and making meaning of losses.
Program Goals
The goals of Grief and Trauma Intervention (GTI) for Children are:
- Learn more about grief and traumatic reactions
- Express thoughts and feelings about what happened
- Decrease posttraumatic stress reactions
- Build coping capacity
Logic Model
The program representative did not provide information about a Logic Model for Grief and Trauma Intervention (GTI) for Children.
Essential Components
The essential components of the Grief and Trauma Intervention (GTI) for Children include:
- Individual or group format
- Parent meetings
- Integrate cognitive-behavioral methods and narrative practice skills to address traumatic stress and grief and loss
- Three Phases:
- Resilience: Promote resilience
- Restorative Retelling: Guide the children through restorative retelling
- Reconnecting: Build connections
- Ground the interventions in the DEC:
- Developmentally appropriate
- Ecological perspective
- Culturally relevant
Program Delivery
Child/Adolescent Services
Grief and Trauma Intervention (GTI) for Children directly provides services to children/adolescents and addresses the following:
- Posttraumatic stress, depression, and internalizing and externalizing symptoms
Parent/Caregiver Services
Grief and Trauma Intervention (GTI) for Children directly provides services to parents/caregivers and addresses the following:
- Parent of a child who is experiencing posttraumatic stress and grief
Services Involve Family/Support Structures:
This program involves the family or other support systems in the individual's treatment: There is at least one parent-child meeting although additional family sessions (including other family members or just with the parent) can be added as needed.
Recommended Intensity:
Weekly one-hour meetings (group or individual) plus at least one parent/caregiver meeting
Recommended Duration:
Estimated 12 weeks
Delivery Settings
This program is typically conducted in a(n):
- Adoptive Home
- Outpatient Clinic
- Group or Residential Care
- School Setting (Including: Day Care, Day Treatment Programs, etc.)
Homework
This program does not include a homework component.
Resources Needed to Run Program
The typical resources for implementing the program are:
Copies of worksheets, art supplies, and private space/room
Manuals and Training
Prerequisite/Minimum Provider Qualifications
Master's degree in mental health related field
Manual Information
There is a manual that describes how to deliver this program.
Training Information
There is training available for this program.
Training Contact:
- Alison Salloum, PhD
asalloum@usf.edu
Training Type/Location:
Training may be provided on-site and it is also offered annually at the Children's Bureau of New Orleans.
Number of days/hours:
Two-day training and consultation through at least one cycle of implementation of GTI for Children
Additional Resources:
There currently are additional qualified resources for training:
Training is also offered by the Children's Bureau of New Orleans. Contact the training contact above for more information.
Implementation Information
Pre-Implementation Materials
There are no pre-implementation materials to measure organizational or provider readiness for Grief and Trauma Intervention (GTI) for Children.
Formal Support for Implementation
There is formal support available for implementation of Grief and Trauma Intervention (GTI) for Children as listed below:
Consultation throughout the implementation of GTI for Children may be provided as part of the training package.
Fidelity Measures
There are fidelity measures for Grief and Trauma Intervention (GTI) for Children as listed below:
In the treatment manual, the there is a chapter on adherence to GTI and a fidelity checklist is provided. See Salloum, A. (2015). Grief and trauma in children: An evidence-based treatment manual. Routledge.
Implementation Guides or Manuals
There are implementation guides or manuals for Grief and Trauma Intervention (GTI) for Children as listed below:
The intervention manual, Grief and trauma in children: An evidence-based treatment manual, has been published and is available for purchase online at https://www.routledge.com/products/9780415708296
Research on How to Implement the Program
Research has been conducted on how to implement Grief and Trauma Intervention (GTI) for Children as listed below:
Salloum, A., & Smyth, K. (2013). Clinicians' experiences of a podcast series on implementing a manualized treatment. Journal of Technology in Human Services, 31(1), 71-83. https://doi.org/10.1080/15228835.2012.738382
Relevant Published, Peer-Reviewed Research
Child Welfare Outcome: Child/Family Well-Being
Salloum, A., & Overstreet, S. (2008). Evaluation of individual and group grief and trauma interventions for children post disaster. Journal of Clinical Child and Adolescent Psychology, 37(3), 495–507. https://doi.org/10.1080/15374410802148194
Type of Study:
Randomized controlled trial
Number of Participants:
56
Population:
- Age — 7–12 years
- Race/Ethnicity — 51% African American, 2% African American/Native American, 2% Caucasian, and 2% Hispanic
- Gender — 64% Male and 36% Female
- Status — Participants were children who experienced different types of potentially traumatic events.
Location/Institution: Children's Bureau of New Orleans, Louisiana
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate a community-based grief and trauma intervention for children, Project Last [now called Grief and Trauma Intervention (GTI) for Children] conducted post-disaster. Participants were randomly assigned to two treatment groups: individual treatment and group treatment, all receiving Project Last. Measures utilized include the UCLA Posttraumatic Stress Disorder Index for DSM–IV (UCLA–PTSD-Index), the Mood and Feelings Questionnaire–Child Version (MFQ–C), and the UCLA Grief Inventory–Revised. Results indicate that there was a significant decrease in all outcome measures over time, and there were no differences in outcomes between children who participated in the group intervention and those who participated in the individual intervention. Limitations include the lack of an untreated control group, small sample size, high attrition rate, and length of follow-up.
Length of controlled postintervention follow-up: 1–31 days (Mean=20 days).
Salloum, A., & Overstreet, S. (2012). Grief and trauma intervention for children after disaster: Exploring coping skills versus trauma narration. Behaviour Research and Therapy, 50(3), 169–179. https://doi.org/10.1016/j.brat.2012.01.001
Type of Study:
Randomized controlled trial
Number of Participants:
70
Population:
- Age — 6–12 years
- Race/Ethnicity — 100% African American
- Gender — 39 Male and 31 Female
- Status — Participants were children who experienced different types of potentially traumatic events in Hurricanes Katrina and Gustav.
Location/Institution: Not specified
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) [now called Grief and Trauma Invention (GTI) for Children] and coping skills only (C). Participants were randomly assigned to two groups: 1) GTI with coping skills and narrative construction (GTI-CN) and 2) GTI with coping skills (GTI-C). Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures utilized include the Mood and Feelings Questionnaire-Child Version (MFQ-C), the UCLA Posttraumatic Stress Disorder Index for DSM-IV (UCLA-PTSD Index), the Extended Grief Inventory, Multidimensional Scale of Perceived Social Support (MSPSS), the Child Behavior Checklist (CBCL), and the Things I Have Seen and Heard Survey. Results indicate that children assigned to GTI-CN reported expressing their thoughts and feelings more than the GTI-C group, who tended to report learning more ways to cope than children in the GTI-CN group. Additionally, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Limitations include the lack of an untreated control group, small sample size, inability to collect all parent assessment data, the social support measure used did not allow for subscales of social support to be explored, difficulty measuring the extent of trauma due to schools not allowing video or audio recordings of the treatment, and finally concerns about reliability of self-reported measures, which may introduce bias.
Length of controlled postintervention follow-up: 3 months and 12 months.
Additional References
Salloum, A. (2015). Grief and trauma in children: An evidence-based treatment manual. Routledge.
Salloum, A., Garfield, L., Irwin, A., Anderson, A., & Francois, A. (2009). Grief and trauma group therapy with children after Hurricane Katrina. Social Work with Groups, 32(1-2), 67-79. https://doi.org/10.1080/01609510802290958
Salloum, A., & Rynearson, E. K. (2006). Family resilience after violent death. In E. K. Rynearson (Ed.), Violent death: Resilience and intervention beyond the crisis (pp.47-64). Routledge Publishing.
Contact Information
- Alison Salloum, PhD
- Email: asalloum@usf.edu
- Phone: (813) 974-1535
- Fax: (813) 974-4675
Date Research Evidence Last Reviewed by CEBC: November 2023
Date Program Content Last Reviewed by Program Staff: August 2022
Date Program Originally Loaded onto CEBC: July 2016
