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In-School Counseling Program Improves Teen Girls’ PTSD Symptoms

Study finds that program decreased PTSD symptoms by 22%, depression by 14%, and anxiety by nearly 10%

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Our research makes it clear that there is real need for programs designed for young women, and that well-designed programs can be both effective and cost-effective.”

Jonathan Guryan
IPR economist

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Young women, especially Black and Latina girls, suffer disproportionately from trauma-related depression, PTSD, and anxiety, yet little is known about treatment options.

Recent research by IPR economist Jonathan Guryan and his colleagues at UChicago’s Education Lab shows that school-based group counseling programs could be an effective option, and significantly improve PTSD, anxiety, and depression symptoms.

The study, published in Science Advances, examines the effectiveness and affordability of Working on Womanhood (WOW), a trauma-informed, relationship-centered counseling and mentoring school-based counseling program designed by and for Black and Latina women. The program is rooted in cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and narrative therapy and was developed and delivered by Youth Guidance, a social services provider based in Chicago.

The study is the first large-scale randomized controlled trial of such an initiative for young women in Chicago. Across the 2017–18 and 2018–19 school years, 3,749 high school girls in 10 public schools in Chicago participated in the study. A baseline survey found that 38% of the tenth and eleventh graders surveyed exhibit signs of PTSD—or twice that of service members returning from Iraq and Afghanistan. 

The young women surveyed had experienced, on average, two serious traumatic experiences in their lifetimes. Nearly 30% had witnessed someone being attacked, stabbed, shot at, hurt badly, or killed. More than 45% had someone close die suddenly or violently. Twenty-four percent scored within the clinical or at-risk range for anxiety and 27% within the same range for depression. 

The research finds that attending the weekly in-school counseling program for four months decreased participants’ PTSD symptoms by 22%, depression by 14%, and anxiety by nearly 10%.

The results suggest that group-based, in-school therapy programs such as WOW can improve mental health symptoms. They also highlight the lack of alternative mental health services available to young women. The authors determine that WOW appears highly cost-effective when judged based on its ability to alleviate mental health symptoms.

Despite quantifying the success of combining CBT, ACT, and narrative therapy in group-based counseling in schools, the study shows some girls had more profound mental health challenges and more significant needs that weren't appropriate for group-based interventions. The researchers suggest that future work should examine how to support these high schoolers.

In addition, the researchers emphasize that mental health interventions in schools should be evaluated using the same criteria as those used in evaluating other interventions to extend life and improve health.

“Many young women suffer in ways that are internalized and therefore can be harder to see. As a result, we don’t provide them with the supports they need,” Guryan said. “Our research makes it clear that there is real need for programs designed for young women, and that well-designed programs can be both effective and cost-effective.”

Jonathan Guryan is the Lawyer Taylor Professor of Education and Social Policy and chair of IPR’s research program on education policy. He also co-directs the UChicago Education Lab.

The research was supported by the AbbVie Foundation, Arnold Ventures, Paul M. Angell Family Foundation, Edna McConnell Clark Foundation, Logan Foundation, MacArthur Foundation, Polk Foundation, and the U.S. Department of Justice.

Photo Credit: UChicago’s Education Lab

Published: August 2, 2023.