Notes from the Field: Trauma Groups delivered online during COVID-19
Meg Smith, MSW, LICSW, ACSW & Paul Reinert, MSW, LICSW
We will describe here our recent and very interesting experience in the online implementation of Bounce Back, a group intervention to support elementary-age students affected by traumatic stress, to two Emotional Impairment (EI) classrooms in a K-8 Boston Public School. The group leaders learned important lessons about adapting the group treatment to online delivery with this special needs population of students during the COVID-19 pandemic.
One advantage of delivering a group treatment to an existing small class of students is that they already know each other and scheduling is much easier. Also, the behavior management and incentive system used throughout the EI program was easily adapted to support positive behavior in the group sessions. It was also helpful to have full buy-in of the EI teachers and staff to support and reinforce the skills that the students were learning in the group sessions. Implementing within an existing program was made easier than groups comprised of students from different classrooms who may not know each other, and have different classroom rules.
Because of online delivery of the intervention and the specific population of students in our two groups, some adjustments were made to accommodate the context. We decided to use a co-facilitation model in which two licensed social workers co-led the groups. This allowed for one leader to use the chat function on Zoom to provide support and keep students engaged who might be getting distracted. Another necessary adaptation was to increase the number of sessions. Bounce Back is designed for 10 weeks of in-person sessions. However, we found it necessary to deliver at a much slower pace given the special emotional needs of the students, and the online delivery format. This allowed for better uptake of the content and allowed for much more time devoted to practicing the skills. More sessions also enabled us to include time for substantial physical activity breaks that our students need to be able to sustain focus during the group sessions. Self-regulation skills were given a high priority because these skills are essential given the heightened levels of stress that all students are experiencing during the pandemic. These skills were included regularly in whatever additional weekly content was introduced.
One surprise was the extent to which the students were less interested in engagement with one another and instead, were more interested in engaging with the adult group leaders. Normally, one of the strengths of the Bounce Back group intervention is the extent to which peer support can be developed, but this turned out to be more challenging than expected because of students’ preoccupation with obtaining the attention of the adults. This points to the importance of school-based adult relationships for students with special needs (and presumably for all students), and how students are experiencing the loss of these relationships during the pandemic.
It was helpful to use the group sessions to engage with real-time COVID-19 issues expressed by students, and by using the skills practiced in the groups to anticipate challenges the students will face as they return to in-person learning. In this way, the skills learned in the Bounce Back group intervention are directly related to their larger school experiences. Our experience demonstrates that Bounce Back is able to be adapted very successfully for online delivery in programs for children with serious emotional and behavioral challenges. The co-facilitators also enjoyed the opportunity to provide skills training in a format that students perceived as fun and reported looking forward to each session. No small benefit in these difficult times of remote learning.