Can cognitive behavioral therapy improve mental health

Why is this issue important in DC?
Experiencing violence or other forms of personal, family, and community trauma can lead to post-traumatic stress disorder (PTSD), anxiety, and depression. CBT is a therapeutic approach that has shown positive effects in managing these conditions in the general population. Prolonged, in-person therapy has also been shown to reduce violent crime, arrests, and antisocial behavior in teenagers and young adults similar to residents of ONSE priority communities. ^2,3 Our goal is to see if a series of 16 CBT telehealth sessions might also have similar benefits for residents impacted by poverty, crime, and violence.

What are we doing?
Our goal is to recruit 160 DC residents and offer CBT services to half via a random lottery. Participants will meet twice a week for eight weeks with a dedicated therapist who will address mental health diagnosis resulting from exposure to violence. Secondarily, therapists will provide patients with behavioral tools to use in heated moments that might escalate to violence. Participants will be compensated for their time. We will measure mental health outcomes with participant surveys and use administrative data to measure violence and employment outcomes.

What have we learned?
We expect results to be released in mid-2021.

What comes next?
The primary outcome of the study is to evaluate the effectiveness of CBT on PTSD. We expect this pilot to inform the District’s ongoing efforts to serve communities affected by violence, particularly as it launches the Building Blocks DC strategy to increase access to services for people and places affected by violence. This study also has a qualitative component. The Lab @ DC will conduct interviews examining barriers to community safety and nonviolence.

What happened behind the scenes?
While CBT can provide valuable mental health tools for use in potentially violent confrontations, we recognize that using CBT as an anti-violence tool places the onus of reducing violence on victims of poverty and personal, family, and community trauma. This logic fails to account for the systemic inequalities that lead to violence in the first place. For this reason, we made mental health the primary outcome of interest, while treating any positive effects on public safety and employment as secondary benefits of CBT.