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 We are analyzing whether a series of 16 CBT telehealth sessions might have similar benefits for residents impacted by poverty, crime, and violence.

What did we do?
In late 2020 and early 2021, ONSE piloted one-on-one CBT sessions with residents dealing with trauma stemming from poverty, crime, and violence. Participants met twice a week for eight weeks with a dedicated therapist and were compensated for their time. The Lab helped design this pilot as a randomized control trial but shifted to a case study due to implementation challenges. Ultimately, we documented a population facing significant challenges to their mental health and wellbeing. For example, 96% of participants reported at least one traumatic exposure and the average study participant reported experiencing racial discrimination three times per week.

What have we learned?
A final report is forthcoming.

What comes next?
For violence-reduction organizations providing therapeutic services, there are multiple considerations for effective delivery that include how the service is promoted, how the service is tailored to the unique individual, and how a lack of basic needs being met may detract from the full benefit of therapeutic services.

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.