Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: We agree with Dr Rappaport that involvement
of teachers and school administrators is an important component of the entire
program. As we have discussed in greater detail elsewhere,1,2 we
involved teachers and school administrators from the early stages of program
development and evaluation design. We paid extensive attention to ensuring
the program's cultural competency, including the use of bilingual, bicultural
therapists, and the pretesting of program and evaluation materials in this
population. We believe that these efforts have been an important part of both
the program's effectiveness and its acceptability to schools, parents, and
students. Because the school-level interventions (increased teacher support
and education) happened for all students, they cannot be responsible for the
differences between the early intervention and delayed intervention groups.
However, these interventions could have contributed to the improvement in
the delayed intervention group in the period prior to receiving our intervention.
Stein BD, Elliot MN, Tu W, Jaycox LH, Kataoka SH, Fink A, Wong M. School-Based Interventions for Children Exposed to Violence. JAMA. 2003;290(19):2541. doi:10.1001/jama.290.19.2541-a