Evaluating the Support for Students Exposed to Trauma (SSET) intervention: multi-domain indicators of change among trauma-exposed adolescents

Introduction and objective: This study presents findings from a clustered randomised controlled trial evaluating the Support for Students Exposed to Trauma (SSET) intervention among trauma-exposed adolescents in public schools of Azad Jammu and Kashmir, Pakistan. Against a backdrop of political unrest, war-related escalations, disasters, and chronic displacement, children in this region face heightened psychological vulnerability. The 10-week intervention was designed to address core trauma-related difficulties using structured, evidence-informed techniques appropriate for low-resource educational settings. Materials and methods: A total of 131 students aged 10–16 were assigned to intervention and control clusters. To assess the effectiveness of SSET, five outcome domains – post-traumatic stress symptoms, psychological distress, behavioural/emotional problems, perceived social support, and resilience – were measured at pre-, post-, and 3-month follow-up stages. These indicators were selected based on the SSET programme’s theoretical foundations in cognitive-behavioural and trauma-informed approaches, each targeting specific emotional and interpersonal capacities expected to change through intervention. Results: Statistical analysis using mixed-design ANOVA revealed significant improvements across all five indicators in the intervention group. Notably, reductions in post-traumatic stress disorder symptoms, emotional/behavioural problems, and psychological distress were accompanied by increased perceptions of social support and resilience. Conclusions: The findings provide strong evidence of the intervention’s effectiveness and demonstrate how schools in under-resourced regions can serve as vital platforms for delivering early psychological interventions.