Evaluating the Implementation of Bounce Back: Clinicians’ Perspectives on a School-Based Trauma Intervention

Bounce Back is a school-based program developed to reduce the negative psychological impact of trauma for elementary school children, and research has shown its effectiveness. Recently, Bounce Back was piloted in a large urban school district using a community partnership model. Clinicians can provide important insights into challenges and promoting factors that are essential for the successful implementation and future scale-up of the program. Two focus groups were conducted with 10 Bounce Back providers serving diverse elementary students in the school district. In addition, quantitative measures of fidelity, satisfaction, school organizational structure, and treatment outcomes were examined. Focus groups were audio-recorded, transcribed, and coded by trained research assistants and themes were identified using ecological models of implementation. Clinicians reported high satisfaction with the program. Several challenges were universal across schools, including limited resources, time intensity of the program, and lack of trauma awareness among members of the school community. Schools with stronger implementation were identified and differentiating factors were examined. Overall, highly supportive school climates and administrations were associated with stronger implementation. However, the effects of less supportive climate and leadership could be mitigated with support from community partnerships and clinician flexibility and creativity. Results from this study underscore the importance of multiple levels of support for providers of Bounce Back.