Treatment Of Trauma Research Articles

Complications after conservative vs. operative treatment of severe thoracic trauma

Thoracic trauma is afrequent injury in the routine treatment of injured patients. Due to the increasing demographic changes afurther increase is to be expected, especially after low-energy trauma. Expected complications after conservative vs. operative treatment of various injury patterns of thoracic trauma. Evaluation of aselective literature search regarding possible complications after thoracic trauma and formulation of instructions for action as expert recommendations. Both conservative and operative treatment of thoracic trauma have their specific complications, which have to be known to the treating physician. Lung contusions are often underestimated in the initial radiological diagnostics but often lead to relevant problems during the further course of treatment. After conservative treatment of rib fractures persistent pain, functional limitations or even relevant deformities due to secondary dislocation, can remain. There is asignificant risk of overlooking or underestimating relevant injuries during the initial diagnostics which then leads to secondary complications. By far the most frequent risk of surgical treatment is an incorrect positioning of chest tubes. Overall, postoperative infections after chest trauma are relatively rare.

Anterior Full-endoscopic Single-port Double Transcorporeal Spinal Cord Decompression for Noncontinuous Two-segment Cervical Spondylotic Myelopathy: A Technical Note.

In clinical practice, noncontinuous two-segment spinal cord cervical spondylosis is a particular form of cervical degenerative disease. Traditional anterior open surgery frequently comes with severe trauma, risks, and debatable treatment options. This study aimed to describe for the first time a novel minimally invasive technique, namely, anterior full-endoscopic single-port double transcorporeal spinal cord decompression for the treatment of patients with noncontinuous two-segment cervical spondylotic myelopathy. From February 2020 to May 2021, five patients with noncontinuous two-segment cervical spondylotic myelopathy were treated with anterior full-endoscopic single-port double transcorporeal spinal cord decompression. Two bone channels were established by the trephine through the vertebral body oblique upward and downward to the herniated disc osteophyte complex, and the full-endoscopic system could decompress the spinal cord through the channels. All cases were followed up for over 2 years. The modified Japanese Orthopaedic Association (mJOA) score and visual analogue scale (VAS) score before and after operation and during follow-up were used to evaluate the clinical effectiveness. Radiological examinations, including CT and MRI, were utilized to evaluate the efficacy of spinal cord decompression and bone channel repair. All operations were successfully completed and the average operation time was 185 min, with no operation-related complications. Compared with the preoperative evaluation, the mJOA score and VAS score were improved at each time point after operation and follow-up. Postoperative CT and MRI scans showed that the intervertebral disc-osteophyte complex was removed through the vertebral bone passage, and the spinal cord was fully decompressed. After 24 months of follow-up, CT and MRI scans showed that the bone channel was almost repaired and healed. Anterior full-endoscopic single-port double transcorporeal spinal cord decompression is an effective minimally invasive technique for noncontinuous two-segment cervical spondylosis. It provides precise and satisfactory spinal cord decompression under endoscopic visualization with minimum trauma.

Use of a statewide solid organ injury procotcol to optimize triage, treatment, and transfer for pediatric abdominal trauma.

The Utah Pediatric Trauma Network (UPTN) is a non-competitive collaboration of all 51 hospitals in the state of Utah with the purpose of improving pediatric trauma care. Created in 2019, UPTN has implemented evidence-based guidelines based on hospital resources and capabilities with quarterly review of data collected in a network-specific database. A blunt solid organ injury (SOI) protocol was developed to optimize treatment of these injuries statewide. The purpose of this study was to review the effectiveness of the SOI guideline. The UPTN REDCap® database was retrospectively reviewed from 2021 through 2022. We compared admissions from the Level 1 pediatric trauma center (PED1) to non-pediatric hospitals (non-PED1) of children with low-grade (I-II) and high-grade (III-V) SOIs. In 2 years, 172 patients were treated for blunt SOI, with or without concomitant injuries. There were 48 (28%) low-grade and 124 (72%) high-grade SOIs. 33 (69%) patients were triaged with low-grade SOI injuries at a non-PED1 center, and 17 (35%) were transferred to the PED1 hospital. Most had multiple injuries, but 7 (44%) were isolated, and none required a transfusion or any procedure/operation at either hospital. Of the 124 patients with high-grade injuries, 41 (33%) primarily presented to the PED1 center, and 44 (35%) were transferred there. Of these, 2 required a splenectomy and none required angiography. Thirty-nine children were treated at non-PED1 centers without transfer, and 4 required splenectomy and 6 underwent angiography/embolization procedures. No patient with an isolated SOI died. Implementation of SOI guidelines across UPTN successfully allowed non-pediatric hospitals to safely admit children with low-grade isolated SOI, keeping families closer to home, while standardizing pediatric triage for blunt abdominal trauma in the state. Therapeutic/Care Management; Level IV.

Trauma and psychosocial adversity in youth with autism spectrum disorder and intellectual disability.

Traumatic experiences contribute significantly to behavioral and mood dysregulation syndromes presenting for treatment to behavioral health settings. Individuals with Autism Spectrum Disorder (ASD), Intellectual Disability (ID) and developmental delay experience traumatic events more frequently than their typically developing peers. However, measures used to identify trauma related disorders and treatment thereof are based on typically developing individuals. Regardless of the baseline characteristics of individuals who experience trauma, trauma exposure is the result of multiple interdependent environmental, social, and familial characteristics. We used the "ecological systems analysis approach" to structure our review of the impact of trauma on those with ASD and ID. In addition, the COVID-19 pandemic which exposed the global population to a collective trauma, has also catalyzed investigations into the challenges faced by members of society most dependent on social services. Children with ASD and ID were among those vulnerable individuals, and the COVID-19 pandemic has allowed researchers to better understand the impact of a collective trauma on those individuals. It is imperative that we understand current research and recommendations for identifying and treating trauma-related disorders in individuals with developmental disorders to best inform clinical practice and directions for future research in this area.

BAMBOO for Refugees—A Culturally Sensitive Positive Psychology Intervention: A Protocol for a Pilot Randomized Controlled Trial

This protocol investigates the efficacy of a mental health and psychosocial support (MHPSS) program named BAMBOO. The goal of this program is to increase resilience and mental well-being among refugees. In recent years, there has been an increasing number of refugees fleeing to Europe and applying for permanent residence. In the Netherlands, a wide variety of programs that focus on increasing mental well-being among refugees is available. BAMBOO is a strengths-based intervention, which consists of five weekly two-hour group-based sessions. It is based on the theoretical framework of positive psychology and adapted according to the guidelines for the implementation of culturally sensitive cognitive behavioral therapy among refugees. The program does not focus on the treatment of trauma, mental disorders, or underlying problems, but aims to increase factors such as personal strengths, positive emotions, positive relations, and self-esteem. The first version of the program (BAMBOO 1.0) has been conducted at over 50 asylum centers in the Netherlands since January 2020. In the time period from September 2020 to September 2022, qualitative and quantitative data were collected among BAMBOO trainers and participants and the program was adapted, leading to a revised version (BAMBOO 2.0). A single-blinded parallel pilot randomized controlled trial, with an intervention group and awaiting list control group, with 34 participants per group will be used to test the program’s efficacy. Outcomes include resilience, satisfaction with life, positive and negative affect, and self-esteem. The study will be conducted among adult Arabic speaking refugees, residing at an asylum center in the Netherlands and/ or in a Dutch municipality, Baseline, post-intervention, and five-week follow-up assessments will be conducted. This paper describes the protocol for the evaluation of a novel and culturally adapted program. The study will shed light on the efficacy of a culturally sensitive strengths-based intervention as a preventive approach to increase refugee well-being. ERB Tilburg University, TSB RP623.

Study protocol and rationale for a pilot randomized clinical trial comparing processing of positive memories technique with supportive counseling for PTSD

BackgroundResearch indicates that positive memories have a role in posttraumatic stress disorder's (PTSD) symptomatology and treatment. Following treatment development guidelines, a novel PTSD intervention – Processing of Positive Memories Technique (PPMT) – was developed and subsequently examined for its effects and feasibility in pilot studies. Extending this research, the proposed pilot randomized clinical trial with PPMT and Supportive Counseling (SC) arms will examine PPMT's effects on PTSD severity and biomarkers of stress systems' dysregulation (awakening salivary alpha amylase [sAA] and cortisol concentrations); examine mechanistic targets (affect) underlying PPMT's effects; and refine PPMT. We hypothesize that the PPMT arm will report greater decreases in PTSD severity and greater decreases in awakening sAA/cortisol ratio compared to the SC arm; and that improved affect (more positive affect and less negative affect) will mediate associations between intervention arm and changes in PTSD severity. MethodsWe will recruit 70 individuals aged 18–65 years with PTSD. They will be randomized to 5 weekly therapy sessions of PPMT or SC, and will be assessed at baseline, weekly during treatment, 1-week post-treatment, and 3-months post-treatment. Primary outcomes are past-week PTSD severity, past-week positive and negative affect levels, and feedback data on PPMT's feasibility, format, and content. The secondary outcome is the awakening sAA/cortisol ratio. Statistical analyses include mixed-effect models and within-subjects cross-lag longitudinal mediation analyses. ConclusionStudy results will advance knowledge of trauma interventions by examining effects and feasibility of a novel PTSD intervention, and by elucidating potential mechanisms underlying PPMT's effects.Clinical Trials #: NCT05523453

Somatic/Psychic Interventions for The Treatment of Trauma and Addictions

The following is from a keynote given at the 2nd International Conference on Addictions & Psychiatry, 2023. A brief description of somatic/psychic interventions is presented, and the common healing elements of these treatment are described. They are resourcing, titration, dyadic neural processing, and repeated exposures over time to facilitate the encoding of new positive neural pathways. A case study is presented illustrating how the therapeutic relationship intersects with the interventions during the treatment of trauma, especially developmental trauma.

Augmented reality-based surgical navigation of pelvic screw placement: an ex-vivo experimental feasibility study

BackgroundMinimally invasive surgical treatment of pelvic trauma requires a significant level of surgical training and technical expertise. Novel imaging and navigation technologies have always driven surgical technique, and with head-mounted displays being commercially available nowadays, the assessment of such Augmented Reality (AR) devices in a specific surgical setting is appropriate.MethodsIn this ex-vivo feasibility study, an AR-based surgical navigation system was assessed in a specific clinical scenario with standard pelvic and acetabular screw pathways. The system has the following components: an optical-see-through Head Mounted Display, a specifically designed modular AR software, and surgical tool tracking using pose estimation with synthetic square markers.ResultsThe success rate for entry point navigation was 93.8%, the overall translational deviation of drill pathways was 3.99 ± 1.77 mm, and the overall rotational deviation of drill pathways was 4.3 ± 1.8°. There was no relevant theoretic screw perforation, as shown by 88.7% Grade 0–1 and 100% Grade 0–2 rating in our pelvic screw perforation score. Regarding screw length, 103 ± 8% of the planned pathway length could be realized successfully.ConclusionThe novel innovative system assessed in this experimental study provided proof-of-concept for the feasibility of percutaneous screw placement in the pelvis and, thus, could easily be adapted to a specific clinical scenario. The system showed comparable performance with other computer-aided solutions while providing specific advantages such as true 3D vision without intraoperative radiation; however, it needs further improvement and must still undergo regulatory body approval. Future endeavors include intraoperative registration and optimized tool tracking.

Outcomes in very elderly ICU patients surgically treated for proximal femur fractures.

Proximal femur fractures (PFF) are a common injury in elderly patients that significantly impact mobility and daily living activities. Mortality rates in this population are also high, making effective treatment essential. Recent advances in intensive and geriatric care have enabled complex surgical interventions that were previously not feasible. However, there is a lack of studies focusing on outcome parameters in very elderly patients (≥ 90years) who receive intensive care treatment following PFFs. In this retrospective study, we analyzed multi-layered data of 148 patients who were 90years or older and received intensive care after trauma and orthopedic surgical treatment for PFFs or periprosthetic fractures between 2009 and 2019. All patients received a 365-day follow-up. To identify potential predictors of mortality, all deceased and surviving patients were subjected to multiple logistic regression analyses. We found that 22% of patients deceased during in-hospital care, and one-year survival was 44%. Independent predictors of one-year all-cause mortality included higher CCI and SOFA scores at ICU admission. Overall, 53% of patients who resided in private dwellings prior to admission were able to return home. Our study highlights the utility of using CCI and SOFA scores at ICU admission as prognostic indicators in critically ill very elderly patients who undergo surgical treatment for PFFs. These scores can provide valuable insight into the severity of illness and potential outcomes, which can inform resource allocation, prioritize endangered patients, and aid in end-of-life discussions and planning with patients and their families. Our findings can help improve the management of PFFs in very elderly patients and contribute to optimized patient care.

How Does Trauma Make You Sick? The Role of Attachment in Explaining Somatic Symptoms of Survivors of Childhood Trauma.

Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders.

PRACTICE makes progress, a self-care course for mental health professionals in the child trauma field: A preliminary investigation.

Mental health professionals who work with clients exposed to trauma commonly experience secondary traumatic stress (STS) and burnout, which have a well-documented negative impact on clinicians as well as clients. As self-care has been identified as a protective factor against STS and burnout, the current study aimed to examine the effects of a self-care course for mental health professionals working with trauma-exposed clients. This pretest-posttest pilot study examined the impact of a six-session virtual self-care course on the well-being of 43 mental health professionals previously trained in Trauma-focused Cognitive Behavioral Therapy(TF-CBT), a well-established, evidence-based treatment for childhood trauma. The components of TF-CBT comprise the acronym PRACTICE, and we are referring to this self-care course as PRACTICE Makes Progress (PMP), as participants receive weekly assignments that encourage the use of many of the same PRACTICE skills clients are taught in the context of TF-CBT. Results comparing pre- and postcourse survey responses indicated significant increases in the use of PRACTICE skills (p = .006, d = .44) as well as the utilization of humor as a coping skill (p < .001, d = .53), and significant decreases in STS symptoms (p < .001, d = .63) and burnout (p = .004, d = .47). These results provide preliminary evidence that mental health professionals working with clients exposed to trauma may benefit from participation in an evidence-informed, standalone virtual self-care course. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Meeting at the precipice: Creative visualization in the treatment of trauma

ABSTRACT This paper illustrates the integration of guided visualization, drawn from clinical hypnosis, in a self-psychologically informed treatment with a traumatized patient. In providing a hypnotic script, I serve as a witness and felt presence as I accompany the patient as she draws upon her imagination. Images and written reflections engage her capacity to creatively symbolize her childhood trauma with distance and reflective space. Eye Movement Desensitization and Reprocessing (EMDR) therapy unlocks state-dependent memories and stimulates new associations and self-compassion. Within a psychodynamic framework, these creative interventions titrate the destabilizing impact of traumatic recall by empowering the patient as an active agent, utilizing her creative resources to create an expanded, healing narrative.

The effectiveness of electronic screening and brief intervention for alcohol-related maxillofacial trauma: a randomized controlled trial

ObjectivesThis study aims to deliver a novel web-app-based electronic Screening and Brief Intervention to patients with alcohol-related facial trauma and assess changes in at-risk drinking behaviors and attitudes towards their drinking and alcohol-related trauma. Study design, setting, and sampleThis was a two-arm parallel randomized controlled trial. Participants who had sustained alcohol-related facial injuries were recruited from three Australian hospitals. Results56 participants were enrolled and randomized initially with 45 participants completing the questionnaire at baseline and 3-month follow-up. Most of the participants were male (71.1%), aged between 18 and 29 (40%), and presented to the ED for the first time (68.9%). The study revealed that the intervention group participants found the information provided via the e-SBI helpful in changing their drinking habits and seek help. The e-SBI intervention had a moderate effect on ASSIST Scores (d=-.59; 95% CI, -.03, 1.18). The effect sizes of the e-SBI on the secondary outcomes also ranged between small and moderate. ConclusionsThe novel app-based e-SBI can effectively deliver information on harmful drinking and provide brief intervention and other venues for help and subsequently improve awareness and willingness to seek help and reduce the risk of injury recurrence. Statement of Clinical RelevanceElectronic Screening and Brief Intervention may provide a means of bypassing clinician based limitations of training and time constraints for tertiary prevention for patients who have sustained alcohol related facial trauma, this project encourages further larger studies in the future to assess the effectiveness of this modality of prevention.

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers.

Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related posttraumatic stress symptoms (PTSS) with various sleep markers in this population. Patients newly diagnosed with colorectal cancer ( n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months after diagnosis) and their sleep-partner caregivers ( n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived. Actor-partner interdependence model revealed that caregivers' greater alterations in arousal and reactivity were associated with their own longer SOL ( b = 15.59, p < .001) and their patients' longer sleep duration ( b = 0.61, p = .014), whereas patients' arousal and reactivity were associated with their caregivers' shorter SOL ( b = -8.47, p = .050). Patients' and caregivers' greater negative alterations in cognitions and mood were associated with patients' longer SOL ( b = 9.15, p = .014) and shorter sleep duration ( b = -0.41, p = .050), respectively. Caregivers' greater intrusion was related to their own shorter SOL ( b = -10.14, p = .004). The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

Speaking Out: Graphic Narrative as Alternative Jurisdiction

Taking its cue from the recent “graphic turn” in law and humanities scholarship, this essay explores the potentially enabling possibilities of graphic literature as a site of doing justice. In particular, it connects critical work on graphic justice with recent theorisations of victims’ justice to ask whether graphic narrative(s) might provide an alternate space, or what Leigh Gilmore terms an “alternative jurisdiction,” that allows victims of international crimes and/or grave human rights violations to claim justice outside the formal bounds of law. From this perspective, the inquiry pursues two complementary aims. First, it seeks to offer new insight into the possibilities of graphic narrative to give voice to the lived experience of trauma and injustice – not just as testimony or evidence, nor as a mere humanistic gloss on the rigidly defined terrain of law, but rather as a form of justice itself. Second, it looks to present a set of fresh reflections on international law’s treatment of violent trauma, and on the sites and spaces within which victims’ justice might be effectively addressed and attained.

Evaluation of an online pilot ‘Complex trauma stabilisation’ group intervention in an adult mental health service

BackgroundComplex-PTSD causes distressing symptoms. NICE guidelines recommend a phased treatment approach, but there are often gaps within services providing psychological treatments for CPTSD. A pilot service in East Anglia aimed to fill gaps in current service provision. An online CPTSD group intervention was developed, focusing on phase one of trauma treatment: stabilisation. AimThis project aimed to evaluate the pilot online CPTSD stabilisation group intervention by exploring if group attendance was associated with changes in CPTSD symptoms, and to explore participant experiences. MethodParticipants attended a 12-session, two-hour, weekly group programme, held online via MS Teams. Three additional individual sessions were offered before, during and after the group. Sixty-six participants completed the programme; of whom 40 completed four pre-post outcome measures (DERS, PTCI, TMQQ, ITQ), and 25 completed an anonymous feedback survey. ResultsPaired t-tests comparing pre-post measure scores showed statistically significant differences across all measures, with medium effect sizes. Lower scores were seen after group completion, indicating the group was associated with reduced CPTSD symptoms. Participant feedback indicated most participants (83 %) expressed a preference for online delivery and 68 % found the intervention beneficial. Conclusions & implicationsAttendance of the pilot online CPTSD stabilisation group intervention was associated with symptom reduction and positive feedback. This appears to be the first online, mixed-gender CPTSD stabilisation group evaluation. Ultimately results are promising, though suggest further research is warranted to establish if such groups would provide an effective treatment for CTPSD and help reduce NHS waitlists. Service recommendations are discussed.

Clinical Control Trial on the Healing Drawing Procedure (HDP) Trauma Treatment Intervention Provided by Non-Specialist Mental Health Providers to Vulnerable Children Living in Taraz, Republic of Kazakhstan

Clinical Control Trial on the Healing Drawing Procedure (HDP) Trauma Treatment Intervention Provided by Non-Specialist Mental Health Providers to Vulnerable Children Living in Taraz, Republic of Kazakhstan

Renal injuries in conflict zones: a 6-year study of traumatic cases in Afghanistan

PurposeDuring hostilities, gunshot wounds are the most common cause of penetrating injuries. In 8–10% of abdominal injuries kidneys are involved. The treatment method include surgical or conservative treatment (fluids + blood components).MethodsOf 1266 combat trauma cases treated during 6 to 14 rotation of the Polish Military Contingent in Afghanistan, we extracted a subgroup of 44 kidney injuries. Corelation of trauma mechanism, PATI score, treatment methods, and outcomes was evaluated.ResultsOut of the 41 renal injuries, 20 considered left, 18 right, and 3 both kidneys. There were no statistical significancy in injury lateralization (p = 0.669), and no differences regarding side of a trauma and quantity of blood component used for the treatment (p = 0.246). Nephrectomy was performed on 17 patients (13 left vs. 4 right). A significant correlation between PATI score and the need for a nephrectomy (p = 0.027) was confirmed. Penetrating trauma recquired higher number of blood components comparing to blunt trauma (p < 0.001). The renal salvage rate was in study group was 61.36%. The overall survival (OS) rate was 90.25% − 4 patients died due to trauma.ConclusionsThe damage side does not result in a statistically significant increase in the need for blood transfusions or differences in the PATI score. The mechanism of trauma does, however, affect the number of blood components required for treatment, particularly in cases of penetrating trauma. With the introduction of proper treatment, the overall survival rate exceeds 90%, even when opting for conservative treatment.

Educational effects of and satisfaction with mixed-reality-based major trauma care simulator: A preliminary evaluation.

Mixed reality (MR) is a hybrid system that projects virtual elements into reality. MR technology provides immersive learning using various real-world tools. However, studies on educational programs using MR are scarce. This study aimed to investigate the educational effects of and satisfaction with an MR-based trauma decision-making simulator. A total 40 of trainees self-selected to participate in this study. All of them participated in the MR trauma simulator for approximately 30 minutes and conducted voluntary learning without any external help. Declarative knowledge, measured using 20 multiple-choice questions, was assessed before and after MR trauma training. To confirm the educational effect, test scores before and after MR trauma training were compared using a paired t-test. Student satisfaction after training was measured using a ten-item questionnaire rated on a five-point Likert scale. A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased (from a mean of 42.3, SD 12.4-54.8, SD 13) after the MR-based trauma assessment and treatment training (P < .001). Of the participants, 79.45% were satisfied with the overall experience of using the MR simulator. This study demonstrated a meaningful educational effect of the MR-based trauma training system even after a short training time.

Examining the Classroom Impact of the Bounce Back Trauma Intervention: Implications for Selecting Progress Monitoring Tools

Limited research has examined the impact of Bounce Back (BB), a trauma-focused intervention for elementary-age students, on student academic engagement and daily classroom behavior. This study utilized both ongoing direct and indirect measures of student functioning to evaluate student progress and inform the implementation of BB. Participants were six U.S. students (four male and two female). We employed an AB single-subject design across cases with follow-up, and we collected data via the Direct Behavior Rating–Single Item Scale (DBR-SIS). We also employed a quasi-experimental pretest–posttest design using the Strengths and Difficulties Questionnaire (SDQ), Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), and mySAEBRS across raters before/after intervention implementation. We found either direct or indirect assessment could be used to monitor intervention effectiveness for youth who presented with some internalizing and externalizing problems, whereas indirect measures (i.e., rating scales) showed the primary effect for youth with solely internalizing problems, and direct assessment (i.e., DBR-SIS) showed the primary effect for youth with predominantly externalizing behaviors. Selecting progress-monitoring tools based on presenting concerns is important to adequately monitor the effectiveness of school-based mental health interventions. Implications for practice are discussed.