Bringing What Works to Youth in Prison: An Evidence-Based Trauma Intervention

为监狱中的青少年提供有效的方法：循证创伤干预

• 批准号: 8323233
• 负责人: Molly A. Lopez
• 金额: $ 26.69万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8323233
• 关键词: Address; Administrator; Adolescent; Adult; Anxiety Disorders; Attitude; Caring; Characteristics; Child Abuse; Childhood; Client; Clinical; Clinical Trials Design; Cognitive Therapy; Communities; Complex; Consent; Consultations; Data; Depressive disorder; Diagnosis; Disease; Domestic Violence; Educational workshop; Effectiveness; Emotional; Enrollment; Ensure; Event; Evidence based treatment; Exposure to; Family; Feasibility Studies; General Population; Goals; Impairment; Imprisonment; Intervention; Justice; Knowledge; Lead; Measures; Mental Health; Mental disorders; Modeling; Modification; Monitor; National Institute of Mental Health; Outcome; Parents; Participant; Pilot Projects; Population; Post-Traumatic Stress Disorders; Prevalence; Prisons; Problem behavior; Process; Productivity; Protocols documentation; Provider; Public Health; Quality of life; Research; Risk Factors; Sampling; Screening procedure; Services; Societies; Strategic Planning; Symptoms; System; Telephone; Testing; Texas; Time; Training; Trauma; Treatment Effectiveness; Treatment Efficacy; Violence; Waiting Lists; Work; Youth; base; community setting; correctional system; cost; design; effective therapy; evidence base; experience; high risk; improved; information gathering; juvenile justice system; meetings; model design; psychologic; rearrest

DESCRIPTION (provided by applicant): Finding effective treatments for incarcerated youth with mental health problems is a critical public health need. Adolescents residing in juvenile correctional facilities have high rates of exposure to traumatic events (e.g., child abuse, domestic violence, community violence) and elevated rates of mental disorders. The long-term outcomes for these youth are disheartening. Correctional systems are limited in their ability to address these complex psychological needs, and administrators and clinicians need research-based guidance to identify which treatments offer the best opportunity to reduce risk factors and enhance the resiliency of youth in their care. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has been shown to be effective with a variety of youth and in a variety of community settings, but has not been studied in correctional settings. Several characteristics of the juvenile justice setting, such as limited availability of parents, may impede implementation. The proposed study has three primary aims: (1) to adapt the TF-CBT protocol to increase its transportability into the prison setting; (2) to conduct a feasibility study of this modified TF-CBT; and (3) to identify factors that facilitate or inhibit the effectiveness of TF-CBT within the prison setting. To accomplish these aims, a team of stakeholders with experience using TF-CBT in a correctional setting will work with one of the treatment developers to adapt the model to address any barriers to its use. Following adaptation, eight to ten practitioners employed within three high-restriction correctional facilities will receive advanced training in TF-CBT followed by nine months of coaching and technical assistance. Youth will be enrolled in a pilot study to determine the feasibility of the screening, recruitment, and consent processes and to examine the acceptability and tolerability of the treatment approach to youth and participating families. Youth receiving TF-CBT will be compared to similar youth waiting for services to explore any differences between groups in changes in emotional and behavioral problems over time. The study will also explore youth, provider, and organizational characteristics that impact treatment effectiveness with this setting. This pilot study will provide preliminary information on the feasibility of implementing a modified version of TF-CBT within juvenile correctional facilities and provide guidance for future research endeavors. The proposed project will begin to address a critical gap in knowledge about effective strategies for treating trauma-related mental disorders in incarcerated youth.

描述（由申请人提供）：为有心理健康问题的被监禁青少年寻找有效的治疗方法是一项重要的公共卫生需求。居住在少年管教所的青少年遭受创伤事件（例如虐待儿童、家庭暴力、社区暴力）的几率很高，精神障碍的发生率也很高。这些年轻人的长期结果令人沮丧。惩教系统解决这些复杂的心理需求的能力有限，管理人员和临床医生需要基于研究的指导，以确定哪些治疗方法最有机会减少风险因素并增强青少年在护理中的适应能力。以创伤为中心的认知行为疗法 (TF-CBT) 已被证明对各种青少年和各种社区环境有效，但尚未在惩教环境中进行研究。少年司法环境的几个特点，例如父母的参与有限，可能会阻碍实施。拟议的研究有三个主要目标：（1）调整 TF-CBT 协议以提高其在监狱环境中的可移植性； (2) 对改进的TF-CBT进行可行性研究； (3) 确定监狱环境中促进或抑制 TF-CBT 有效性的因素。为了实现这些目标，具有在惩教环境中使用 TF-CBT 经验的利益相关者团队将与治疗开发人员之一合作，调整模型以解决其使用的任何障碍。适应后，三个高限制惩教设施中雇用的八到十名从业人员将接受 TF-CBT 高级培训，然后是九个月的辅导和技术援助。青少年将参加一项试点研究，以确定筛选、招募和同意程序的可行性，并检查青少年和参与家庭的治疗方法的可接受性和耐受性。接受 TF-CBT 的青少年将与等待服务的类似青少年进行比较，以探索不同群体之间情绪和行为问题随时间变化的差异。该研究还将探讨在这种情况下影响治疗效果的青少年、提供者和组织特征。这项试点研究将为在青少年惩教设施内实施改良版 TF-CBT 的可行性提供初步信息，并为未来的研究工作提供指导。拟议的项目将开始解决在治疗被监禁青少年创伤相关精神障碍的有效策略方面的知识空白。