A Brief Family-Based Program to Bridge Youth on Probation to Trauma-Specific Treatment

一个简短的以家庭为基础的计划，以帮助缓刑青少年接受创伤特定治疗

• 批准号: 10591873
• 负责人: Corianna Sichel
• 金额: $ 19.55万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10591873
• 关键词: Address; Adolescence; Affect; Anxiety; Area; Award; Behavioral; Behavioral trial; Caregiver support; Caregivers; Caring; Collaborations; Communities; Complex; County; Development; Disease; Education; Effect Modifiers (Epidemiology); Eligibility Determination; Evaluation; Evidence based treatment; Family; Funding; General Population; Goals; Health Personnel; Health Services; Health system; Healthcare; Impaired health; Impairment; Institution; Intervention; Justice; Knowledge; Left; Link; Logistics; Mediator; Mental Depression; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Mission; Motivation; National Institute of Mental Health; New York; Oppositional Defiant Disorder; Pathway interactions; Phase; Play; Policies; Population Heterogeneity; Post-Traumatic Stress Disorders; Protocols documentation; Provider; Randomized; Recovery; Regulation; Reporting; Research; Research Activity; Research Personnel; Role; Secure; Service delivery model; Service provision; Strategic Planning; Suicide; Supervision; System; Training; Training Activity; Trauma; Treatment outcome; Underserved Population; Universities; Vulnerable Populations; Waiting Lists; Work; Youth; acceptability and feasibility; adverse childhood events; barrier to care; behavioral health; brief intervention; community based treatment; critical period; design; distrust; evidence base; experience; health knowledge; improved outcome; innovation; juvenile justice system; non-suicidal self injury; pilot test; post-traumatic stress; post-traumatic symptoms; prevent; probation; programs; psychoeducation; psychoeducational; psychologic; randomized trial; reduce symptoms; service engagement; services as usual; skills; skills training; social stigma; substance use; success; suicidal behavior; suicidal risk; system-level barriers; theories; therapy development; traumatic event; treatment effect; treatment services; trend; uptake

Abstract/Summary Youth involved in the juvenile justice system (YIJ) experience traumatic events and adverse childhood experiences (ACEs) at disproportionately high rates, leading to posttraumatic stress (PTS). When left untreated, YIJ’s PTS contributes to posttraumatic stress disorder (PTSD), suicidal behavior, non-suicidal self-injury, and other disorders which factor into youth impairment and the escalation of their justice system involvement. Recent legislative and policy trends have led to an increasing number of YIJ residing not in detention, but instead under community supervision (i.e., on probation). However, despite the existence of evidence-based treatments for PTS in the community, YIJ on probation frequently do not receive the care they need, due to complex, multi- level factors (e.g., cross-system coordination between behavioral health and justice; long waitlists; lack of identification and appropriate referral; caregiver minimization of youths’ problems; youths’ distrust of providers). There are promising, evidence-based protocols to refer and link YIJ to community-based treatment services, however, these methods have not yet been adapted to address YIJ PTS (e.g., through the incorporation of appropriate referral pathways, or increasing youth motivation for, and caregiver support of, trauma treatment). This K23 Award builds upon the candidate’s prior training and experience to fill critical gaps in the areas of robust intervention development incorporating implementation considerations, expertise in trauma sequalae and trauma treatment, and the design and evaluation of behavioral trials. Additionally, this award will result in the development of T-Connect, a trauma-informed multi-level intervention to bridge YIJ under community supervision to care and increase youth and caregiver engagement in YIJ’s trauma treatment. The research plan is divided in to three phases, which correspond to the candidates training objectives and research aims. First, the candidate will conduct formative work with YIJ who have PTS, their caregivers, probation staff, and community-based trauma treatment providers. Second, the candidate will develop, through established, collaborative, community- engaged methods, an intervention (T-Connect) that integrates into existing probation protocols to 1) refer/link YIJ in need of trauma treatment to appropriate care and 2) increase youth and caregiver motivation for and support of treatment. Third, the candidate will evaluate T-Connect through a randomized trial, comparing youth who receive T-Connect to a services-as-usual control. The proposed training and research activities will take place at the Center for Behavioral Health and Youth Justice at Columbia University/New York State Psychiatric Institute and be supervised by a team of NIMH-funded mentors with expertise in the sequalae and treatment of trauma, the provision of services for YIJ under community supervision, and the design, implementation, and evaluation of behavioral trials.

摘要/摘要 参与青少年司法系统（YIJ）的青年经历创伤事件和不利的童年 经验（ACE）的比例不成比例，导致创伤后应力（PTS）。当不进行治疗时， Yij的PTS有助于创伤后应激障碍（PTSD），自杀行为，非杀伤性自我伤害和 导致青年障碍的其他疾病以及其司法系统参与的升级。最近的 立法和政策趋势导致越来越多的Yij居住在拘留中，而是在 社区监督（即缓刑）。但是，多皮的存在是基于证据的治疗 社区中的PT，YIJ在探测器上经常不接受他们所需的护理，因为复杂，多 级别因素（例如，行为健康与正义之间的跨系统协调；长期候补名单；缺乏 识别和适当的推荐；照料者最小化青年问题；青年对提供者的不信任）。 有希望的，基于证据的协议，可以将YIJ与基于社区的治疗服务联系起来， 但是，这些方法尚未适应用于解决yij pts的问题（例如，通过 适当的转诊途径，或增加青年动机和护理人员的支持，对创伤治疗）。 该K23奖基于候选人的先前培训和经验，以填补稳健领域的关键空白 干预开发编码实施注意事项，创伤序列和创伤方面的专业知识 治疗以及行为试验的设计和评估。此外，该奖项将导致 在社区监督下开发T-Connect（T-Connect），这是一种受创伤信息的多层干预措施，以弥合Yij 照顾和增加青年和照顾者参与YIJ的创伤治疗。研究计划分为 在三个阶段，与候选人培训目标和研究目的相对应。首先，候选人 将与拥有PTS，他们的护理人员，缓刑人员和社区的YIJ进行形成性工作 创伤治疗提供者。其次，候选人将通过建立，协作，社区 - 参与方法，一种干预措施（T-Connect），将现有缓刑协议集成到1）参考/链接 需要创伤治疗以进行适当护理和2）增加青年和照料者的动机和 支持治疗。第三，候选人将通过随机试验评估T连接，并比较青年 他们接收到与服务相同的控制。拟议的培训和研究活动将进行 哥伦比亚大学/纽约州精神病学的行为健康与青年正义中心的地点 由NIMH资助的导师团队进行研究，并在序列和治疗方面具有专业知识 创伤，在社区监督下为YIJ提供服务，以及设计，实施以及 评估行为试验。