2 - (IOP 38) Extending the Reach of TF-CBT Integrating Racial Socialization (TF-CBT+RS): Data from Group Delivery of TF-CBT+RS in Three Community Contexts

Trauma-Focused Cognitive Behavioral Therapy (TF- CBT; Cohen et al., 2017) is an evidence-based CBT for youth ages 3–18 with trauma-related mental health needs and their caregivers. Designated a well-established treatment for youth trauma-related mental health problems (Dorsey et al., 2017), TF-CBT can be delivered individually or in a group format. Despite its evidence base, Black families are more likely to attrit from TF-CBT due to culturally specific engagement barriers (e.g., stigma, racism; Planey et al., 2019). To address these barriers, Metzger et al. (2021) developed cultural modifications to TF-CBT for Black youth and their caregivers (TF-CBT and Racial Socialization [TF-CBT+RS]; Metzger et al., 2023), with initial evidence showing enhanced outcomes for individual delivery (Stewart et al., 2021). One way to increase the availability of culturally responsive services is via group delivery (Deblinger et al., 2016). Benefits of group-delivery include ability to meet treatment demand, cost-effectiveness, reduced shame and isolation, and provision of social support, which may be especially salient for minoritized communities.

This presentation will describe the implementation outcomes (i.e., retention, fidelity, acceptability, appropriateness, feasibility), preliminary clinical outcomes, and participant feedback from group-delivered TF-CBT+RS across three community contexts: (1) A university-based outpatient clinic (5 youth, 5 caregivers), (2) A community-based prevention organization (6 youth, 4 caregivers), and (3) A residential group home (6-7 youth). Data collection at the group home is expected to be completed by May 2025.

Youth participants ranged in ages from 8-17. Three of the 5 youth in the university-based clinic and all 6 youth in the community-based organization completed treatment. In both settings, acceptability, appropriateness, and feasibility of group-delivered TF-CBT+RS were high (all means > 4; possible range = 1-5). Intervention fidelity was also high, with 75% and 100% of components delivered, respectively. Comparison of these outcomes showed higher engagement and adherence in the community-based setting compared to the university-based training clinic. There were practical advantages for recruitment and attendance in the community setting given preexisting connections between families and organization staff and facility. Clinical challenges of group delivery common to both settings included coordinating and tailoring trauma narration (delivered individually; Deblinger et al., 2016) given the range of severity in youth trauma histories. Nonetheless, 9 of the 11 youth demonstrated improvement in one or more symptom domains (i.e., PTSD, internalizing, externalizing). Feedback from participants indicated that youth found coping skills and their application to racial stressors as most helpful, whereas caregivers found parenting skills and a sense of community to be the most helpful. Additional results and recommendations including those from the group home will be presented to inform next steps in the dissemination of group-delivered TF-CBT+RS in community contexts, with implications for promoting equitable trauma-related treatment outcomes for Black youth.