Therapist Participation in a Learning Collaborative on Trauma-Focused Cognitive Behavioral Therapy: Impact of COVID-related Stressors and Challenges.

The rise in mental health problems during the COVID-19 pandemic amplified the need to improve access to evidence-based treatments (EBT) and necessitated changes in treatment delivery and training of mental health providers (MHPs). There is limited information on how the pandemic may have impacted MHPs' participation in training and treatment delivery. This study included 269 MHPs who participated in a Learning Collaborative (LC) focused on an EBT. Qualitative interviews conducted with 15 MHPs who participated in the LC during the pandemic identified facilitators and barriers to training participation and EBT delivery that included social support, technology challenges, and difficulty completing cases following the transition to telehealth. Quantitative results showed that MHPs in the peri-COVID cohorts completed significantly fewer cases and fewer consultation calls compared to those prior to the pandemic. Findings suggest that providing support to train MHPs and promote EBT delivery may be beneficial during times of heightened stress.

Immigration Trauma among Hispanic Youth: Missed by Trauma Assessments and Predictive of Depression and PTSD Symptoms.

Few quantitative studies have examined the rate of exposure to traumatic events during immigration among Hispanics or its relation to mental health outcomes. Failing to capture traumatic events that occur during immigration may impede investigations of trauma and related mental health disparities with Hispanics. In order to better understand the need for immigration-related trauma assessment, interviews were conducted with 131 immigrant Hispanic youth. First, youth completed a comprehensive trauma assessment interview. Items were added to the interview to assess if each traumatic event occurred during the process of immigration. An immigration-focused module was then added to the end of the assessment. A substantial minority of youths reported experiencing a traumatic event during immigration (n = 39; 29.8%). The majority of these were not captured by the standard trauma assessment (n = 32; 82.1% of those with in-transit trauma). Of these, the majority stated that the process of immigration itself was traumatic, but had not indicated experiencing any event assessed during the standard trauma assessment (n = 28; 87.5% of those with unidentified in-transit trauma). The traumatic events that were not captured during the standard trauma assessment significantly predicted both depression (p < .001) and PTSD symptoms (p = .012). Results suggest that standard trauma assessments may not capture traumatic events that occur during immigration for Hispanic youth. Failing to capture these events during trauma assessment may have large implications for research on trauma-related mental health disparities, as the events that were not captured overlapped significantly with depression and PTSD.

Pocas investigaciones cuantitativas han examinado la tasa de trauma que ocurre entre Hispanos durante el proceso de inmigración a los Estados Unidos. Cuando evaluaciones de trauma no capturan trauma de inmigración, puede impedir investigaciones de disparidades de salud mental y trauma para Hispanos. Para entender mejor la necesidad de incluir componentes de inmigración en evaluaciones de trauma, se entrevistaron 131 adolescentes Hispanos. Primero, los adolescentes cumplieron una entrevista comprensiva y estándar de trauma. Se añadieron preguntas a la entrevista para determinar si el evento ocurrió durante inmigración. Luego, se añadió una sección enfocada en inmigración. Una menoridad sustancial de adolescentes indicó trauma durante inmigración (n = 39; 29.8%). La mayoría de estos casos no se capturaron durante la evaluación estándar (n = 32; 82.1% de los quienes indicaron trauma durante inmigración). De estos, la mayoría indicaron que fue el proceso de inmigración que fue traumático (n = 28; 87.5% de los quienes no indicaron trauma durante la evaluación estándar). Los eventos los cuales no se capturaron en la evaluación estándar correlacionaron con síntomas ambos de depresión (p < .001) y estrés postraumático (p = .012). Los resultados sugieren que evaluaciones estándares de trauma no capturan eventos traumáticos que ocurren durante inmigración para adolescentes Hispanos. Además, el no capturar estos eventos tal vez tiene implicaciones para investigaciones de disparidades de trauma y salud mental, porque los eventos que no se capturaron correlacionaron con depresión y el estrés postraumático.