Determinants of Implementing Evidence-Based Trauma-Focused Interventions for Children and Youth: A Systematic Review.

A systematic review was conducted to identify determinants (barriers and facilitators) of implementing evidence-based psychosocial interventions for children and youth who experience emotional or behavioral difficulties due to trauma exposure. Determinants were coded, abstracted, and synthesized using the Exploration, Preparation, Implementation, and Sustainment framework. Twenty-three articles were included, all of which examined implementation of Trauma-Focused Cognitive Behavioral Therapy or Cognitive-Behavioral Intervention for Trauma in Schools. This review identified multilevel and multiphase determinants that can be addressed by implementation strategies to improve implementation and clinical outcomes, and suggests how future studies might address gaps in the evidence base.

Does Model Matter? Examining Change Across Time for Youth in Group Homes.

Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths' positive outcomes during and after group home placements.

Improving the content validity of the Trauma and Adverse Childhood Experiences Survey (TRACES) and the Child and Adolescent PTSD Checklist for DSM-5 (CAPC-5): A collaborative research methodological approach.

OBJECTIVE: The current study aimed to improve the content validity of the Trauma and Adverse Childhood Experiences Survey (TRACES) and the Child and Adolescent PTSD Checklist for the DSM-5 (CAPC-5). METHOD: Two community-based collaborative research methods were used-cognitive interviewing and focus groups. Three rounds of cognitive interviews included a racially and economically diverse sample of 12 trauma-exposed youth and 12 caregivers. Three focus groups involved 19 clinicians with diverse disciplines and years of practice. Modifications to the measures were made after each round of interviews and after completion of all focus groups. RESULTS: Both methods provided beneficial information about issues with the measures. Feedback from youth, caregivers, and clinicians was distinct, though data across groups generally converged. Improvements were made to the measures in multiple areas, such as instructions and clarity. CONCLUSIONS: Incorporating feedback from multiple stakeholders increased the content validity of the TRACES and CAPC-5. Collaborative research methods provide a trauma-informed initial step in the development of assessment measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Polyvictimization and Psychosocial Outcomes Among Trauma-Exposed, Clinic-Referred Youth Involved in the Juvenile Justice System.

Polyvictimization is a robust predictor of emotional and behavioral problems and is linked to involvement in juvenile justice and other public sector systems. This study extends prior research by employing person-centered methods for identifying polyvictimization patterns among trauma-exposed, clinic-referred, justice-involved youth (n = 689; ages 12-18 years) and how identified classes differ on psychosocial outcomes and demographic characteristics. Most participants had experienced multiple traumatic event (TE) types. Latent class analyses identified three classes: mixed trauma/bereavement exposure group (55.1%; Mean = 3.0 TE types); maltreatment polyvictimized group (29.3%; Mean = 5.7 TE types); and maltreatment plus extreme violence polyvictimized group (15.7%; Mean = 9.3 TE types). Polyvictimized youth were more likely to be female, in out-of-home placements, and experiencing negative psychosocial outcomes (e.g., Posttraumatic Stress Disorder). Hispanic/Latino youth were overrepresented in the extreme polyvictimized subgroup. Results underscore the need for cross-system coordination of trauma-informed, comprehensive services for clinic-referred, justice-involved youth.

Restoration of movement using functional electrical stimulation and Bayes' theorem.

Various computational approaches have been applied to predict aspects of animal behavior from the recorded activity of populations of neurons. Here we invert this process to predict the requisite neuromuscular activity associated with specified motor behaviors. A probabilistic method based on Bayes' theorem was used to predict the patterns of muscular activity needed to produce various types of desired finger movements. The profiles of predicted activity were then used to drive frequency-modulated muscle stimulators to evoke multijoint finger movements. Comparison of movements generated by electrical stimulation with desired movements yielded root mean squared errors between approximately 18 and 26%. This reasonable correspondence between desired and evoked movements suggests that this approach might serve as a useful strategy to control neuroprosthetic systems that aim to restore movement to paralyzed individuals.

Patterns of maltreatment and diagnosis across levels of care in group homes.

Patterns of Axis I psychiatric diagnosis and maltreatment history were explored among youth in group homes, including match of clinical need to level or restrictiveness of care. Data on demographics, diagnoses, maltreatment, and group home level of care (Level I, II, or III homes, representing lower to higher intensity of supervision and treatment) were obtained from 523 youth who participated in a quasi-experimental study of group homes. Three quarters of youth had a diagnosis and two-thirds of youth had a maltreatment history. Youth in higher level homes had more diagnoses and higher rates of all disorders except adjustment disorders. Youth in Level I homes had a history of more maltreatment types, particularly high rates of neglect. Sexual abuse, physical abuse, and emotional abuse were most common among youth in higher level homes. Regardless of diagnosis history, comparable proportions of youth had a maltreatment history, and similar patterns were found across levels of care. Together, findings indicate that group homes with varying degrees of restrictiveness serve youth with different psychiatric diagnosis and maltreatment histories. Youth triaged to higher level homes had more diagnoses, while youth placed in the least restrictive homes had a history of more maltreatment subtypes. Further, distinct patterns of diagnosis types and maltreatment subtypes were seen across homes. Implications include the importance of assessing unique clinical needs of youth to promote an appropriate match to level of care and treatment plan.