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

Abstract 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 for and increase youth and caregiver engagement in YIJ’s trauma treatment. The research plan is divided into 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 Columbia University and be supervised by a team of NIMH-funded mentors.