RESUMO
PURPOSE: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has not yet been systematically evaluated in the Caribbean context, particularly with Hispanic youth exposed to multiple disasters. The objective of this project was twofold: 1) to train mental health providers in Puerto Rico in TF-CBT as part of a clinical implementation project within the largest managed behavioral health organization (MBHO) on the island, and 2) to conduct a program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. METHOD: Fifteen psychologists were trained in TF-CBT. These psychologists then provided TF-CBT to 56 children and adolescents, ages 5-18, in community-based mental health clinics and one primary care clinic with a co-located psychologist in Puerto Rico. The mean number of traumatic events reported by youth referred for TF-CBT was 4.11. RESULTS: Thirty-six out of 56 children enrolled in the project (64.3%) successfully completed all components of TF-CBT. Results demonstrated large effect sizes for reduction in youth-reported posttraumatic stress symptoms (PTSS) (Cohen's d = 1.32), depressive symptoms (Cohen's d = 1.32), and anxiety symptoms (Cohen's d = 1.18). CONCLUSIONS: These results suggest that it was feasible to train providers in TF-CBT, that providers were able to deliver TF-CBT in community-based settings both in person and via telehealth (due to the COVID-19 pandemic), and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in Puerto Rico in a post-disaster context. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for Hispanic youth and disaster-affected youth in the Caribbean.
Assuntos
COVID-19 , Terapia Cognitivo-Comportamental , Desastres , Transtornos de Estresse Pós-Traumáticos , Adolescente , Criança , Pré-Escolar , Terapia Cognitivo-Comportamental/métodos , Hispânico ou Latino , Humanos , Pandemias , Avaliação de Programas e Projetos de Saúde , Porto Rico/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
Central American youth are at a high risk for experiencing trauma and related psychosocial problems. Despite this, few studies of evidence-based trauma-focused interventions with this population exist. The objective of this project was twofold: 1) to train providers in El Salvador in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as part of a clinical implementation project within a non-governmental organization, and 2) to conduct program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. Fifteen Salvadoran psychologists were trained in TF-CBT who then provided TF-CBT to 121 children and adolescents ages 3-18 in community-based locations. The mean number of traumas reported by youth was 4.39. Results demonstrated large effect sizes for reduction in youth-reported trauma symptoms (Cohen's d = 2.04), depressive symptoms (Cohen's d = 1.68), and anxiety symptoms (Cohen's d = 1.67). Our program evaluation results suggest that it was feasible to train providers in TF-CBT, that providers were in turn able to deliver TF-CBT in community-based settings, and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in El Salvador. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for youth in Latin American countries.