Faculty Bibliography

An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization's mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor's Office of Community Mental Health, the intervention was intensively workshopped through eight weekly sessions with adolescents (n = 18) and caregivers (n = 12). Documentation of the process followed the Reporting Cultural Adaptation in Psychological Trials criteria. Surface adaptations involved revising the storybook to reflect key challenges faced by adolescents and caregivers of these communities, such as social media usage, economic stressors, and racial diversity. Deep adaptations addressed cultural concepts of distress by incorporating topics such as identity exploration, socioemotional learning, and the mind-body connection. Feedback from stakeholders indicated that the basic components of EASE are relevant for members in their communities, but additional changes would foster greater engagement and community building. These findings will inform upcoming program implementation across NYC and may guide adaptation work in other contexts.

Although abundant evidence exists indicating the prevalence of trauma exposure among youth in residential care, few models exist for creating trauma-informed milieu treatment. This article outlines the problem and describes the implementation of Trauma Systems Therapy (TST) in three residential centers. TST is unique in emphasizing youth emotions and behaviors as well as the role a distressed or threatening social environment may play in keeping a traumatized youth in a dysregulated state. This dual emphasis makes TST specifically appropriate to implementation in congregate care, focusing assessment and intervention strategies on both clinical treatment and the functioning of the therapeutic milieu itself. Data are reported on incidents of the use of physical restraint; numbers of disrupted foster care placements following discharge from residential treatment; and scores on psychometric measures of children's functioning and emotion regulation capacity. Knowledge gained through TST implementation in these three residential centers has important implications for developing a model of trauma-informed congregate care.