Implementation of CBT for Youth Affected by the World Trade Center Disaster: Matching Need to Treatment Intensity and Reducing Trauma Symptoms
Hoagwood, Kimberly Eaton; Felton, Chip; Donahue, Sheila; Appel, Anita; Rodriguez, James; Murray, Laura; Fernandez, David; Legerski, Joanna; Chung, Michelle; Gisis, Jacob; Sawaya, Jennifer; Weaver, Jamie; Mehta, Sudha; Levitt, Jessica Mass; Radigan, Marleen; Foster, Jameson; Abramovitz, Robert; Abright, Reese; D'Amico, Peter; Constantino, Giussepe; Epstein, Carrie; Havens, Jennifer; Kaplan, Sandra; Newcorn, Jeffrey; Perez, Moises; Silva, Raul; de Bocanegra, Heike Thiel; Vogel, Juliet
An implementation study of cognitive-behavioral therapies (CBT) was conducted for traumatized youth in a postdisaster context. Headed by the New York State Office of Mental Health, the study targeted youth (N = 306) ages 5-21 affected by the World Trade Center disaster. They received either trauma-specific CBT or brief CBT skills depending upon the severity of trauma symptoms. Clinicians were trained to deliver these interventions and received monthly consultation. A regression discontinuity design was used to assess optimal strategies for matching need to service intensity. At 6-months postbaseline, both groups had improved. Rate of change was similar despite differences in severity of need. The implications for the implementation of evidence-based treatments postdisaster are discussed
Implementing CBT for traumatized children and adolescents after september 11: lessons learned from the Child and Adolescent Trauma Treatments and Services (CATS) Project
Steinberg, Allan; Appel, Anita; Mannarino, Anthony; Epstein, Carrie; Felton, Chip; Layne, Christopher M.; Fernandez, David; Constantino, Giussepe; de Bocanegra, Heike Thiel; Gisis, Jacob; Rodriguez, James; Foster, Jameson; Newcorn, Jeffrey; Havens, Jennifer; Sawaya, Jennifer; Levitt, Jessica Mass; Legerski, Joanna; Cappelleri, Joseph; Cohen, Judith; Vogel, Juliet; Hoagwood, Kimberly Eaton; Murray, Laura; Palinkas, Lawrence; Bickman, Leonard; Radigan, Marleen; McKay, Mary; Crowe, Maura; Chung, Michelle; Perez, Moises; D'Amico, Peter; Jensen, Peter S.; Silva, Raul; Abright, Reese; Abramovitz, Robert; Pynoos, Robert; Kaplan, Sandra; Donahue, Sheila; Mehta, Sudha; Marcus, Sue; Essock, Susan; Silverman, Wendy; Saltzman, William R.
The Child and Adolescent Trauma Treatments and Services Consortium (CATS) was the largest youth trauma project associated with the September 11 World Trade Center disaster. CATS was created as a collaborative project involving New York State policymakers; academic scientists; clinical treatment developers; and routine practicing clinicians, supervisors, and administrators. The CATS project was established to deliver evidence-based cognitive-behavioral trauma treatments for children and adolescents affected by the September 11 terrorist attack in New York City and to examine implementation processes and outcomes associated with delivery of these treatments. Referrals were obtained on 1,764 children and adolescents; of these, 1,387 were subsequently assessed with a standardized clinical battery and 704 found to be eligible for services. Ultimately 700 youth participated in the project. Treatments were delivered in either school or clinic settings by clinicians employed in 9 provider organizations in New York City. All participating clinicians were trained on the cognitive behavioral therapy models by the treatment developers and received case consultation for 18 months by expert clinician consultants and the treatment developers. The challenges of mounting a large trauma treatment project within routine clinical practices in the aftermath of a disaster and simultaneously evaluating the project have been significant. We outline the major challenges, describe strategies we employed to address them, and make recommendations based on critical lessons learned