Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma.

Youths and parents/caregivers who have experienced multiple forms of severe interpersonal trauma may demonstrate severe and persistent symptoms of complex trauma including high-risk behaviors. Engagement, and sustaining engagement, of these youths and parents/caregivers in evidence-supported trauma treatment is a critical challenge, especially when youths or parents/caregivers have experienced chronic traumas that may be expected to continue into the foreseeable future. An extensive literature review was conducted leading to development of an assessment framework that could increase engagement of youths and parents/caregivers in trauma treatment based on research on chronic trauma, complex trauma, Developmental Trauma Disorder (DTD), and factors that promote engagement. A multi-dimensional assessment guide was developed to enable clinicians to differentiate types of chronic trauma based on a continuum of past, current and expected exposure over time and then to use this guide collaboratively with youths and parents/caregivers to develop priorities for treatment and service planning that matches their needs and strengths. The assessment guide incorporates exposure to intra-familial and community forms of interpersonal trauma, attachment disruptions, established symptoms of PTSD, Complex PTSD and DTD, as well as social-emotional development. The assessment and treatment planning guides proposed in this article expand applicability of evidence-supported trauma-informed therapy to youths and families who have not been engaged by programs offering treatments that are focused on past or single incident traumas or do not address disrupted attachments, multi-generational experiences of adversity, discrimination and community violence, life-threatening dangers or the impact of chronic trauma on youth, parent/caregiver and family development.

The impact of social support on adolescent coping in the context of urban poverty.

OBJECTIVE: This study used a mixed method, prospective, multi-informant design to (a) identify coping strategies used by youth residing in urban poverty and (b) test whether these coping strategies buffer the effects of stress exposure when adult support is present and when absent. METHOD: There were 286 youth ages 10 to 16 (mean age at Time 1 = 13; 65% female; 34% male; 1% not identified; 46% African American; 25% Latino; 11% European American; 8% Asian American, 4% Mixed/Biracial, 6% Other) and their parents who participated. Thematic analyses were used to code adolescent interviews about protective factors to identify specific coping strategies used. Hierarchical regression analyses tested whether these coping strategies moderate the association between stress exposure and psychological symptoms for youth with and without adult support. RESULTS: Youth identified multiple coping strategies as protective including Expressing Oneself, Self-Soothing, Seeking Help, Seeking Safety, Distraction, Problem-Solving, Self-Care, and Avoidance. A number of these coping strategies (Expressing Oneself, Self-Soothing, Seeking Help, and Seeking Safety) attenuated the association between stressors and psychological symptoms over time for youth with adult support. For youth without adult support, a number of the strategies they identified as protective (Distraction, Problem-Solving, and Self-Care) accentuated the association between stress exposure and psychological symptoms over time. The only strategy that proved protective for youth without adult support was avoidance. CONCLUSIONS: Findings suggest that youth require adult support to effectively make use of a range of coping strategies and that avoidance is the sole effective strategy for youth without support. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Development of an Empirically Based Preventive Intervention for Depression in Preadolescent African American Girls.

We describe the development, feasibility, and acceptability of a novel preventive intervention for depression in African American girls living in urban poverty. Our approach targeted individual and interpersonal vulnerabilities that have been shown to confer risk for depression in samples of African American girls living in low-income, urban settings, including suppression of negative emotion and lack of assertiveness with peers, memory for positive emotion, active coping, and family connection. Focus groups and an open trial were conducted to refine the goals and mechanisms for skill building. A randomized controlled trial (RCT) of the new program (Cities Mother-Daughter Project) was conducted with 3rd-5th grade students from Chicago Public Schools (CPS). Three cycles of screening, randomization, and deployment were conducted to assess feasibility, satisfaction, and usability. Results indicate that feasibility was weak; whereas, satisfaction and usability were high. Future directions for testing efficacy are discussed.

Development of cities mentor project: an intervention to improve academic outcomes for low-income urban youth through instruction in effective coping supported by mentoring relationships and protective settings.

This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3) identify effective elements of targets; 4) vet intervention with stakeholders; 5) develop models for sustaining the intervention; 6) develop measures of relevant constructs currently missing from the literature; 7) assess feasibility and usability of the intervention. Methods used to accomplish these steps include basic research studies, literature reviews, meta-analyses, focus groups, community advisory meetings, consultations with scholarly consultants, and piloting. The resulting intervention provides early adolescents in low-income urban communities with a) training in contextually relevant coping, b) connection to mentors who support youth's developing coping strategies, and c) connection to youth-serving community organizations, where youth receive additional support.