Bridging the gap: Evaluating the efficacy of racial trauma therapy training for community mental health clinicians.

OBJECTIVE: Although there is a growing body of literature that discusses the etiology and impact of racial trauma, there are few evidence-based treatment modalities to support BIPOC individuals who have experienced race trauma. Furthermore, current clinicians are ill-equipped to navigate racial trauma symptoms in the therapy due to a dearth in training opportunities during their educational and professional careers. The current study addresses the dearth in racial trauma therapy training opportunities for clinicians through the implementation and evaluation of a training protocol based on the KNIFFLEY Racial Trauma Therapy Model (KRTTM) with community-based clinicians. METHOD: Fifty-four clinicians who participated in the KRTTM training protocol completed a 7-item efficacy scale as well as a 17-item training satisfaction survey before and at the end of the training. RESULTS: Results of the paired-samples t-test revealed a statistically significant change in perceived efficacy among clinicians who completed the KRTTM training. Specifically, survey scores among clinicians averaged approximately 22 (i.e., M = 22.2, SD = 4.9) at pretest and 30 (i.e., M = 29.8, SD = 3.7) at posttest, indicating a statistically significant increase in perceived efficacy, t(53), -9.9, p = .000. Further, results of the paired-samples t-test split by race indicated differences in pretest efficacy scores between White (M = 21.7, SD = 4.5) and BIPOC (M = 23.6, SD = 5.9) clinicians in this study. CONCLUSIONS: Overall, the results from the current study highlight that there is a need for more training on evidenced-based treatment models, to include the KRTTM intervention, to build clinicians' capacity to provide support to BIPOC individuals who have experienced racial trauma during their lifetimes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Academic Achievement Among a Sample of Youth in Foster Care: The Role of School Connectedness.

Research shows that youth in foster care experience poor academic performance and disciplinary actions in school more frequently than do non-foster care youth. The purpose of this cross-sectional study was to further examine youth in foster care and the relationship between individual/intrapersonal factors (future orientation and school connectedness) and exosystem factors (number of placement and school moves) and academic performance (grades) and disciplinary referrals among 363 youth (9-11 years of age; males=52.9%). Controlling for key variables, hierarchical linear regression analysis was utilized to understand how well students' school connectedness, future outlook, number of placement changes, and number of school moves predicted academic and disciplinary outcomes. Beyond the variance explained by control variables, school connectedness made a significant contribution to this model. Results are discussed in the context of implementing interventions that foster school connectedness among this vulnerable population.

Perceived Treatment Needs Among Women With Co-occurring Substance Use Disorders and PTSD.

OBJECTIVE: Perception of need is a key factor that influences decisions to seek help and complete treatment for substance use and mental health problems. In the current study, we examine patterns of perceived treatment needs among women with co-occurring substance use disorders and posttraumatic stress disorder (PTSD) and explore how these patterns are associated with demographics, psychosocial variables, and treatment-related factors. METHODS: Secondary data analysis of the Women and Trauma Study from the National Institute on Drug Abuse's Clinical Trial Network was conducted. The sample included 353 women with co-occurring substance use disorders and PTSD (full or subthreshold) receiving outpatient substance abuse treatment. Latent class analysis was used to examine patterns of perceived treatment need and multinomial logistic regression was used to identify characteristics associated with these patterns. RESULTS: The sample included women between the ages of 18 and 65 (mean = 39.2, SD = 9.3) and was 46% White, 34% African American, and 21% other races/ethnicities. A three-class model representing unique perceptions of treatment needs demonstrated the best fit (Bayesian information criterion = 2101.43; entropy = 0.76; average posterior probabilities ≤ 0.82). Class one reported elevated needs in multiple areas (38%), class two reported low needs (23%), and class three reported substance use and psychological needs (40%). Living with a substance abuser, depression symptoms, recent substance use, and treatment coercion were significantly associated with membership in class 2 (OR = .28, .84, .22, and 2.32, respectively). Other race, being married, depression symptoms, recent substance use, and criminal justice involvement were associated with membership in class 3 (OR = 2.32, 2.32, .94, .42, and 1.69, respectively). Number of treatment sessions attended was not significantly associated with class membership. CONCLUSIONS: Results provide insight into how women with co-occurring PTSD and substance use disorders view their treatment needs. While some women reported high levels of self-identified need in other areas (e.g., physical health, employment/financial support, and family or social relationships), others did not identify as having any problems (including substance use or psychological problems). Level of severity and temporal aspects of problems may be significant factors that influence women's perceived need for treatment. This clinical trial is registered at www.clinicaltrials.gov as trial #NCT00078156.

Timely Health Service Utilization of Older Foster Youth by Insurance Type.

PURPOSE: To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). METHODS: A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. RESULTS: Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p < .0001) and days to the first visit decreased from a median of 62 days for those who entered foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. CONCLUSIONS: Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements.

Individual and Contextual Factors Associated with Immigrant Youth Feeling Unsafe in School: A Social-Ecological Analysis.

Despite the increasing proportion of immigrant youth in U.S. school districts, no studies have investigated their perceptions of their school. This study examines factors associated with perceptions of school safety among immigrant youth within individual, family, peer, and school contexts. Data were drawn from Wave II of the Children of Immigrants Longitudinal Study (n = 4288) and hierarchical logistic regression analyses were conducted. African-Americans, females, and youth with limited English proficiency were more likely to perceive their school as unsafe. Youth who reported that family cohesion was important and those who had close friends perceived their school as safe. Also, those who experienced illegal activities in school reported feeling unsafe. Assessment and intervention in schools needs to consider individual and contextual factors associated with perceptions of school safety. Additional research is needed to examine individual and contextual factors related to immigrant youths' perceptions of school.

School staff perspectives on the challenges and solutions to working with court-involved students.

BACKGROUND: Court-involved students, such as those in foster care and the juvenile justice system, generally experience high incidences of both acute and chronic trauma, adversely impacting their educational well-being and overall academic trajectory. Utilizing perceptions of teachers and other school staff, this study explores the challenges and needs of school personnel working with this student population. METHODS: Participants were school personnel employed at a Midwest, urban, public charter school during the 2012-2013 academic year. Focus groups explored the perceptions of school staff members working with court-involved students to develop a staff training curriculum. Focus groups also were conducted after the training intervention to get feedback from participants and identify remaining challenges. Focus group data were analyzed and results were member-checked with study participants. RESULTS: Findings included 7 major themes (14 subthemes) regarding student behaviors that were challenging for school staff to manage. Themes included trauma-related behaviors, attachment-related behaviors, staff preintervention needs, intervention feedback, and staff postintervention needs. CONCLUSIONS: Teachers and school staff can play a role in the educational well-being of court-involved youth. However, they need trauma-specific knowledge and resources to be effective.