Florida International University - Center for Children and Families and Department of Psychology, 11200 SW 8th Street, Miami, FL, 33199, USA.
Emily Arcia Consulting Co., Miami, USA.
Adm Policy Ment Health. 2022 Sep;49(5):881-898. doi: 10.1007/s10488-022-01207-0. Epub 2022 Jul 22.
Children and adolescents ("youth") experiencing homelessness are at a disproportionately high risk of exposure to potentially traumatic events (PTE). However, limited evidence exists as to what interventions are effective when implemented with this high-risk population. The purpose of this study was to (1) document the mental health and trauma-related needs of sheltered youth and their mothers, and (2) examine the feasibility/effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) administered within the context of a homeless shelter. Three hundred and twenty-one youth (M = 10.06 years, SD = 3.24 years, 56.4% male, 70.1% Black/African American, 34.6% Hispanic/Latinx) and their mothers were recruited from a homeless shelter and provided 10 weeks of TF-CBT, with the option for up to eight additional weeks of therapy based on clinical need. Families completed pre- and post-intervention assessments. Results demonstrated clinically elevated pre-intervention PTSD symptoms and rates of exposure to PTE in sheltered youth well above those previously reported in the general population. TF-CBT resulted in substantial reductions in both maternal and self-reported severity of youth PTSD symptomology, which were largely attributable to reductions in re-experiencing and arousal. Effectiveness of TF-CBT varied by age and the number of exposures to PTE. Overall, these findings illustrate the importance of assessing and addressing the mental health and trauma-related needs of sheltered youth and the feasibility and efficacy of embedding an evidence-based trauma-focused treatment protocol within a shelter environment. Additional implications of these findings are discussed.
无家可归的儿童和青少年（“青年”）面临着不成比例的高风险，可能会接触到潜在的创伤性事件（PTE）。然而，对于在这个高风险人群中实施哪些干预措施有效，目前证据有限。本研究的目的是：（1）记录庇护青年及其母亲的心理健康和与创伤相关的需求；（2）研究创伤焦点认知行为疗法（TF-CBT）在收容所环境中的可行性/有效性。从一个无家可归者收容所招募了 321 名青年（M=10.06 岁，SD=3.24 岁，56.4%为男性，70.1%为黑人/非裔美国人，34.6%为西班牙裔/拉丁裔）及其母亲，并为他们提供了 10 周的 TF-CBT，根据临床需要，最多可选择另外 8 周的治疗。家庭在干预前后完成了评估。结果表明，庇护青年的 PTSD 症状和创伤性事件暴露率在干预前明显高于一般人群。TF-CBT 导致母亲和自我报告的青年 PTSD 症状严重程度显著降低，这主要归因于重新体验和唤醒的减少。TF-CBT 的有效性因年龄和 PTE 暴露次数而异。总体而言，这些发现说明了评估和满足庇护青年的心理健康和与创伤相关的需求的重要性，以及将基于证据的创伤焦点治疗方案嵌入收容所环境的可行性和有效性。讨论了这些发现的其他意义。
