Symposia
Dissemination & Implementation Science
Stephanie H. Yu, M.A.
Doctoral Candidate
University of California, Los Angeles
LOS ANGELES, California
Caroline E. Shanholtz, Ph.D.
Postdoctoral Scholar
University of California, Los Angeles
Scottsdale, Arizona
Kenya Rodriguez-Montalvo, BA in progress
Undergraduate Student
UCLA
Los Angeles, California
Qiwen Jin, B.A.
Post-baccalaureate
UCLA
Los Angeles, California
Alyssa De Los Santos, AA, BA in progress
Undergraduate Student
UCLA
Los Angeles, California
Adriana I. Perez, B.A.
Post-baccalaureate
UCLA
Los Angeles, California
Eman Magzoub, B.A.
Post-baccalaureate
UCLA
Los Angeles, California
Ana Berman, AA, BA in Progress
Undergraduate Student
UCLA
Los Angeles, California
Umiemah Farrukh, Other
Undergraduate Student
University of California Los Angeles
Gardena, California
Qasim Farrukh, AA, BA in progress
Undergraduate Student
UCLA
Los Angeles, California
Xinran Wang, B.A.
Master's Student
Vanderbilt University
Nashville, Tennessee
Joanna J. Kim, PhD
Assistant Research Professor
Arizona State University
Tempe, Arizona
Lauren Brookman-Frazee, Ph.D.
Professor
University of California, San Diego
San Diego, California
Anna S. Lau, PhD (she/her/hers)
Professor
UCLA
Los Angeles, California
Trauma-focused cognitive behavioral therapy (TF-CBT) is a leading youth trauma treatment and has been widely disseminated in public mental health systems serving diverse youth. Community therapists frequently report adapting evidence-based practices (EBPs), including TF-CBT, to enhance their fit when transported into public systems of care. Developing methods to characterize session-level adaptations and understand factors associated with their delivery are needed next steps. Studies of therapist-reported adaptations in a large system-driven multiple EBP implementation identified Augmenting adaptations as those that add to or tailor the EBP. The current study employed an observer measure of previously identified Augmenting adaptation types, including modifying presentation of EBP content, integrating supplemental content and strategies, and extending through repetition. A sample of 46 community therapists provided 190 TF-CBT session audio recordings and surveys on client and session characteristics delivered to 82 youth clients (67.07% Latinx, 21.95% Black, 7.32% Asian American/Pacific Islander, 2.44% White, 1.22% Multiracial). Coders rated the occurrence and extensiveness of each adaptation type (0 = no occurrence, 6 = great extent). 62 sessions (32.63%) were double coded and kappas and intraclass correlations (ICCs) computed to assess interrater reliability. Multilevel regression was used to examine session, client, and therapist factors associated with Augmenting adaptations observed at the session-level. ICCs ranged from good to excellent (.65-.96). Fleiss’ Kappas for occurrence ranged from moderate to excellent (.45-.90). Modifying presentation adaptations were most common and observed in 46.32% of sessions (Mextent=2.95). Associations with session, therapist, and client factors varied by adaptation type. For example, sessions had lower extensiveness of Modifying presentation adaptations the older the client (B=-0.09, p=.039), higher extensiveness of Integrating adaptations when an acute client stressor was discussed in the session (B=0.88, p=.002), and higher extensiveness of Repeat adaptations the more positively the therapist viewed TF-CBT (B=0.38, p=.014). The landscape of Augmenting adaptations reliably observed by coders at the session-level, along with associated factors, will be presented. By observing how local community therapists make Augmenting adaptations within TF-CBT, this study holds translational value for improving community EBP training and delivery for diverse youth.
