How do community therapists adapt evidence-based practices (EBPs) to better fit the diverse youth and families they serve?

My dissertation looked at how community therapists adapt trauma-focused cognitive behavioral therapy (TF-CBT) when working with racial/ethnic minoritized youth and families. Community therapists hold valuable local expertise about what may promote client understanding or engagement in their care contexts, especially when they identify with the communities they serve. Supported by a University of California Office of the President Fellowship, I developed two observational coding systems for Augmenting adaptations (a specific type of therapist adaptation that adds to or tailors an EBP) and adherence to TF-CBT (how much key TF-CBT components are delivered as intended). I trained two incredible teams of undergraduate coders to apply the two coding systems in 190 session audio recordings of TF-CBT delivered with primarily racial/ethnic minoritized youth and caregivers.

I looked at:

1. what session, client, and therapist factors were related to Augmenting adaptations and

2. how Augmenting adaptations were related to:

   • therapist adherence to TF-CBT in a given session

   • client engagement in a given session.

Findings suggested meaningful relationships between therapist Augmenting adaptations and client engagement, and that therapists were able to augment their sessions while still remaining adherent to the intervention’s components in those sessions. This work highlights the importance of harnessing practice-based evidence and community partnership to learn about what may promote racial/ethnic minoritized youth response to EBPs. To learn more, see my dissertation (manuscripts are underway)!