Partnership and Adaptation to Implement Trauma Focused Therapy in Low Resourced Settings in the US and Latin America

Rosaura Orengo-Aguayo, PhD
Medical University of South Carolina

ABSTRACT:
Clinical psychological science has developed many efficacious treatments for diverse emotional and behavioral difficulties encountered by children and adolescents, yet most of these studies have disproportionally been conducted by American, university-based research labs. Dissemination and implementation of evidence-based services designed to meet the needs of a broader global population may require cultural and contextual adaptation to be successful. The current presentation will describe the implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in 3 separate low-resourced settings (rural South Carolina, Puerto Rico, and El Salvador) utilizing the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and guided by a community-based participatory research framework. We will discuss program development, building collaborative and responsive partnerships, and the use of implementation strategies to guide continuous quality improvement. Program evaluation data comparing baseline to posttreatment trauma symptoms and treatment completion rates for all settings will also presented, which suggests that treatment was associated with a large reduction in symptoms, exceeding that noted in many TF-CBT randomized trials. The implications of attention to context, adaptation, and methods of building partnerships with global communities will be discussed.