Providing Evidence-Based Practice to Ethnically Diverse Youths: Examples From the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) Program

UCLA Semel Institute, Division of Child and Adolescent Psychiatry, Los Angeles, CA 90024-6505, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 08/2008; 47(8):858-62. DOI: 10.1097/CHI.0b013e3181799f19
Source: PubMed
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Available from: Bradley Stein, Nov 13, 2014
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    • "d impact their adherence to the core components of an EBP ( e . g . , Gleacher et al . 2011 ) . Although there has been very little research on the effi - cacy of interventions after they have been adapted , there is general consensus that any adaptations must retain core components of the intervention ( e . g . , Amaya - Jackson and DeRose 2007 ; Ngo et al . 2008 ) . For instance , some studies of have found that tailoring interventions can increase their effectiveness ( e . g . , Bernal 2006 ; Hirachi et al . 1997 ; Ros - sello and Bernal 1999 ) . However , there is evidence that some cultural adaptations may actually dilute the effec - tiveness of the original treatment ( Kumpfer et al . 2002 "
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    ABSTRACT: There is great interest in the dissemination and implementation of evidence-based treatments and practices for children across schools and community mental health settings. A growing body of literature suggests that the use of one-time workshops as a training tool is ineffective in influencing therapist behavior and patient outcomes and that ongoing expert consultation and coaching is critical to actual uptake and quality implementation. Yet, we have very limited understanding of how expert consultation fits into the larger implementation support system, or the most effective consultation strategies. This commentary reviews the literature on consultation in child mental health, and proposes a set of core consultation functions, processes, and outcomes that should be further studied in the implementation of evidence-based practices for children.
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    • "This includes a recent trend that argues for the preferential use of interventions for which empirical research has provided evidence of efficacy. Advocates of such evidence-based treatment (EBT) in turn argue for the adaptation of EBT to culturally diverse populations (Lau 2006; Ngo et al. 2008) emphasizing issues of cultural adaptation and cultural competency (Bernal et al. 1995; Ivey and Ivey 1999; Sue et al. 2009). Moreover, reflections on the cultural compatibility and adaptations of interventions have been explored within non-western settings (Berry et al. 2002; Tol et al. 2005), including those elaborating and modifying existing forms of psychotherapy following research into ethno-physiological and ethno-psychological perceptions and characteristics (Hinton et al. 2008). "
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    • "Acknowledging beforehand that access to specialized therapeutic resources in the host country is limited safeguards the consultee and the patient against unrealistic expectations. Short-term therapy – either cognitive behavioural therapy (CBT) or narrative exposure therapy (NET) – has been promoted for refugee children and adolescents not because it provides a complete resolution of trauma-related suffering, but because it is helpful in alleviating symptoms and can realistically be implemented in standard-care settings (Ehntholt & Yule, 2006; Kataoka et al., 2003; Ngo et al., 2008). Drawing up an inventory of available resources prior to consultation is essential for a realistic treatment plan. "
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    ABSTRACT: Primary care institutions, including clinics, schools and community organizations, because of their closeness to the family living environment, are often in a privileged position to detect problems in traumatized refugee children and to provide help. In a collaborative care model, the child psychiatrist consultant can assist the primary care consultee and family in holding the trauma narrative and organizing a safe network around the child and family. The consultant can support the establishment of a therapeutic alliance, provide a cultural understanding of presenting problems and negotiate with the consultee and the family a treatment plan. In many settings, trauma focused psychotherapy may not be widely available, but committed community workers and primary care professionals may provide excellent psychosocial support and a forum for empathic listening that may provide relief to the family and the child.
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