Treatment research for children and youth exposed to traumatic events: moving beyond efficacy to amp up public health impact

• Published in: General hospital psychiatry 2010-09, Vol.32 (5), p.465-476
• Main Authors: Kolko, David J., Ph.D., A.B.P.P, Hoagwood, Kimberly Eaton, Ph.D, Springgate, Benjamin, M.D., M.P.H
• Format: Article
• Language: English
• Subjects: Adolescent; Attitude of Health Personnel; Biological and medical sciences; Biomedical Research - organization & administration; Biomedical Research - trends; Child; Delivery of Health Care - organization & administration; Delivery of Health Care - trends; Diffusion of Innovation; Dissemination; Effectiveness research; Evidence-Based Practice - organization & administration; Evidence-Based Practice - trends; Evidence-based practices; Feedback; Health Plan Implementation - organization & administration; Health Plan Implementation - trends; Health Services Research - organization & administration; Health Services Research - trends; Humans; Life Change Events; Medical sciences; Mental health; Models, Organizational; Organization of mental health. Health systems; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public Health - trends; Referral and Consultation - organization & administration; Referral and Consultation - trends; Social psychiatry. Ethnopsychiatry; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; Trauma; Treatment Outcome; United States; Youth
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2010.05.003

Abstract Objective Population-based demands for trauma services have accelerated interest in the rapid deployment of efficacious interventions to address the diverse mental health consequences of traumatic experiences. However, optimal strategies for supporting either implementation or dissemination of trauma-focused interventions within healthcare or mental healthcare systems are underdeveloped. Methods This work offers suggestions for adapting treatment research parameters in order to advance the science on the implementable and practical use of trauma-focused interventions within a public health framework. To this end, we briefly examine the current status of research evidence in this area and discuss efficacy and effectiveness treatment research parameters with specific attention to the implications for developing the research base on the implementation and dissemination of effective trauma practices for children and adolescents. Results Examples from current studies are used to identify approaches for developing, testing and enhancing strategies to roll out effective treatment practices in real-world settings. Conclusions New approaches that reflect the contexts in which these practices are implemented may enhance the feasibility, acceptability, replicability and sustainability of trauma treatments and services, and thus improve outcomes for a broader population of youth and families.