Abstract/Summary
Youth involved in the juvenile justice system (YIJ) experience traumatic events and adverse childhood
experiences (ACEs) at disproportionately high rates, leading to posttraumatic stress (PTS). When left untreated,
YIJ’s PTS contributes to posttraumatic stress disorder (PTSD), suicidal behavior, non-suicidal self-injury, and
other disorders which factor into youth impairment and the escalation of their justice system involvement. Recent
legislative and policy trends have led to an increasing number of YIJ residing not in detention, but instead under
community supervision (i.e., on probation). However, despite the existence of evidence-based treatments for
PTS in the community, YIJ on probation frequently do not receive the care they need, due to complex, multi-
level factors (e.g., cross-system coordination between behavioral health and justice; long waitlists; lack of
identification and appropriate referral; caregiver minimization of youths’ problems; youths’ distrust of providers).
There are promising, evidence-based protocols to refer and link YIJ to community-based treatment services,
however, these methods have not yet been adapted to address YIJ PTS (e.g., through the incorporation of
appropriate referral pathways, or increasing youth motivation for, and caregiver support of, trauma treatment).
This K23 Award builds upon the candidate’s prior training and experience to fill critical gaps in the areas of robust
intervention development incorporating implementation considerations, expertise in trauma sequalae and trauma
treatment, and the design and evaluation of behavioral trials. Additionally, this award will result in the
development of T-Connect, a trauma-informed multi-level intervention to bridge YIJ under community supervision
to care and increase youth and caregiver engagement in YIJ’s trauma treatment. The research plan is divided
in to three phases, which correspond to the candidates training objectives and research aims. First, the candidate
will conduct formative work with YIJ who have PTS, their caregivers, probation staff, and community-based
trauma treatment providers. Second, the candidate will develop, through established, collaborative, community-
engaged methods, an intervention (T-Connect) that integrates into existing probation protocols to 1) refer/link
YIJ in need of trauma treatment to appropriate care and 2) increase youth and caregiver motivation for and
support of treatment. Third, the candidate will evaluate T-Connect through a randomized trial, comparing youth
who receive T-Connect to a services-as-usual control. The proposed training and research activities will take
place at the Center for Behavioral Health and Youth Justice at Columbia University/New York State Psychiatric
Institute and be supervised by a team of NIMH-funded mentors with expertise in the sequalae and treatment of
trauma, the provision of services for YIJ under community supervision, and the design, implementation, and
evaluation of behavioral trials.