The science-practice gap in the treatment of mental health is most pronounced in community settings, where clients with the highest needs often receive their care. Implementation science and community-based participatory research (CBPR) strategies aim to effectively address this gap by establishing partnerships that focus on scientifically rigorous as well as clinically and socially relevant research. Despite significant benefits, the CBPR implementation framework has a unique set of challenges. The current paper describes evidence-based implementation strategies that were deployed to address various barriers to implementation and long-term sustainability of an innovative cognitive behavioral theory (CBT) life skills program identified during a feasibility trial. Through the committed work of an established partnership between a community-based nonprofit organization and researchers, barriers were jointly identified as well as the strategies for mitigating these obstacles. Specific challenges included fidelity (variability in staff's CBT competency and delivery), sustainability, and cost of guideline implementation (data collection, time, and resources) of the CBT curriculum. We also provide details on the partnership solutions

Psychosocial interventions for common emotional and behavioral difficulties have been developed for use in correctional facilities, yet these programs are largely unavailable upon community re-entry due to a shortage of trained mental health specialists. In this study, we developed and piloted a youth worker-delivered cognitive behavioral therapy (CBT) program for young men at high risk for incarceration receiving services at a youth development organization. We formed a community-academic partnership to support the conduct of research across all phases of this project (2014–2016). We analyzed data gathered through focus groups and individual interviews with program staff, administrators, and young men. This study reports on implementation process and outcomes across phases. Main findings indicate the preliminary feasibility and acceptability of the youth worker-delivered CBT curriculum. We discuss strengths and limitations of our approach and provide suggestions for future studies that aim to implement paraprofessional-delivered CBT programs within community-based organizations.

ObjectiveMale youth who have been involved in the juvenile legal system have disproportionate rates of trauma and violence exposure. Many justice-involved youth have untreated mental illness, with an estimated 66% of young men who are incarcerated meeting criteria for at least one mental health disorder, including posttraumatic stress disorder (PTSD), depression, and substance abuse. While Cognitive Behavioral Therapy (CBT) approaches are considered among effective evidence-based treatments for addressing and treating behavioral and emotional difficulties, male youth with a history of incarceration and youth who are at risk for (re)incarceration, violence, emotion dysregulation, and trauma face significant barriers in accessing these services.MethodsRoca, Inc. (Roca), an internationally recognized organization moving the needle on urban violence by working relentlessly with young people at the center of violence in Massachusetts and Maryland, employs a trauma-informed CBT-based skills curriculum and approach in their intervention model, to improve youths' educational, employment, parenting, and life skills opportunities, while decreasing risk for recidivism, addressing trauma and increasing skills for emotion regulation. The aim of this analysis was to assess the effectiveness of Roca's trauma-informed CBT skills curriculum on youths' emotional and behavioral outcomes. We analyzed data from over 300 participating emerging adult men from four sites in Massachusetts and one site in Baltimore, Maryland who had at least three series of data collection across multiple skills-based sessions.ResultsWe found improvements in outcomes in overall mean scores related to decreased distress about employment and education, as are expected with standard intervention approaches for justice-involved youth. Participants who show improvement in emotion regulation across engagement (approximately half the cohort), were found to have significant improvements in distress related to relationship and family functioning and self-care, and decreased substance use, along with other outcomes compared to those participants with less improvement in emotion regulation. Furthermore, improvement in different aspects of emotion regulation were associated with improved relationships, life distress, substance use, and improved prosocial thinking.ConclusionsTogether, these data suggest that adding mental health support and skills training, such as with trauma-informed CBT models, to programs for justice-involved youth may lead to significant improvements in functioning, quality of life, and mental health outcomes.

The aim of this study was to evaluate the effectiveness of a flexible modular cognitive-behavioral theory (CBT) skills curriculum delivered by paraprofessionals in a community organization targeting high-risk justice-involved youth. Programmatic data were collected from 980 high-risk young men (M age, 21.12; SD, 2.30), and Cox proportional hazards regression was used. The results showed that compared with young men with no CBT encounters, those with one or more CBT encounters had a 66% (hazard ratio [HR], 0.34; 95% confidence interval [CI], 0.28–0.42; p < 0.001) lower risk of unenrolling from programming, 65% (HR, 1.65; 95% CI, 1.29–2.12; p < 0.001) higher risk of obtaining a job, and no difference in risk of engaging in new criminal activity while enrolled in programming (HR, 0.99; 95% CI, 0.78–1.25; p = 0.918), despite higher risk factors. Training paraprofessionals to deliver CBT skills to high-risk populations is effective and has scalability potential.

Conduct a comprehensive needs assessment to evaluate the fit of a Cognitive Behavioral Theory (CBT) curriculum implemented within a community organization and inform possible adaptations to fit the mental health difficulties of high-risk Latina young mothers. The PRECEDE-PROCEED implementation framework guided the assessment and results. Focus groups were conducted with high-risk Latina young mothers and staff members to assess the priority mental health problems, environmental stressors and factors contributing and maintaining these difficulties, and existing resources that could be leveraged to address them. Latina young mothers experience a variety of mental health needs and immigration and interpersonal-related stressors. The organization's existing CBT curriculum was found to be feasible and a good fit for the target population. Proposed minor adaptations included a focus on parenting. Results support the robust effects of CBT interventions, including when delivered by paraprofessionals to a high-risk population in a low-resource community setting. 1 | INTRODUCTION Every one in five women in the United States identifies as a Latina (Gándara, 2015), and by 2060, it is projected that Latinas will comprise nearly one-third of the female population in the United States (Colby & Ortman, 2015). Derri L. Shtasel and Luana Marques are co-senior authors.