Objective: Few studies have investigated determinants of trauma-informed care (TIC) in vulnerable youth populations. The purpose of the present study was to investigate factors associated with initiation, completion, and selection of type of TIC treatment among a sample of 128 treatment-seeking youth who experienced crime or violence. Method: This retrospective medical record review study used data collected through routine clinical care at an outpatient, no-cost community mental health clinic. Results: We found that 69.5% of treatment-seeking youth (n ϭ 89) initiated treatment, defined as attending at least 1 TIC session. Among youth who initiated treatment, 61.8% (n ϭ 55) completed a TIC treatment. Predisposing and need characteristics were not significantly associated with initiating or completing treatment in adjusted models. Youth assigned to trauma-focused cognitive-behavioral therapy (TF-CBT) were more likely to complete treatment compared with those assigned to child-centered therapy (CCT) approaches (odds ratio [OR] ϭ 4.48, 95% CI [1.35, 14.91], p ϭ .014). Logistic regression analyses suggested therapists were less likely to select TF-CBT for children with higher externalizing symptoms (OR ϭ 0.92, 95% CI [0.85, 0.99], p ϭ .035). Conclusions: Findings suggest among youth who called in for treatment, many successfully initiated treatment, and of those who initiated, most completed treatment. Empirically supported treatments such as TF-CBT may further promote treatment completion.
Clinical Impact StatementVulnerable youth populations who have experienced trauma may benefit from emerging best practices in TIC. These practices may include attending to clinical issues, such as using a structured treatment protocol and multiple attempts to schedule appointments, that have the potential to improve engagement with mental health services. Since low-income populations often have difficulty initiating and engaging in mental health treatment, Masked Manuscript without Author Information INITIATION, COMPLETION AND TREATMENT SELECTION IN YOUTH 2 findings suggest TF-CBT may help address such challenges in this population. Training community-based clinicians in TF-CBT and other TIC is imperative to meet the needs of this vulnerable population.