Continuum-of-Care Project

The neediest youth, with complex trauma histories, severe psychiatric profiles, and dangerous misbehavior, are served by the New York State Office of Mental Health (NYS-OMH) inpatient and day-treatment facilities. 

In 2004, the leadership of NYS-OMH sought evidence-based treatment (EBT) for these extremely ill youth, and found that nothing had been developed and tested.  As a result, NYS-OMH leadership collaborated with Dr. Elissa Brown and other experts in the assessment, treatment, and study of traumatized children and adolescents, to design such a program. 

A Complex Trauma-Cognitive Behavior Therapy (CT-CBT) intervention was compiled by combining two EBTs: one focused on trauma-related misbehavior and social skills deficits (Kolko, 1996), and one focused on PTSD and depression (Cohen et al., 2004). 

PARTNERS has initiated clinical trials with youth treated in NYS-OMH inpatient and day-treatment programs for trauma-related mental health problems. 

These projects will inform us about: (1) the feasibility of doing CT-CBT in these settings, (2) the ability to train seasoned clinicians in CT-CBT, and (3) the effectiveness of CT-CBT in reducing symptoms of PTSD, depression, and disruptive behavior disorders among chronically traumatized youth.

Inpatient Outcomes to Date

  • Following treatment, social skills improvements were higher for youth receiving CT-CBT than for those receiving standard clinical care. 
  • PTSD symptoms decreased for the youth who received CT-CBT, whereas they increased for those who received standard clinical care. 
  • No differences between treatments were found for depression symptoms


Day-Treatment Outcomes to Date

  • Following treatment, the children who received CT-CBT were in the normal range for depression, self-esteem, and locus of control, whereas the child who received SCC remained at-risk for depression, low self-esteem, and external locus of control
  • The children who received CT-CBT reported having only one PTSD symptom, whereas the child who received SCC continued to experience PTSD (endorsing eight of 17 symptoms) 
  • No differences between treatments were found on social skills deficits