Adaptation of a Transdiagnostic Cognitive-Behavioral Treatment for Adolescents with Comorbid Mental Health Conditions and High Risk Behavior

ABSTRACT

Millions of adolescents seek treatment for mental health concerns and high-risk behaviors (e.g., suicidality, non-suicidal self-injury, substance use) each year. Use of services for mental health crises have only increased since the onset of the COVID-19 pandemic. Evidence-based treatments that can be readily employed in community settings are sorely needed to address the growing adolescent mental health crisis. To be most effective, they must be able to accommodate the common comorbidity and high-risk behaviors present among the treatment-seeking adolescent population, and be designed in a manner that can be readily adopted by clinicians that serve these youth within community-based organizations. Following the Replicating Effective Programs (REP) framework, we describe the adaptation and pre-implementation process of a transdiagnostic and modular cognitive-behavioral treatment, which integrates motivational interviewing and dialectical behavior therapy techniques, to address multiple adolescent mental health conditions and high-risk behaviors. Using a mixed-methods design, we collected data from community clinicians and/or other stakeholders on perceptions of the training protocol and treatment manual, self-efficacy and knowledge in manual use, use of modules with clients, and treatment adherence, to inform our REP efforts around modifications to the training and treatment manual. We present these data and describe modifications made using the Framework for Reporting Adaptations and Modifications (FRAME) to evidence-based interventions. Overall, data support our intensive training model and transdiagnostic treatment for use by clinicians in community settings. Stakeholder engagement, adaptations to the training and treatment materials, and participation in post-training consultation, appeared to facilitate successful pre-implementation efforts.

Acknowledgments

We would like to thank James Gillespie and Rick Leichtweis whose leadership made this work possible. We would also like to sincerely thank all members of the Fairfax Consortium for Evidence-Based Practice (FCEBP) Leadership Group, all of whom contributed significantly to the work reviewed in this manuscript. Finally, we would like to extend our sincerest gratitude to the Fairfax County Community Policy and Management Team who authorized funding for the FCEBP through Healthy Minds Fairfax.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/23794925.2022.2124556

Additional information

Funding

Healthy Minds Fairfax, Grant ID: 223181.