Integrating Trauma-Focused CBT and Racial Socialization for Traumatized Black Youth

Black youth experience disproportionately high rates of trauma including racial trauma and resultant PTSD. Racial socialization (RS) provides strategies to recognize, prepare for, and manage racial stress and trauma. Integrating RS with an evidence-based trauma-focused (TF) treatment such as TF-CBT may enhance outcomes for Black youth who experience racial and/or other traumas. Isha Metzger, PhD, describes the RS approach, examples of RS strategies, the TF-CBT model, and the rationale for integrating RS with TF-CBT for Black youth who experience trauma including racial trauma. Anthony Mannarino, PhD, describes a yearlong National Child Traumatic Stress Network (NCTSN) Learning Community (LC) to integrate RS with TF-CBT for traumatized Black youth. The Therapist Racial Trauma Efficacy Scale (TRTES) assessed therapist self-reported efficacy pre- to post-LC. Ashley Dandridge, PsyD, describes LC clinical cases to illustrate TF-CBT + RS strategies for implementing the integrated approach, with pre- and post-Child PTSD Symptom Scale for DSM-5 (CPSS-5) outcomes from these cases. Judith Cohen, MD, describes youth LC demographic and clinical outcome data using the CPSS-5 to assess youth PTSD symptoms. Lisa Amaya-Jackson, MD, NCTSN Co-Director, discusses potential future implications for integrating RS into other evidence-based treatments for traumatized Black youth. Thirty clinicians, supervisors, and trainers from 6 NCTSN organization participated in the learning community. TRTES scores increased significantly from pre- to post-LC (t = 3.53, p = .0002). Fifty Black youth ages 7 to 20 years and their primary caregivers began TF-CBT + RS; 28 youth have completed treatment and posttreatment CPSS-5 to date, and 8 continue in treatment with no significant demographic differences between completers and noncompleters. Among completers, CPSS-5 scores have documented significant improvement from pretreatment (mean = 43.18, severe PTSD) to posttreatment (mean = 24.21, moderate PTSD; t = 4.42, p = .00002). This evidence suggests that integrating TF-CBT and RS can be an effective strategy for significantly improving outcomes for traumatized Black youth. Implications for integrating RS with other trauma-focused evidence-based treatments are discussed.