Integrating Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Racial Socialization for Traumatized Black Youth

Black youth in America are at elevated risk for experiencing trauma, including racial trauma, and for developing posttraumatic stress disorder (PTSD) and other related mental health and medical problems. Through our SAMHSA-funded National Child Traumatic Stress Network (NCTSN, www.nctsn.org) grant, Allegheny General Hospital’s Center for Traumatic Stress in Children & Adolescents hosted a 12-month Learning Community focused on integrating TF-CBT with Racial Socialization for Black youth who experience trauma, including racial trauma. Racial Socialization incorporates a variety of systematic strategies and behaviors that Black families use to instill resilience and positive racial identity. This Learning Community greatly benefited from prior work developed by Isha W. Metzger, Ph.D., and colleagues (Metzger et al, 2021); https://www.drishametzger.com/research

The Learning Community consisted of 28 clinicians, supervisors and trainers from six NCTSN centers: Allegheny General Hospital (Pittsburgh, PA), Center for Children and Families (Durham, NC), Dee Norton Low Country Children’s Advocacy Center (Charleston, SC), Healing Hurt People, Drexel University (Philadelphia, PA), Georgia Center for Child Advocacy (Atlanta, GA), and PACTS (Philadelphia, PA). All members had completed prior TF-CBT training and consultation. Goals of the Learning Community were to 1) collaboratively discuss how to integrate Racial Socialization strategies into TF-CBT for Black youth who experience trauma including racial traumas, using clinical cases seen by members of the Learning Community; 2) treat Black youth using these integrated strategies and assess treatment outcomes for PTSD; and 3) develop an Integrated TF-CBT and Racial Socialization Implementation Manual.

The Learning Community began with a full-day training on Racial Socialization and Racial Trauma by Dr. Metzger (https://www.drishametzger.com/racial-trauma-trainings). This was followed by monthly calls. During each call, one of the teams presented a clinical case of a Black youth receiving integrated TF-CBT +RS that one of their clinicians was providing, focusing on how to integrate Racial Socialization into a specific TF-CBT PRACTICE component; team members discussed successes and how to address challenges. Each month, data were collected from clinicians with regard to youth they were seeing through the project. Additionally, participants completed the Therapist Racial Trauma Efficacy Scale at the beginning and the end of the Learning Community to assess changes in our perceptions of changes in our personal efficacy in treating racial trauma.

The outcomes of this Learning Community have been very positive. Clinicians reported significant increases in their perceived efficacy related to treating racial trauma. Black youth who have completed treatment in the project to date have reported highly significant improvement in PTSD symptoms. In response to many inquiries about this project, we are creating this page to disseminate resources and information about implementing TF-CBT + Racial Socialization for TF-CBT therapists who are interested in this application. In the coming months we will post more resources, including the TF-CBT + Racial Socialization Implementation Manual. We are very excited about this application, and look forward to providing more information and resources on this page in the near future.

Resources for Implementation can be downloaded from https://www.drishametzger.com/online-resources

Additional TF-CBT Resources can be found at https://tfcbt.org/implementation

Metzger, I. W., Anderson, R. E., Are, F., & Ritchwood, T. (2021). Healing Interpersonal and Racial Trauma: Integrating Racial Socialization into Trauma-Focused Cognitive Behavioral Therapy for African American Youth. Child Maltreatment, 26(1), 17–27. https://doi.org/10.1177/1077559520921457

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