Adaptation of a trauma-informed intervention for youth involved in the legal system.

Background: Youth in the legal system (YILS) have high rates of trauma exposure, which are associated with increased risk of behavioral health needs (e.g., substance-use problems) and recidivism. Research suggests that a trauma-focused therapeutic approach can improve outcomes for YILS, but few evidence-based interventions (EBIs) are designed with justice-involved youth in mind. Consequently, implementing trauma-informed EBIs within juvenile justice (JJ) systems is challenging. The current paper describes the systematic adaptation of Trust-based Relational Intervention (TBRI) as a substance use prevention intervention for YILS and their caregivers. Methods: The current study utilized a methodology based on the ADAPT-ITT framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention program. Phases of adaptation included (1) Results: The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the Conclusions: Utilizing an implementation science framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually-appropriate interventions. Accounting for contextual factors and population needs can improve the fit of EBIs in juvenile justice, facilitating uptake and ultimately improving outcomes for youth. Trial registration: ClinicalTrials.gov Identifier: NCT04678960.