Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based intervention to treat post-traumatic stress disorder among youth ages 3–18 years old. In this pilot study, 31 clinicians in 13 urban public schools received TF-CBT training to improve access to high-quality trauma treatment for youth in need. A mixed methods design was used to assess implementation barriers, facilitators, and outcomes to examine initial feasibility, acceptability, and appropriateness of TF-CBT delivered in school settings. Although 70% of clinicians reported confidence in the evidence-base of TF-CBT and its potential to support their students who have a very high prevalence of lifetime trauma exposure, implementation practice outcomes suggest a wide range of TF-CBT use (range = 0–11 students enrolled per clinician, mean = 1.4 students) with 23 clinicians implementing the TF-CBT model with at least one case. Results point to the potential value of training school mental health clinicians in TF-CBT based on its compatibility with student needs. Yet, by connecting focus group results to top-rated barriers and facilitators, we identify several adjustments that should be made to improve intervention-setting fit in future studies. Specifically, school setting-specific intervention adaptations, school-tailored implementation support, and thoughtful consideration of school-based clinicians’ roles and responsibilities are needed to enhance future implementation success.

以创伤为中心的认知行为疗法 (TF-CBT) 是一种基于证据的干预措施，用于治疗 3-18 岁青少年的创伤后应激障碍。在这项试点研究中，13 所城市公立学校的 31 名临床医生接受了 TF-CBT 培训，以改善有需要的青少年获得高质量创伤治疗的机会。混合方法设计用于评估实施障碍、促进因素和结果，以检查在学校环境中提供的 TF-CBT 的初步可行性、可接受性和适当性。尽管 70% 的临床医生表示对 TF-CBT 的证据基础及其支持终生创伤暴露患病率非常高的学生的潜力充满信心，但实施实践结果表明 TF-CBT 的广泛使用（范围 = 0每位临床医生招收 –11 名学生，平均值 = 1。4 名学生）和 23 名临床医生在至少一个案例中实施 TF-CBT 模型。结果表明，基于 TF-CBT 与学生需求的兼容性，培训学校心理健康临床医生具有潜在价值。然而，通过将焦点小组的结果与排名最高的障碍和促进因素联系起来，我们确定了应该进行的几项调整，以提高未来研究中干预设置的适应性。具体而言，需要针对学校环境进行干预调整、为学校量身定制实施支持以及对校本临床医生角色和责任的深思熟虑，以提高未来实施的成功率。通过将焦点小组的结果与排名靠前的障碍和促进因素联系起来，我们确定了应该进行的几项调整，以提高未来研究中干预设置的适应性。具体而言，需要针对学校环境进行干预调整、为学校量身定制实施支持以及对校本临床医生角色和责任的深思熟虑，以提高未来实施的成功率。通过将焦点小组的结果与排名靠前的障碍和促进因素联系起来，我们确定了应该进行的几项调整，以提高未来研究中干预设置的适应性。具体而言，需要针对学校环境进行干预调整、为学校量身定制实施支持以及对校本临床医生角色和责任的深思熟虑，以提高未来实施的成功率。