Clinical psychological science has developed many efficacious treatments for diverse emotional and behavioral difficulties encountered by children and adolescents, although randomized trials investigating these treatments have disproportionally been conducted by American, university-based research labs. The subsection of the world population involved in these studies, however, represents very few people among those in need of psychological services whose voices, perspectives, and orientations to therapy have not generally been reflected in well-funded research trials. Dissemination and implementation of evidence-based services designed to meet the needs of this broader global population, therefore, may require cultural and contextual adaptation to be successful. The current article describes the implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in 3 separate low-resourced settings (rural South Carolina, Puerto Rico, and El Salvador) utilizing the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and guided by a community-based participatory research framework. Emphasis is placed on description of program development, building collaborative and responsive partnerships, and the use of implementation strategies to guide continuous quality improvement. Program evaluation data comparing baseline to posttreatment trauma symptoms and treatment completion rates for all sites are also presented, which suggests that treatment was associated with a large reduction in symptoms, exceeding that noted in many TF-CBT randomized trials. The implications of attention to context, adaptation, and methods of building partnerships with global communities are discussed, with a particular focus on propelling more refined models and controlled studies in the future. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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听，不说：在资源匮乏的环境中实施以创伤为中心的认知行为疗法的伙伴关系和适应。

临床心理科学已经为儿童和青少年遇到的各种情绪和行为困难开发了许多有效的治疗方法，尽管调查这些治疗方法的随机试验不成比例地由美国大学研究实验室进行。然而，参与这些研究的世界人口中很少有需要心理服务的人，他们的声音、观点和治疗方向并未普遍反映在资金充足的研究试验中。因此，旨在满足更广泛的全球人口需求的循证服务的传播和实施可能需要文化和背景适应才能成功。当前文章描述了利用探索、准备、实施和维持 (EPIS) 在 3 个独立的低资源环境（南卡罗来纳州农村、波多黎各和萨尔瓦多）中实施以创伤为中心的认知行为疗法 (TF-CBT)框架并以社区为基础的参与式研究框架为指导。重点是描述计划开发、建立协作和响应式伙伴关系，以及使用实施策略来指导持续的质量改进。还提供了比较基线与治疗后创伤症状以及所有部位的治疗完成率的计划评估数据，这表明治疗与症状的大幅减少有关，超过了许多 TF-CBT 随机试验中指出的情况。讨论了对背景、适应和与全球社区建立伙伴关系的方法的关注的影响，特别关注在未来推动更完善的模型和受控研究。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。