3 - (SYM 47) Applying the ADAPT-ITT Framework to Modify Trauma-focused Cognitive Behavioral Therapy for Autistic Youth

Autistic youth are at increased risk for both trauma exposure and trauma-related symptoms (e.g., PTSD, depression). Yet, interventions to address trauma have been understudied in autistic individuals. Fortunately, an evidence-based intervention for youth trauma (i.e., Trauma-Focused Cognitive Behavioral Therapy; TF-CBT; Cohen et al., 2017) holds promise for treating trauma in autistic youth. While TF-CBT has not yet been tested with autistic youth, several reviews have proposed modifications to tailor TF-CBT for autistic youth. However, these modifications were not developed with input from autistic people nor have these models been rigorously tested. Therefore, the present study applies an adaptation framework (i.e., ADAPT-ITT; Wingood & DiClemente, 2008) to guide systematic, community-partnered modification of TF-CBT for autistic youth served in community settings.

Given its prioritization of community engagement, the ADAPT-ITT framework was selected to guide the modification process. We are engaging community partners in co-designing TF-CBT modification via two primary methods: (1) the formation of a community advisory board (CAB) and (2) focus groups. The role of the CAB is to identify and plan modifications to TF-CBT materials to be presented for feedback during focus groups. Focus groups will be conducted with three key groups: (1) autistic young adults and caregivers of autistic youth, (2) certified TF-CBT clinicians working in community mental health, and (3) TF-CBT trainers. The type and content of modifications will be documented using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME; Wiltsey Stirman et al., 2019).

This presentation will advance community-partnered methodologies to tailor EBPs for autistic people across the lifespan by: (a) describing the rationale and decision-making process for selecting an adaptation framework that prioritizes community engagement to modify TF-CBT for autistic youth; (b) describing the methods used to guide planned modifications to TF-CBT with partners, including how modifications will be distinguished from drift from intervention fidelity; and (c) highlighting the importance and implications of including key groups of community partners, ranging from intervention recipients to end-users, to optimize intervention fit. This project not only addresses a significant services gap and research priority for autistic individuals but also advances the science of intervention adaptation through application of implementation science frameworks.