This study focuses on the translation of child-parent psychotherapy, an evidence-based intervention shown to improve the mental health and behavioral outcomes of infants and toddlers exposed to maltreatment, into the juvenile court system. The Infant Mental Health-Court Team Program (IMH-CTP) is an innovative, systems-changing model in which the child and family court becomes the platform for assuring timely referrals to child-parent psychotherapy, monitoring treatment, and ensuring that the child's emotional well- being is at the center of judicial decision-making and permanency planning. The model was developed and implemented in the Dependency Division of the Miami-Dade Juvenile Court (11th Judicial Circuit). The research study will examine the implementation process and outcomes associated with dissemination of child-parent psychotherapy via the IMH-CTP model in two new community settings: Leon County in Tallahassee, Florida (2nd Judicial Circuit Court) and Wayne County in Detroit, Michigan (3rd Judicial Circuit Court). The dissemination sites will receive intensive technical assistance in the form of periodic on-site annual trainings/workshops and peer-to-peer judicial mentoring, participation in a Webinar Learning Collaborative, and regular frequent communication with the """"""""expert"""""""" Miami court team. We will take a mixed- methods (quantitative/qualitative) approach to study implementation, collecting (a) semi-structured interview data on adoption and implementation processes from community stakeholders at the dissemination sites, (b) semi-structured interview data on implementation and maintenance at the originating Miami site, (c) court and clinical observational fidelity assessments at the dissemination sites, (d) structured and naturalistic documentation of dissemination and implementation activities, and (e) in-depth interviews with a subset of mothers who complete child-parent psychotherapy on satisfaction with treatment, the IMH-CTP experience, and facilitators/barriers to engagement in treatment. For the outcomes component of the study, 90 mother- infant dyads (30 at each of the three study sites) will be followed and mother/infant assessment data collected pre- and post-treatment and at 6-month follow-up. We will examine the relationship between fidelity of implementation and effectiveness, comparing the new dissemination sites (Tallahassee and Detroit) to the original site (Miami). Comparisons will be made in maltreatment recurrence, injuries, permanency outcomes, changes in the quality of the mother-child relationship, child development and behavioral health, and maternal depression and stress. The study findings will contribute to the translation research field with an evidence-based dissemination strategy for the IMH-CTP and represents an important step towards the institutionalization of child-parent psychotherapy in judicial practice to prevent recurrence of maltreatment and promote the health and well-being of maltreated infants and toddlers.
The principal aim of this multi-site, multi-disciplinary research application is to address the need for improved service integration by institutionalizing child-parent psychotherapy in the settings and systems that serve maltreated children and their families. The study findings will contribute to the translation research field with an evidence-based dissemination strategy for an innovative, systems-changing model whereby the child and family court is the platform for increasing the reach and effectiveness of child-parent psychotherapy. This effort represents an innovative public health approach to prevent recurrence of maltreatment and promote the health and well-being of maltreated infants and toddlers.
|Fraser, Jenifer Goldman; Lloyd, Stacey; Murphy, Robert et al. (2013) A comparative effectiveness review of parenting and trauma-focused interventions for children exposed to maltreatment. J Dev Behav Pediatr 34:353-68|