title: Community-based implementation of trauma-focused interventions for youth: Economic impact of the learning collaborative model.
abstract: This study investigated the economics of the learning collaborative (LC) model in the implementation of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), an evidence-based intervention for traumatic stress in youth. We evaluated the cost-effectiveness of the LC model based on data from 13 LCs completed in the southeastern United States. Specifically, we calculated cost-effectiveness ratios (CERs) for 2 key service outcomes: (a) clinician TF-CBT competence, based on pre- and post-LC self-ratings (n = 574); and (b) trauma-related mental health symptoms (i.e., traumatic stress and depression), self- and caregiver-reported, for youth who received TF-CBT (n = 1,410). CERs represented the cost of achieving 1 standard unit of change on a measure (i.e., d = 1.0). The results indicated that (a) costs of $18,679 per clinician were associated with each unit increase in TF-CBT competency and (b) costs from $5,318 to $6,548 per youth were associated with each unit decrease in mental health symptoms. Thus, although the impact of LC participation on clinician competence did not produce a favorable CER, subsequent reductions in youth psychopathology demonstrated high cost-effectiveness. Clinicians and administrators in community provider agencies should consider these findings in their decisions about implementation of evidence-based interventions for youth with traumatic stress disorders. (PsycINFO Database Record
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.
authors.forename: Alex R
authors.initials: AR
authors.lastname: Dopp
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.
authors.forename: Rochelle F
authors.initials: RF
authors.lastname: Hanson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.
authors.forename: Benjamin E
authors.identifier: 0000-0001-5357-4006
authors.initials: BE
authors.lastname: Saunders
authors.affiliation: Center for Health Disparities Research, Medical University of South Carolina.
authors.forename: Clara E
authors.initials: CE
authors.lastname: Dismuke
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Moreland
mesh_terms: D000293:Adolescent; D002983:Clinical Competence / Q000191:economics / Q000592:standards; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods / Q000592:standards; D003156:Community Mental Health Services / Q000191:economics / Q000379:methods / Q000592:standards; D003362:Cost-Benefit Analysis; D055317:Evidence-Based Practice; D006801:Humans; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D015144:Southeastern United States; D040921:Stress Disorders, Traumatic / Q000628:therapy*