From Pilot to Practice: Adapting Trauma Intervention for Foster Youth

Trauma-informed care for youth in foster care has long fallen short of the urgent need despite overwhelming evidence of the long-term consequences of untreated trauma. A multisite randomized control trial led by Dr. Tanya Renn (FSU College of Social Work) and Dr. Taylor Dowdy-Hazlett (University of Kentucky) (PhD ’22) and their dedicated team at the Stoops Center for Communities, Families, and Children (Stoops CFC Center) is generating new insights into how adapted trauma interventions can meet this challenge.

The study builds on a 2022 pilot that modified the school-based Cognitive Behavioral Intervention for Trauma in Schools (CBITS) for use in community-based group homes for foster youth. The pilot study evaluates the adapted intervention with 80 youth in out-of-home care settings in collaboration with Boys Town North Florida and Boys Town Central Florida, funded by the Florida Institute for Child Welfare.

Pilot Project Update

To date, 26 participants have engaged in the intervention, completing at least one session. An additional 24 youths are enrolled as part of a waitlist control group.

“Innovative trials like the CBITS work are invaluable to uncovering new, impactful, and scalable ways to support system-impacted youth. The Florida Institute for Child Welfare is proud to fund this work, and I am highly encouraged by the initial findings,” said Dr. Lisa Magruder, director of the Florida Institute for Child Welfare.

Initially designed for classrooms, CBITS equips youth with coping skills, emotional regulation strategies and trauma-processing techniques through structured cognitive behavioral therapy. To adapt CBITS for residential care, the Stoops CFC Center team applied the ADAPT-ITT framework, integrating feedback from youth, clinicians, and national stakeholders to inform every modification.

Key modifications included introducing a minimum of three individual sessions prior to group participation to build rapport and prepare youth for trauma narrative work. Group sizes were reduced from eight to five to better support behavioral needs and cohesion. The content was also adapted to more accurately reflect the lived experiences of abuse, neglect, and placement instability commonly faced by foster youth.

Quantitative data from the pilot phase revealed clinically significant trauma symptomology at baseline. Following the intervention, participants demonstrated:

• reduced trauma symptoms,
• improved emotional regulation and
• greater engagement in problem-solving.

Qualitative feedback added depth to these findings, with youth participants reporting that CBITS helped them develop coping skills, manage stress, and reframe how they approach challenges. Participants shared that the intervention taught them to “keep calm,” “cope with stressors,” and “problem-solve tough situations.”

One youth explained they “have proper coping skills now” and appreciated learning “how we can look at things differently.” Reported usage of CBITS tools was high—35.3% of youth reported using them three or more times a week, another 35.3% one to three times weekly, and 5.9% one to three times a month.

“This project reflects the heart of what we strive to do at the Stoops CFC Center - collaborate with community partners to implement evidence-based solutions that meet children and families where they are. Seeing youth not only engage with CBITS but apply what they’ve learned in meaningful ways is incredibly rewarding,” said Savannah Collier, assistant director at the center.

To uphold the rigor of the multisite trial, data collection occurs at post-intervention, 3-month, and 6-month intervals. In response to early challenges with self-administered surveys, particularly among participants with varying literacy levels, the team transitioned to structured interviews, enhancing the accuracy and depth of responses.

“This project is special because it opens the door to alternative treatments for youth in foster care who frequently face significant barriers to accessing mental health care, especially evidence-based trauma treatment,” said Dr. Dowdy-Hazlett, assistant professor at the University of Kentucky College of Social Work and FSU alumna (PhD 2022). “By using a group-based therapy model, we not only increase access and efficiency, but also deliver focused, trauma-informed care that directly addresses the high rates of post-traumatic stress among these youth.”

A strong partnership with Boys Town has been critical to implementation. From consent procedures to youth grouping logistics, agency staff collaborated closely with researchers to ensure trauma-informed, participant-centered practices. According to Dr. Renn, co-principal investigator, these relationships were foundational to the project’s success.

“Engaging community partners from the start grounded our research in real-world experience. Their insight shaped everything—from our research questions to how we delivered the intervention. That trust and collaboration are what made this trial both ethical and impactful,” Dr. Renn emphasized.

As the trial continues through 2025, early findings suggest that the adapted CBITS model has strong potential to improve outcomes for youth in residential care. With data collection underway and further analysis on the horizon, the Stoops CFC Center hopes the intervention can inform broader systems change, providing a scalable trauma-informed model for foster care environments across the state and beyond.