Confirmatory Efficacy of the Building a Strong Identity and Coping Skills Program for Low-Income Young Adolescents

PROJECT SUMMARY Levels of adolescent anxiety, depression, and suicidality have been steadily rising over the last decade and have reached record levels in the wake of the COVID pandemic, prompting declarations of a national emergency in youth mental health. These alarming trends are especially dramatic for youth living in poverty, and low-income youth who are members of minoritized racial or ethnic groups and those living in isolated rural areas, who experienced some of the most severe impacts from the pandemic. The COVID pandemic and its mitigation efforts exacerbated these disparities by increasing potent stressors such as social isolation, loss, and family disruptions. Mental health risks evident for diverse low-income adolescents are further compounded by limited access to culturally affirming services made even scarcer in the pandemic. Waitlists at many youth- serving clinics approach 12 months, and access to affordable services is even more limited. Equally important is the dearth of interventions designed specifically to meet the needs of low-income adolescents that are trauma-informed, and based on inclusive empowerment principles, contextual strength-based frameworks, and firm empirical evidence. The Building a Strong Identity and Coping Skills (BaSICS) program is a trauma- informed coping and empowerment intervention for early adolescents exposed to chronic stress that (1) teaches individual and collaborative skills for coping with stress and trauma, (2) develops positive social identity, and (3) culminates in group-based community action. By building supportive relationships with peers, improving active engagement coping, fostering identity development, and empowering youth to action, BaSICS gives adolescents tools with which to address the myriad stressors to which they are exposed. The proposed work aims to replicate and extend the findings from a smaller-scale trial of BaSICS where, relative to control group, youth randomized to BaSICS acquired targeted coping and self-regulation skills and demonstrated improved cortisol reactivity and reduced internalizing problems. The proposed study will examine treatment effects on depression, anxiety and suicidality in clinically referred youth from four sites across central Pennsylvania. The proposed project will also extend prior findings by integrating data across multiple biological stress response systems to further evaluate the potential for BaSICS to re-calibrate dysregulated stress physiology. Enrolling low-income youth from various racial and ethnic groups and from urban and rural areas, the trial will enable examination of potential moderators of BaSICS that can inform future dissemination efforts. The proposed study promises to further NIMH’s Strategic Framework on Youth Mental Health Disparities by improving our understanding of interventions with potential to reduce mental health disparities. Adding to our mental health arsenal a biologically potent, targeted intervention that balances the need for fundamental self-regulation and coping skills with the need for a culturally affirmative strength and resource building approach, could help move the needle on socioeconomic health disparities.