(PS5-C66) Adaptations and Pilot Implementation of the Datesmart Dating Violence Intervention Group on a Youth-serving Inpatient Unit

Teens with severe psychopathology are at elevated risk of involvement in adolescent dating violence (ADV), and psychiatrically hospitalized youth are at a greater likelihood of experiencing ADV risk factors. Further risk is noted for LGBTQ+ youth who are at much greater risk of ADV than their non-LGBTQ+ peers. Ongoing efforts to prevent and intervene in ADV focus primarily on school-based implementation.  Unfortunately, these programs often fail to address the needs of high-risk teens who may not consistently attend school, and no programs are specifically designed to target youth in intense psychiatric settings. One way to address this gap is by adapting existing programs to this unique setting.  DateSMART, a newer ADV prevention program, targets high-risk adolescent females through group-based, community implementation. Developed around the principles of Cognitive-Behavioral Therapy, DateSMART teaches skills to target known mechanisms of ADV. The current study sought to develop a modified version of DateSMART for a youth-serving inpatient unit with a high LGBTQ+ population, and to determine the feasibility and acceptability of the implementation.

Patients were on average 15 years old, with 53% self-reporting as sexual minority and 20% gender minority. In addition, 10% of patients endorsed having a disagreement or fight with a dating partner in the month prior to hospitalization. Based patient demographics, feedback from clinicians and unit staff, and consultation with an ADV expert, adaptations included the removal of sexual health content to account for younger developmental ages and to acknowledge the possible sexual trauma history of youth. Content was modified for delivery of stand-alone modules due to limited length of stay, and session length was shortened to align with other skills-based groups offered on the unit. The curriculum was made to be inclusive of co-ed and LGBTQ+ participants. Patients were asked to complete a session evaluation form following each session to incorporate feedback in an iterative process. The modified DateSMART group protocol was offered to all admitted patients as part of the general clinical services provided.

Preliminary findings indicate that adapting DateSMART to this acute setting was feasible as demonstrated by an ability to meet the unit’s unique programming needs while maintaining the integrity of the original DateSMART protocol. The modified DateSMART protocol was also observed to have comparable acceptability to currently run skills-based groups (p=0.284), and 71% (N=61) of participants agreed the group was relevant to their lives. Attendance was also equivalent to another skills-focused group run simultaneously on an opposite unit (p=0.074). 
As therapeutic engagement in skills-groups is notably difficult in this setting, fluctuations in perceived acceptability and engagement appear to be affected by environmental factors such as group cohesion and overall unit dynamics (e.g., unit acuity, COVID-related isolation). Other behavioral observations suggest that staff participation in group discussion, use of media to deliver group content, and prior dating experience also affects engagement. Finalized adaptations and considerations for implementation will be discussed.