Clinical Outcomes of Outpatient SPARCS Group Therapy for Adolescents with Chronic Trauma Histories

Background Despite widespread dissemination of Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) for youth with complex trauma histories, relatively little research has evaluated its implementation in routine outpatient behavioral health settings. Objective: The current study evaluated trajectories of traumatic stress symptoms and everyday functioning among adolescents participating in SPARCS groups within a large urban academic pediatric hospital.Method Participants included 73 adolescents (Mage = 15.51 years) who participated in SPARCS groups between 2022 and 2024. The sample was characterized by diverse racial and socioeconomic backgrounds, extensive adversity exposure, high rates of psychiatric comorbidity, and significant baseline impairment. Traumatic stress symptoms (Child PTSD Symptom Scale for DSM-5) and everyday functioning (Ohio Scales for Youth – Functioning Scale) were assessed at pre-, mid-, and post-treatment, and linear growth models evaluated change over time. Exploratory analyses evaluated whether sociodemographic and clinical characteristics were associated with treatment trajectories.Results Adolescents demonstrated significant reductions in traumatic stress symptoms (Est = -3.155, SE Est = 0.817, p < .001) and improvements in everyday functioning (Est = 3.471, SE Est = 0.744, p < .001) across treatment. Although everyday functioning improved over time, most participants continued to report clinically impaired functioning at treatment completion. Trajectories of traumatic stress symptoms and everyday functioning did not differ as a function of demographic or clinical characteristics. Greater cumulative adversity exposure was associated with higher traumatic stress symptoms and poorer everyday functioning at baseline.Conclusions Findings provide preliminary support for the implementation of SPARCS within routine outpatient pediatric behavioral health settings serving adolescents with complex trauma histories and psychiatric comorbidity. Results highlight the importance of addressing functional recovery as a distinct treatment target and underscore the need for continued research examining SPARCS’ mechanisms of change and long-term outcomes.