Danica Knight, Texas Christian University – Hope Connection 2.0

Connection with others can bring better outcomes for children afflicted with trauma.

Danica Knight, Rees-Jones Director of the Karyn Purvis Institute and professor of psychology at Texas Christian University, examines how to foster this.

Danica Kalling Knight, Ph.D. serves as Professor of Psychology and Rees-Jones Director of the Karyn Purvis Institute of Child Development (KPICD) at Texas Christian University (TCU). As director, her primary responsibility is to ensure that Karyn’s dream of “bringing hope and healing to children around the world” is realized through the institute’s mission of research, education, and outreach efforts. Her current efforts focus on the dissemination and implementation of Trust-based Relational Intervention® (TBRI®), a whole-child, attachment-based, trauma-informed, and sensory-rich approach to addressing the needs of children who’ve experienced trauma. TBRI’s applicability and effectiveness within and across systems of care, including juvenile justice, child welfare, courts, schools, etc., provides rich opportunities to transform communities and affect outcomes for children and families around the world.

Danica earned her PhD in Experimental Psychology from TCU under the tutelage of Dr. David Cross, and after serving as Senior Research Scientist at TCU’s Institute of Behavioral Research, joined the KPICD in 2019. In her 30-plus years as a researcher and scholar, Danica has led large-scale efforts to adapt, test, and implement effective interventions for vulnerable populations, including youth and adults in the criminal legal and child welfare systems. These efforts have resulted in over 65 publications, including peer-reviewed articles on trauma-informed prevention interventions, improving linkages to social support and substance use services, and strategies for supporting the successful implementation of new practices within social service organizations. Her research has included seven NIH/NIDA-funded grants (three funded through NIH cooperative agreements) and two SAMHSA-funded projects, including the Center for the Adaptation and Implementation of TBRI (CAIT) grant, a Category II center funded as part of SAMHSA’s National Child Traumatic Stress Initiative (NCTSI).

Hope Connection 2.0

In the U.S., 1 in 7 children experience trauma in the form of child abuse or neglect.  

Scientists now understand that behaviors such as aggression and unprovoked emotional outbursts—disruptive behavior in a classroom or angry outbursts in the grocery store—are for many children deeply ingrained, neurologically-based trauma responses.  

In response, our team developed Trust-based Relational Intervention® (or TBRI®), a trauma-informed approach with scientific foundations in attachment theory, neuroscience, sensory processing, and behavioral science.  

Our research documents the effectiveness of TBRI for children through a variety of modalities, including therapeutic family camps. In a study of our “Hope Connection” camp model, we used a within-subjects waitlist control design to examine change in children’s trauma-related emotional expression and behavior before and after camp.  

Adopted children and their siblings engaged in experiential activities designed to build trusting relationships, promote felt-safety, and practice regulation. Each child was assigned a “buddy”—a college student trained in TBRI—who served as their attachment figure while parents received TBRI training.  

6-months after camp ended, parents reported decreased conduct problems and posttraumatic stress (arousal) over time, reductions in hyperactivity and anger, and decreased sensory processing challenges (such as sensory seeking and sensory avoidance behaviors).  

The camp experience is particularly powerful because all members of the family are immersed in TBRI. Children experience what it feels like to have someone see and meet their needs; parents learn with coaches in real time; and students gain valuable expertise while serving as catalysts for family transformation.

Publications

• Knight, D.K., Belenko, S., Dennis, M.L., Wasserman, G. A., Joe, G. W., Aarons, G. A., Bartkowski, J. P., Becan, J. E., Elkington, K. S., Hogue, A., McReynolds, L. S., Robertson, A. A., Yang, Y., & Wiley, T. R. A. (2022). The comparative effectiveness of Core versus Core+Enhanced implementation strategies in a randomized controlled trial to improve substance use treatment receipt among justice-involved youth. BMC Health Services Research,22(1), 1-16.  https://doi.org/10.1186/s12913-022-08902-6
• Belenko, S., Dembo, R., Knight, D. K., Elkington, K. S., Wasserman, G. A., Robertson, A. A., Welsh, W. N., Schmeidler, J., Joe, G. W., & Wiley, T. (2022). Using structured implementation interventions to improve referral to substance use treatment among justice-involved youth: Findings from a multisite cluster randomized trial.Journal of Substance Abuse Treatment, 140, https://doi.org/10.1016/j.jsat.2022.108829
• Knight, D. K., Becan, J. E., Olson, D., Davis, N. P., Jones, J., Wiese, A., Carey, P., Howell, D., & Knight, K. (2021). Justice Community Opioid Innovation Network (JCOIN): The TCU research hub. Journal of Substance Abuse Treatment. 1
  (5). https://www.sciencedirect.com/science/article/pii/S0740547221000167
• Knight, D.K., Yang, Y., Joseph, E.D., Tinius, E., Young, S., Shelley, L., Cross, D.R., & Knight, K. (2021). Preventing opioid use among justice involved youth as they transition to adulthood: Leveraging safe adults (LeSA) protocol paper. BMC Public Health.21(1). doi: https://doi.org/10.1186/s12889-021-12127-3
• Wasserman, G. A., McReynolds L. S., Taxman, F., Belenko, S., Elkington, K. S., Robertson, A., Dennis, M. L., Knight, D. K., Knudsen, H. K., Dembo, R., Ciarleglio, A., Wiley, T. A. (2021). The missing link(age): Multilevel contributors to service uptake failure in youths on community justice supervision. Psychiatric Services. online. https://ps.psychiatryonline.org/doi/epub/10.1176/appi.ps.202000163
• Elkington, K. S., Spaulding, A., Gardner, S., Knight, D., Belenko, S., Becan, J. E., Robertson, A. A., Oser, C., & DiClemente, R. (2020). A system-level intervention to encourage collaboration between juvenile justice and public health agencies to promote HIV/STI testing. AIDS Education Prevention, 32(4), 337-355. doi: 10.1521/aeap.2020.32.4.337
• Becan, J. E., Fisher, J. H., Johnson, I. D., Bartkowski, J. P., Seaver, R., Gardner, S. K., Aarons G. A., Renfro, T. L., Muiruri, R., Blackwell, L., Piper, K. N., Wiley, T. A., & Knight, D. K. (2020). Improving substance use services for juvenile justice-involved youth: Complexity of process improvement plans in a large-scale multi-site study. Administration and Policy in Mental Health, 47(4), 501-514. doi: 10.1007/s10488-019-01007-z
• Dennis, M. L., Smith, C. N., Belenko, S., Knight, D. K., McReynolds, L., Dembo, R., … Wiley, T. (2019). Operationalizing a behavioral health services cascade of care model: Lessons learned from a 33-site implementation in juvenile justice community supervision. Federal Probation Journal, 83(2), 52-64.
• Gardner, S. K., Ellington, K. S., Knight, D. K., Huang, S., DiClemente, R. J., Spaulding, A. C., … Baird-Thomas, C. (2019). Juvenile Justice Staff Endorsement of HIV/STI Prevention, Testing, and Treatment Linkage. Health & Justice. doi.org/10.1186/s40352-019-0096-7
• Knight, D. K., Blue, T. R., Flynn, P. M., & Knight, K. (2019). The TCU Drug Screen 5: Identifying justice-involved individuals with substance use disorders. Journal of Offender Rehabilitation, 57(8), 525-537. https://doi.org/10.1080/10509674.2018.1549180
• Hogue, A., Henderson, C. E., Becker, S. J., & Knight, D. K. (2018). Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use, 2014-2017: Outcomes, Treatment Delivery, and Promising Horizons. Journal of Clinical Child and Adolescent Psychology, 47(4), 499–526.
• Knight, D. K., Joe, G. W., Crawley, R. D., Becan, J. E., Dansereau, D. F., & Flynn, P. M. (2016). The effectiveness of the Treatment Readiness and Induction Program (TRIP) for improving during-treatment outcomes. Journal of Substance Abuse Treatment, 62, 20-27.  PMCID: PMC4304896  abstract
• Knight, D. K., Dansereau, D. F., Becan, J. E., Rowan, G. A., & Flynn, P. M. (2015). Effectiveness of a theoretically-based judgment and decision making intervention for adolescents. Journal of Youth and Adolescence, 44, 1024-1038.  PMCID: PMC4208977  abstract
• Joe, G. W., Knight, D. K., Becan, J. E., & Flynn, P. M. (2014). Recovery among adolescents: Models for post-treatment gains in drug abuse treatments. Journal of Substance Abuse Treatment, 46, 362-373.  PMCID: PMC3947115  abstract
• Knight, D. K., Becan, J. E., Landrum, B., Joe, G. W., & Flynn, P. M. (2014). Screening and assessment tools for measuring adolescent client needs and functioning in substance abuse treatment. Substance Use & Misuse, 49(7), 902-918.  PMCID: PMC3998717  abstract