ABSTRACT
Over the past three decades, rigorous empirical research has highlighted both cumulative and non-additive effects of childhood trauma, which are intricately intertwined with the broader developmental and psychosocial context. Latent class analysis has proven useful in identifying at-risk groups, thereby informing the design of targeted prevention and early-intervention efforts. Extending prior research to highly complex, high-risk children and families receiving intensive home-based treatment (IHBT), this study analyzed archival data from 10,301 Connecticut families enrolled in the Intensive In-Home Child & Adolescent Psychiatric Service (IICAPS) from May 2014 to February 2020. The objective was to identify clusters of child traumatic events alongside familial and community-level adversities that predict treatment engagement within this marginalized and hard-to-reach population. Using latent class analysis (LCA), four classes emerged: (1) Unspecified Adversity (69% probability of membership across the sample); (2) High Family Adversity (13%); (3) High Child Trauma & Family Adversity (11%); and (4) High Child Trauma (7%). Relative to the Unspecified Adversity group (reference class), all other groups exhibited lower odds of completing treatment. These findings hold implications for developing targeted assessment and intervention strategies to enhance treatment engagement and outcomes for underserved youth in intensive home-based programs.