Implementation Outcomes of a CBT-Based Psychosocial Intervention for Gang-Recruitment-Vulnerable Youth in Medellín

This study examines the implementation outcomes of Parceros Creadores, a municipal government program in Medellín, Colombia, that deployed novice psychologists to deliver a cognitive-behavioral therapy (CBT) protocol to youth aged 14-28 in neighborhoods controlled by local gangs.Twelve psychologists wrote reflective essays about their implementation experience.We analyzed the essays using reflexive thematic analysis and organized findings around four implementation outcomes from the Proctor et al. (2011) taxonomy: acceptability, feasibility, appropriateness, and fidelity, with workforce-capacity development examined as a precondition for sustainability.Providers reported high acceptability driven by therapeutic bond formation in a context of institutional distrust.Feasibility obstacles included youth distrust of government programs, dropout linked to competing survival needs, and bureaucratic barriers to psychiatric referrals.Psychologists perceived that youth adopted CBT techniques in daily life, which they read as evidence for the appropriateness of the protocol.Providers adapted the protocol for neurodivergent participants, incorporated family psychoeducation, and adjusted session modality.The experience generated professional competencies that constitute workforce capacity for sustained service delivery.Psychologists also perceived a reduction in mental health stigma among participants.The findings position novice professionals as a distinct implementer category in the task-shifting literature and identify design features that may transfer to similar urban settings in low-and middle-income countries.

Context (archaeology) · Distrust · Focus group · Government (linguistics) · Mental health · Psychological intervention · Psychosocial · Qualitative research · Thematic analysis · Community Health and Development · Health Policy Implementation Science · Mental Health Treatment and Access