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Article History

Received: 7 March 2024

Accepted: 24 December 2024

First Online: 30 January 2025

Declarations

:

: The authors have no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

: This study was approved as exempt by the University of Hawaiʻi at Mānoa’s Committee on Human Studies Institutional Review Board as well as the State Department of Health’s Child and Adolescent Mental Health Division. Clinical documentation of all client and therapist data within the State Department of Health’s Child and Adolescent Mental Health Division adhere to Health Insurance Portability and Accountability Act (HIPAA) standards and are recorded and stored in compliance with state standards (CAMHD, ). Following Institutional Review Board and State Department of Health approval, a limited data set was electronically extracted from the Child and Adolescent Mental Health Division system.

: Upon entry into system of care, youths’ legal guardians receive informed consent, which includes consent for the use of data for research purposes.