Massachusetts

The purpose of the project "Advancing Treatment and Services for Refugee Children and Adolescents: Boston Children's Hospital Center for Refugee Trauma and Resilience" is to provide national expertise in the area of Refugee Displacement and War Zone Trauma Refugee Health and Resettlement Agencies (Refugee Trauma). The proposed activities seek to achieve substantial progress in the development, training, dissemination, and evaluation of interventions that address refugee trauma. The project seeks to advance treatment and services for refugee trauma by pursuing the following goals:
1) To develop the infrastructure for successful dissemination of a known effective intervention for refugees (Trauma Systems Therapy for Refugees) 2) To further support the development, training, dissemination and evaluation of a web-based providers guide to assessing and responding to the needs of young refugees, the Refugee Services Toolkit, in key service system settings, 3) To develop and evaluate an innovative preventative intervention for refugee trauma called "Promoting Positive Social Identity" using a social media platform to promote positive social identity and resilience, 4) To provide leadership and support infrastructure within the National Child Traumatic Stress Network (NCTSN) that promotes the collection of high quality data for policy and advocacy related to refugee trauma, and 5) To provide leadership within our local community,  to the NCTSN and nationally on refugee trauma and the trauma-related  needs of children within the refugee health and refugee resettlement  service systems.  The project expects to train more than 150 service providers in refugee services, have more than 5000 providers access the RST and use it to improve services, and over the lifetime of the project to enhance the refugee expertise of providers both within and outside of the NCTSN.
 

The University of Massachusetts Medical School Child Trauma Training Center (CTTC) will be developed by the Department of Psychiatry to improve identification of trauma, to increase trauma-sensitive care, and to increase access to evidence-based, trauma-focused treatment for at-risk and underserved children and youth aged 6–18 in central and western Massachusetts—including court-involved youth and youth in military families. During the grant period CTTC anticipates: 1) training 1,800 child-serving professionals in trauma-sensitive care; 2) reaching approximately 20,000 children/youth with trauma-informed services; and 3) providing TF-CBT to 900 children/youth. The service array for the CTTC includes 60 cities and towns in central Massachusetts (Worcester County) and 23 cities and towns in western Massachusetts (Hampden County). Additionally, the CTTC will create a centralized referral system that will include a network of agencies with documented training in evidence-based trauma treatment. Along with providing trauma-informed training, the CTTC will offer training for first responders (e.g., police) in trauma-sensitive practices, and will disseminate culturally competent trauma screening tools to pediatricians, juvenile courts, and schools.

The Complex Trauma Treatment Network (CTTN) will develop, adapt, and disseminate evidence-based practices (EBPs) for children and adolescents impacted by complex trauma. The project’s goals are to: 1) transform multicounty and state systems of care serving children and families impacted by complex trauma; 2) address gaps in complex trauma services to youth of color living in poverty and/or with urban violence; and in residential treatment centers, juvenile justice detention centers, shelters, and foster care; 3) enhance graduate-level social work education to cultivate a sustainable provider workforce across the child services continuum trained in complex trauma; 4) increase national access to EBPs for complex trauma including: Attachment, Self-Regulation, and Competence (ARC), Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), and Trauma Affect Regulation: Guide for Education and Therapy (TARGET); and 5) expand regional, national, virtual, and Web-based dissemination of products and resources from CTTN and NCTSN. The CTTN will also provide intensive training and technical assistance to transform systems of care in more than 200 community and state agencies participating in one of 18 Learning Communities; and will train more than 20,000 multidisciplinary child service providers on the impact, assessment diagnosis, and treatment of complex trauma in at least twenty states. This initiative will directly impact 100,000+ children and families nationwide.

Therapy House Calls: Effective Treatment in the Home for Families Experiencing Trauma and Loss (House Calls) will improve access to and the quality of mental health care for children and families who are experiencing symptoms stemming from trauma or loss. The project will adapt Trauma- Focused Cognitive Behavioral Therapy (TF-CBT) for use in the In-Home Therapy (IHT) setting, which is a model of community-based mental health treatment in which patients receive intensive psychotherapy in their own homes. In addition to improving access, this adaptation will offer significant advantages for selected patients over the traditional outpatient TF-CBT by addressing the impact of trauma on the entire family unit. The treatment will then be disseminated through trainings and ongoing consultation. House Calls will serve children and adolescents aged 5–18 residing in Hampden and Hampshire counties. Objectives include: 1) training 24 IHT clinicians and their paraprofessionals in the adapted form of TF-CBT; 2) enrolling 120 children and their families in TF-CBT, 30 percent of whom will be military families; 3) gathering NCTSN-required data and appropriate clinical measures; 4) significantly reducing depressive, anxiety, PTSD, and behavioral symptoms in 90 percent of children and families completing therapy; 5) maintaining robust partnerships with partner agencies and community stakeholders; and 6) ensuring fidelity to the TF-CBT model.

Building Resilience through Intervention: Growing Healthier Together (BRIGHT II) is a collaboration between the Institute for Health and Recovery (IHR), Jewish Family & Children’s Service, and Boston University. The project will address traumatic stress in 110 children, aged 0–7, and their mothers who are in recovery from substance use and co-occurring disorders. Services will be provided at three Opioid Treatment Programs (OTPs)—located in Cambridge, Boston, and Fall River, Massachusetts—that provide methadone maintenance and buprenorphine.

The National Collaborative for Homeless Children and Trauma was formed by the National Center on Family Homelessness in partnership with the Trauma Center and the Vanderbilt Institute for Public Policy Studies. In conjunction with three community-based domestic violence and homeless agencies, the collaborative provides trauma-related services to homeless children and their families, and builds on local work to increase knowledge within NCTSN and beyond about the range of trauma experienced by homeless children and their parents (e.g., physical and sexual assault, witnessing violence, abrupt separation). The collaborative also helps develop effective cross-system partnerships that meet survivors' needs; creates effective services in Boston area shelters; and advocates locally and nationally to improve society's response to homeless families.

Through the Latino Child Trauma Stress Initiative (LCTSI) Project, Latino Health Institute, Inc. (LHI) is improving access to and quality of treatment and intervention services for Latino children and their families living in the Greater Boston area who have been impacted by traumatic events. The program is also focused on working with mental health providers that serve Latinos in Greater Boston and in other areas of Massachusetts to increase their knowledge of evidence-based interventions. The target population has experienced losses, domestic and community violence, disasters, severe and chronic neglect, physical and sexual abuse, and chronic trauma. Using a consensus-building model, LHI works closely with community stakeholders, and the NCTSN centers to enhance its capacity to adapt, implement, and evaluate evidence-based interventions.

To gain a better understanding of the needs of the target population and to implement strategies to address those needs, the project is working with consumers; community providers; trauma experts; and representatives from state agencies and from other service agencies in the fields of child welfare, trauma, and Latino mental health. In addition, LIH is educating and training private and governmental providers on treatment needs of trauma-exposed Latino children, and on effective trauma-informed services and trauma-focused interventions, beginning with Trauma Focused Cognitive Behavioral Therapy (TF-CBT).

LUK Crisis Center—working in partnership with public and private agencies, and military entities—will enhance its Central Massachusetts Child Trauma Center (CMCTC) to strengthen, expand, and improve access to and availability of effective and culturally competent trauma-informed services and evidence-based trauma treatment for children/youth aged 0–18. With a focus on children/youth in military families who experience traumatic events, CMCTC will target 400 children/youth and families, implementing Child-Parent Psychotherapy (CPP) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), in 65 cities and towns in central Massachusetts. Strategies include: 1) increasing the identification of trauma symptoms among children/youth, with an emphasis on military families; 2) building sustainable capacity to provide evidence-based trauma treatment and trauma-informed services within the community agencies implementing the models; and 3) improving the cultural competence of providers and child-serving entities in working with military families who have experienced trauma.