Hi - this is Clyde Comstock from the Hillside Family of Agencies with an evidence-based practice update.

 

Hillside has been working on creating trauma-informed environments of care across our service array.  As we all know, trauma has enormous effects on the lives of children and families that we serve.  Hillside is committed to integrating evidenced based treatment models that have been proven to facilitate recovery from trauma and the reduction of trauma symptoms.

 

For the past year, we have been implementing Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in Residential Treatment, Day Treatment, and Therapeutic Foster Care programs.  TF-CBT is an evidenced-based model developed by Drs. Judy Cohen, Anthony Mannarino, and Esther Deblinger. The eight components of the model are:  psychoeducation and parenting skills, relaxation, affective expression and modulation, cognitive coping, trauma narrative, in vivo desensitization, conjoint parent-child sessions, and enhancing social and safety skills.  80 staff participated in Drs. Cohen and Mannarino's 2 day training at Hillside last June (07).

 

We have been learning that training in new models is usually insufficient if we expect effective implementation of a new model. Consequently, our Masters level clinicians participate in biweekly consultation with Drs. Cohen and Mannarino and other consultants located around the country.  Topics discussed during consultation include case selection, the implementation of TF-CBT with skill and fidelity, and the use of standardized assessments to evaluate the child's progress. 

 

In March 2008, we were invited to participate in National Childhood Traumatic Stress Network TF-CBT Learning Collaborative.  The Learning Collaborative methodology was adapted from the Institute for Healthcare Improvement's Breakthrough Series Collaborative (BSC), a quality improvement methodology focused on, adopting, adapting, and spreading best practices across multiple settings, and creating the organizational changes necessary for sustaining these practices.  5 staff from Hillside Children's Center's Western Region are working with the TF-CBT developers and other practitioners to effect improvements in three domains: clinical competence in delivering TF-CBT, effective family and youth engagement and organizational support and capacity for implementing evidence-based practices.

 

At our May Inter-affiliate Services Committee meeting, Hillside's TF-CBT practitioners presented case studies of their work.  One example is a young man who has caused sexual harm.  In addition, he has substance abuse issues and is dealing with death of a grandparent.  The family has learned his coping strategies and practices relaxation techniques.  Currently the client is working on the trauma narrative and certain themes and patterns are emerging.  He is preparing to share the narrative with his family soon.  Stress is reduced in the family; the number of crises has decreased significantly.   The child is learning to de-escalate and regulate his emotions in the treatment milieu. 

 

There are currently 40-50 clinicians practicing TF-CBT at Hillside.  If you would like more service specific examples or if you have any questions, please let me know!