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National Child Traumatic Stress Network e-Bulletin June 2012


The Child Welfare Committee is proud to announce a new Network product: Birth Parents and Trauma Histories in the Child Welfare System: A Guide for Mental Health Professionals This factsheet, the last in a series of five, helps mental health professionals understand the serious consequences that trauma histories can have for birth parents and the potential effects on their parenting.  

The NCTSN's Empirically Supported Treatments and Promising Practices page provides links to fact sheets which describe some of the clinical treatment and trauma-informed service approaches being used by National Child Traumatic Stress Network centers, with the common goal of reducing the effects of exposure to traumatic events on children and adolescents. Select from forty-two treatment options listed on the easy-to-use table. 
Final Opportunity for Public Comment on DSM-5 Ends June 15th 
The American Psychiatric Association (APA) recently released the proposed revisions to the draft criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the window of opportunity for the public to comment closes on June 15. NCTSN has been working to assure that the new DSM criteria adequately represent the clinical presentations of children who have experienced traumatic stress. The proposed organizational structure, which includes a Trauma- or Stressor-Related Disorders category includes numerous revisions that should be of interest to NCTSN members, including (1) revisions of the criteria for PTSD; (2) a preschool subtype of PTSD; (3) a subtype of PTSD with prominent dissociative symptoms; (4) a proposed splitting of Reactive Attachment Disorder into two separate diagnoses: Reactive Attachment Disorder and Disinhibited Social Engagement Disorder; and (5) a new category, Trauma- or Stressor-Related Disorder Not Elsewhere Classified. The DSM-5 website no longer includes a list of disorders proposed by outside sources. We appreciate the contributions that many of you have made to this manual and for conducting ongoing field trials to learn about complex trauma. 

New on the NCTSN Learning Center

Addressing Transition Issues for Young Foster Children
June 7, 2012 (9:00 a.m. PDT)
Presenters: Anna Smyke, PhD, Tulane University School of Medicine; Devi Miron, PhD, Tulane University Hospital, and Julie Larrieu, PhD, Tulane University School of Medicine
Faculty will discuss the many transitions experienced by—and the challenges transitions pose for—young traumatized children in the child welfare system. Whether responding to the transition from the biological parents' home to a foster home, from foster home to foster home, or the changes accompanying reunification, those working in the child welfare system will benefit from understanding the effects of these transitions and the appropriate methods for facilitating them.
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Child Abuse and Neglect in Military Families: Community and Military Partnerships
Tuesday, June 19, 2012 (10:00 a.m. PDT)
Faculty: Carole Campbell Swiecicki, PhD, CHKD Child Abuse Program, Eastern Virginia Medical School; Gregory Leskin, PhD, Military Families Initiatives, UCLA-Duke National Center for Child Traumatic Stress
Faculty will present on current efforts by community-based organizations to support US Military Family Advocacy Programs (FAP) related to issues of child abuse and child maltreatment. This presentation will describe evidence-based interventions and coordinated models of care for addressing issues of child abuse in military families.
Audio: 866-295-5950, Code 5318986#
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The Need for Trauma-Informed Screening and Assessment in Juvenile Justice Settings: Strengths and Limitations of commonly-Used Instruments 
June 21, 2012 (11:00 a.m. PDT) 
Presenters: Patricia K. Kerig, PhD, University of Utah; Carly Dierkhising, MA, UCLA-Duke National Center for Child Traumatic Stress
Faculty will discuss the need for trauma-informed screening in juvenile justice settings while providing information on key differences between screening and assessment. The presentation will highlight the benefits and challenges of two popular screening tools; the MAYSI and the UCLA PTSD-Reaction Index. 
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Noteworthy Resources

Network Colleagues Ellen Puccia, Terry Redding, Rebecca Brown, Patricia Gwynne, Allegra Hirsh, Rebecca Hoffmann Frances, and Betsy Morrison are the authors of Using Community Outreach and Evidenced-Based Treatment to Address Domestic Violence Issues in Social Work in Mental Health (Volume 10, Issue 2). Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is one evidence-based treatment for posttraumatic stress (PTS) that has shown great promise. This article examines The Children's Initiative that used this treatment model successfully to alleviate symptoms of PTS as a result of witnessing domestic violence. When this treatment model is used within a cohesive community structure with maximum inclusion of all local agencies and coordinated referral efforts, it is highly effective as a response to domestic violence.

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 Network Members  Erika Tullberg, Claude Chemtob, Alison Hendricks, Joy Osofsky, and James Caringi all had articles published in CW360°: Secondary Trauma and the Child Welfare Workforce. The Spring 2012 edition explores secondary traumatic stress (STS) in the child welfare workforce: how it develops, how to recognize symptoms in yourself and your colleagues, and intervention strategies for individuals and organizations. Although turnover and burnout are well known to the field of child welfare, the concept of secondary traumatic stress is relatively new and can be confused with burnout. STS develops as a result of making empathic connections with traumatized individuals, while burnout is the result of administrative stresses, such as too much paperwork and large caseloads. STS can occur from one traumatic instance (e.g. the death of a child by maltreatment) or the accumulated impact of everyday work with traumatized children, youth, and families. 

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 Network Colleagues Julian Ford, Karen Steinberg, Josephine Hawke, Joan Levine, and Wanli Zhang are the authors of Randomized Trial Comparison of Emotion Regulation and Relational Psychotherapies for PTSD with Girls Involved in Delinquency in Journal of Clinical Child & Adolescent Psychology (Volume 41, Issue 1). As posttraumatic stress disorder (PTSD) is prevalent in youth involved in delinquency and not effectively treated, a randomized clinical trial was conducted comparing the outcomes of an emotion regulation therapy (Trauma Affect Regulation: Guide for Education and Therapy, or TARGET) with a relational supportive therapy (Enhanced Treatment as Usual or ETAU) with 59 delinquent girls (age 13-17 years) who met criteria for full or partial PTSD. This article discusses the results of both therapies and provides preliminary support for TARGET as a potentially efficacious therapy for PTSD with delinquent girls. Relational therapies such as ETAU also may be beneficial for delinquent girls with PTSD, particularly to enhance optimism and self-efficacy and to reduce anger.

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Coming Next Month

Screening and Assessment in the Juvenile Justice System

PTSD and Risk Assessments for Juvenile Court Evaluations
July 10, 2012 (9:00 a.m. PDT) 
Presenters: David Foy, PhD, Pepperdine University; Julian Ford, PhD, University of Connecticut Health Center 
Presenters will provide an overview of juvenile court evaluation procedures, highlight how PTSD and Risk Assessments are utilized within these evaluations, and discuss ways to improve their use. 
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Cultural Implications of Secondary Traumatic Stress 
July 17, 2012 (9:00 a.m. PDT) 
Presenters: Blanca Nellie Hernandez, PhD, DePelchin Children's Center; Marta Casas, MA, Child Witness to Violence Project; Susana Rivera, Serving Children and Adolescents in Need; Adriana Molina, MS, LMFT, Children's Institute, Inc. 
Presenters will address the influence of culture on mental health providers coping with secondary traumatic stress (STS) and the choices that clinicians make to seek, or not seek, support. They also will explore how cultural background—including immigration history—informs clinicians' work with children and families who have experienced trauma; illustrate the relationship between culture and STS through a personal case example; and introduce the concept of vicarious resiliency.  
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July 18, 2012 (9:00 a.m. PDT) 
Presenters: Blanca Nellie Hernandez, PhD, DePelchin Children's Center; Marta Casas, MA, Child Witness to Violence Project; Susana Rivera, Serving Children and Adolescents in Need; Adriana Molina, MS, LMFT, Children's Institute, Inc. 
Presenters will deliver the Cultural Implications for Secondary Traumatic Stress webinar, described above, in Spanish, two days after the English presentation. 
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The Application of Trauma Screening/Assessment in Child Welfare Settings: PartI - Systems Level 
July 26, 2012 (9:00 a.m. PDT) 
Presenters: Jason Lang, PhD, Child Health & Development Institute of Connecticut; Marilyn Cloud, LCSW, Connecticut Department of Children & Families
Presenters, who are partnering to introduce universal trauma screening to the state of Connecticut, will explore issues of implementation and sustainability in an already over-burdened child welfare system, how to meaningfully and successfully integrate and embed this practice, and ways to address the affects of this practice on case workers.  
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