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National Child Traumatic Stress Network e-Bulletin November 2015
Public Awareness
Month of the Military Family (November 2015)
November is the Month of the Military Family. Military families make tremendous sacrifices as they contend with separation from their families and make adjustments to new living situations and communities. However, most military families embody strength, resilience, and courage. The NCTSN has a number of excellent resources, webinars, and links to partner organizations to support the well-being of our nation’s military families, including those with a service member currently serving in the US Armed 
Forces, or those who have retired or separated. The NCTSN offers a special thanks to all NCTSN sites that provide care and support for our military and veteran families. Most importantly, the NCTSN appreciates and acknowledges the tremendous contributions that military families make to our nation.
Holiday Stress (November 2015)
As the holiday season approaches, many of us look forward to spending time with family and friends and to sharing in the joys of the season. However, for people who have had a traumatic event, the holiday season may bring up negative feelings. Thinking about loved ones who have died is painful—particularly for those who have lost someone recently. Even for people who have not been exposed to trauma, the holidays can be a stressful time. Besides the stressors of buying gifts, travel expenses and hassles, and family interactions, winter’s short days and lack of sunlight can trigger bouts of depression and seasonal affective disorder (SAD). A 2008 poll on holiday stress conducted by the American Psychological Association found that eight out of ten Americans an-ticipate stress during the holiday season. The APA's 2012 Stress in America survey found that 69 percent of Americans attribute their stress to money-related concerns and 61 percent attributed stress to the economy. To help people cope with grief, stress, and depression during the holiday season, the National Child Traumatic Stress Network (NCTSN) offers the following resources for educators, families, and mental health professionals.

Noteworthy Resources
**Release of the Persistent Complex Bereavement Disorder Checklist to NCTSN Member Sites and Affiliates**
NCTSN members Drs. Christopher Layne (NCCTS Program Director of Education in Evidence Based Practice), Julie Kaplow (University of Texas Trauma and Grief Center for Youth), and Robert Pynoos (NCCTS Co-Director) are pleased to announce the release of the Persistent Complex Bereavement Disorder (PCBD) Checklist to NCTSN and affiliate sites who complete a no-cost site license. The PCBD Checklist is the first assessment tool of its kind specifically developed to measure PCBD reactions in bereaved children and adolescents. The authors’ hope is that the PCBD Checklist will help the NCTSN to raise the standard of care for bereaved children and adolescents by incorporating bereavement-informed assessment tools into their assessment protocols. 
Becoming an Informed Test Consumer: What is the PCBD Checklist?
The PCBD Checklist is a 39-item psychological test for bereaved children and adolescents ages 8-18. It assesses DSM-5 pro-posed symptom criteria for Persistent Complex Bereavement Disorder, including such grief reactions as Separation Distress, Reactive Distress, Existential/Identity Related Distress, and Distress over Circumstances of the Death. Under development for over five years, the checklist is currently undergoing additional validation for various types of clinical applications and for its utility in informing various types of clinical decisions. To date, a team of ten masters-level clinicians and clinical child psychologists, supervised by clinical child psychologist Dr. Kaplow, has field-tested each PCBD item. Items were iteratively tested and refined with 237 bereaved children/adolescents aged 8-18 in diverse settings (bereavement camps, bereavement support cen¬ters, community clinics, school-based mental health clinics). Items were rated highly on content validity (developmental appro-priateness, relevance to PCBD symptom criteria) by a panel of international experts in childhood grief. PCBD test scores have shown good criterion-referenced validity in relation to standardized measures of PTSD, depression, and anxiety symptoms.
How do you Administer and Score the PCBD Checklist?
Test administration time is typically 5-8 minutes. Scoring and interpretation typically requires 5-10 minutes. Clinicians may ad-minister the PCBD Checklist to children/adolescents in either individual or group settings or they can adapt the Checklist for self-report with older children/adolescents. Clinicians can access training in test administration, scoring, interpretation, and use of test data to support clinical decision-making in person or online. The test comes with a 38-page administration manual including a color-coded scoring sheet and a visual aid to help younger children understand the frequency scale.
For what settings and applications can the PCBD Checklist be used?
Potential applications of the PCBD Checklist currently include risk screening, estimating diagnostic prevalence, client feedback, triage to services, case conceptualization, intervention planning, monitoring response to intervention, and evaluating intervention outcome. Appropriate settings for using the PCBD Checklist include hospice/palliative care, bereavement support centers, bereavement camps, community clinics, school-based health clinics, academic medical centers, and research studies with bereaved children and families. With respect to diagnosis, PCBD is a proposed diagnosis included in the appendix of DSM-5 as an invitation for further study and application. Thus, clinicians can use the PCBD Checklist to assign a provisional (unofficial) PCBD diagnosis or, as needed, a formal diagnosis of an adjustment disorder (secondary to bereavement) for billing purposes. 
How can NCTSN sites and affiliates obtain a license to use the PCBD Checklist?
We are issuing no-cost licensing agreements to use the PCBD Checklist to individual NCTSN sites (currently funded and affili¬ate) upon request and on a site-by-site basis. To obtain a no-charge licensing agreement, each interested NCTSN site should submit a request to Christopher Layne (at containing the following information: (1) The name and title of the individual at that site to whom the license will be issued on behalf of that institution and who assumes responsibility for overseeing its appropriate administration (as described in the test administration manual) at the site; and (2) the site name, address, and status (currently funded or affiliate Category II or III, etc.) as it appears in the NCTSN site registry. 
Non-NCTSN affiliated sites can access the UCLA Office of Intellectual Property (at) to learn more about obtaining a license for the PCBD Checklist. You can download a 1-page flyer, review the cost schedule, and review the licensing agreement (available for online purchase) here:
Publications by Network Members and Collegues
► Network colleagues Damion J. Grasso, Carly B. Dierkhising, Christopher E. Branson, Julian D. Ford, and Robert Lee have authored Developmental Patterns of Adverse Childhood Experiences and Current Symptoms and Impair-ment in Youth Referred for Trauma-Specific Services, published in the Journal of Abnormal Child Psychology (first online: 06 October 2015). Authors examined patterns of adverse childhood experiences (ACE) in three developmental epochs from early childhood to adolescence in an ethnically and geographically diverse sample of youth receiving trauma-specific services. Study findings highlight the need for a comprehensive approach in research and clinical efforts to identify and prevent children from experiencing what can be a complex and varied set of constellations of exposure to ACEs. While multiply exposed or poly-victimized children warrant particular attention by programs designed to prevent or remediate emotional and behavioral problems before or during adolescence, study findings also suggest that certain children (e.g., girls) and certain types of ACEs (e.g., early childhood intra-familial violence; middle childhood sexual trauma; adolescent exposure to community violence; traumatic loss in early and middle childhood) warrant careful attention in both research and clinical services. 

On the Learning Center
New RPC Blog Post! 
Resiliency and Humor: Other Essential Elements
In this RCP blog entry, Liza Simon-Roper, LCSW, shares her reflections on discovering in her group work how humor and “out of the box” thinking enrich group members’ resiliency. Ms. Simon-Roper works with resource parents in northern Illinois, where she is project director for The Healing Path: A Trauma Treatment Program for Youth at One Hope United.
New RPC Podcast!
Getting Started with the RPC
What are the essential elements of the RPC?
What is should agencies to know when they are thinking about launching RCP workshops? What happens when a workshop facilitator turns out not to be a good fit for the RPC? 
Listen as presenters Chris Foreman, CISW, Liaison, National Center for Child Traumatic Stress, and Melissa L. Hoff-mann, PhD, Project Director for the Tennessee Network of Trauma-Informed and Evidence-Based Systems (TN-TIES), explore these questions and more in this 15.5-minute podcast. 
Upcoming Webinars
Child Traumatic Grief Speaker Series
Responding to Traumatically Bereaved Military Children in Educational Settings: Barriers and Opportunities
Tuesday, November 10, 2015 (12:00 pm PT)
Presenters: Vanessa Daley, Tragedy Assistance Program for Survivors; Mary Keller, PhD, Military Child Education Coalition; Marlene Wong, PhD, USC School of Social Work; Funda Yilmaz, LPC, NCTSN Individual Affiliate 
Presenters will (1) identify common challenges encountered by traumatically bereaved military children and families in school settings; (2) discuss enhancing connectedness and support in public (i.e., predominantly civilian) schools; (3) describe ways military CTG may present in educational settings; (4) delineate barriers to accommodating the needs of bereaved military children; and (5) explain steps that schools can take to help children focus on academics (e.g., recognize CTG, give accommodations, educate peers, refer for help). 
Policy Speaker Series
State Policy Innovations in Child Trauma: Lessons from North Carolina and Arkansas 
Tuesday, November 17, 2015 (11:30 am PT)
Presenters: Lisa Amaya-Jackson, MD, MPH, NCCTS-Duke University, Duke EPIC; Teresa Kramer, PhD, University of Arkansas for Medical Sciences; Diane Elmore, PhD, NCCTS-Duke University 
Many states are playing a leadership role in enacting and implementing policies to support trauma-informed services for children and families. Presenters will highlight two examples of such state-based child trauma policy innovations.

Upcoming Events
Twitter Chat: Complex Trauma and Homeless Youth 
If you work with families and youth, you've likely seen how a traumatic situation can influence a young person's life. But what happens when one person lives through multiple traumatic events, one on top of another, often beginning at a young age? These experiences, known as complex trauma, can negatively impact a developing teen, hindering their brain development and damaging their ability to form healthy, supportive relationships. In recognition of National Runaway Prevention Month, the NCTSN (@NCTSN) is partnering with the National Clear-inghouse on Families and Youth (@NCFY) for a Twitter chat on complex trauma in adolescence, and particularly how it can contribute to--and may result from--youth homelessness. We'll discuss strategies for identifying and treating complex trauma, with an emphasis on how pro-fessionals working with youth can be more trauma-informed. Join the conversation at #NCFYtalk November 20 at 2 pm EDT
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