The Child Advocacy Center (CAC) at Children’s Hospital of The King’s Daughters (CHKD) is dedicated to providing expert forensic, mental health, and advocacy services to children who may have experienced maltreatment and trauma. CHKD’s CAC has been Accredited by National Children’s Alliance since 2003, and includes three child-friendly facilities in which law enforcement, child protection, medical and mental health, judicial, and victim advocacy professionals work together to provide a multidisciplinary, collaborative response to children and families when there is a concern that abuse or neglect has occurred. As the largest CAC in Virginia, the program serves approximately 1,500 children annually in the eastern region of Virginia (Hampton Roads) by identifying and providing trauma-informed and evidence-based services with the goal of preventing further trauma and strengthening resilience. As a NCTSN Community Treatment and Services Center, the CHKD CAC aims to increase access to and participation in evidence-based screening, assessment, treatment, and prevention services for children through the GRowing Evidence-based Assessment and Treatment (GREAT) for Children project. Providing these vital services for our diverse community of children ages 12 months-18 years will reduce health disparities and increase individual and family resilience. The project also aims to enhance the capacity of key stakeholders and multidisciplinary partners to identify, refer, and serve children who have experienced traumatic stress.

The Early Childhood Trauma Collaborative (ECTC) is developing a more trauma-informed early childhood system of care in Connecticut, with an emphasis on the state’s neediest communities. The ECTC is led by the Child Health and Development Institute (CHDI), an intermediary organization that has partnered with state and provider agencies to disseminate and sustain children’s behavioral health evidence-based practices for more than 10 years. The ECTC is a collaboration between CHDI, the Connecticut Office of Early Childhood, The Connecticut Department of Children and Families, The Consultation Center at Yale University (evaluator), a family partner, treatment developers at other NCTSN sites, and a network of community-based provider agencies. The ECTC is improving access to trauma-focused services for Connecticut’s young children aged birth through 7 exposed to violence, abuse, and other forms of trauma by: 1) disseminating evidence-based treatments in the community; 2) developing internal capacity to support sustainability of these EBPs; and 3) improving the ability of the state’s early childhood workforce to identify and refer children and families in need of trauma-focused services. The ECTC will disseminate and sustain Attachment, Self-Regulation, and Competency (ARC), Child Parent Psychotherapy (CPP), Trauma Affect Regulation: Guide for Education and Treatment (TARGET), and Child and Family Traumatic Stress Intervention (CFTSI).

The Center will train and support the delivery of evidence-based, culturally adapted trauma services and interventions for children exposed to disaster, sexual abuse, family violence, race-based and immigration trauma (e.g., unaccompanied minors), COVID-19, and traumatic deaths. Major stakeholders in children’s mental health–school personnel, parents, and mental health providers–will work in partnership to create a continuum-of-care at 18 sites nationwide. The Center aims to serve underserved children (ages 4-17) from culturally diverse backgrounds (e.g., people of color, LGBTQ+) who have been exposed to trauma and are experiencing diverse mental health responses. Each site’s trauma team will have representatives from schools, parents, youth, mental health clinics, and other social systems (e.g., police) and be responsible for implementing a tiered approach to services and interventions. Tier 1 is system-level psychoeducation (i.e., Trauma 101) to create a trauma-informed culture and provide a foundation for trauma EBIs. Tier 2 is early intervention delivered after trauma (i.e., Skills for Psychological Recovery) to prevent the development of mental disorders. Tier 3 is treatment for traumatized children and their caregivers (i.e., Trauma-Focused Cognitive-Behavioral Therapy and Alternatives for Families-A Cognitive-Behavioral Therapy). After being trained and implementing the interventions, school counselors and mental health supervisors will participate in train-the-trainer programs to train others (e.g., teachers, clinicians).

Foundations for Out Reach through Experiential Child Advocacy Studies Training (FORECAST) is a collaboration of the University of Missouri-St. Louis, the University of Illinois-Springfield, the National Child Protection Training Center, and the National Children’s Alliance. FORECAST will disseminate the Core Concepts for Understanding Traumatic Stress Responses in Childhood to communities with Child Advocacy Studies (CAST) undergraduate university programs, equipping students from a range of child-serving disciplines as well as professionals in the local workforce with Trauma Informed Experiential Reasoning Skills (TIERS). The Core Concepts and TIERS will be disseminated via Problem Based Learning Simulations by undergraduate CAST faculty and community workforce trainers, who will be trained at FORECAST learning collaboratives. FORECAST anticipates impacting psychology, social work, criminal justice, sociology, education, and nursing students at the undergraduate level, and the full range of Multidisciplinary Team (MDT) members at the community level. We anticipate impacting not only the population trained, but also workforce retention as people are better prepared to enter a trauma-informed workforce and agencies are better prepared to receive new graduates.