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REACH ND is led by Treatment Collaborative for Traumatized Youth (TCTY) housed within Sanford Research North and represents a consortium of organizations with the shared mission of Reducing barriers, Expanding access, and Advancing trauma care for Children to Heal in North Dakota. REACH ND aims to increase access to trauma-focused, evidence-based treatments (EBTs) for underserved/under-resourced children (3-18) and families impacted by trauma in ND. To increase access, REACH ND will address behavioral health disparities, reduce barriers to access and engagement in trauma EBTs, and improve frameworks for sustainability. The project will collaborate with partners including Children’s Advocacy Centers and NCTSN Category II TSAs to achieve goals and objectives that include (1) Providing care coordination using intensive engagement strategies and effective EBTs (TF-CBT, CFTSI, SPARCS) via telehealth; (2) Conducting training on telehealth and complex trauma for providers; (3) Adapting treatment resources for rural populations, American Indian/Alaskan Native children, and linguistic minorities; and (4) Increasing professional and community trauma awareness and engagement using outreach education and media strategies. Goals & Objectives Goal 1: Reduce barriers and increase access to trauma services throughout the rural and frontier regions of North Dakota with equitable care delivery as core consideration. 1. Procedures for intensive engagement & telehealth. 2. Care coordination with enhanced engagement strategies. 3. Assessments & trauma EBTs via telehealth. 4. Significantly reduced trauma symptoms at discharge. 5. Decrease barriers to telehealth treatment by enabling at-home access. 6. Translate or adapt treatment resources. Goal 2: Advance trauma care practices and network of treatment providers in North Dakota through training, consultation, and statewide and national collaboration. 1. Train treatment providers on telehealth delivery of TF-CBT. 2. Host quarterly education series for clinical teams on topics in complex trauma. 3. Host statewide telehealth biannual consultations to develop resources for telehealth. 4. Protocol for new provider telehealth onboarding. 5. Collaborate with NCTSN Cat II TSA on train-the-trainer models to sustain training. Goal 3: Increase professional and community trauma awareness and engagement using outreach education and media strategies. 1. Appear on North Dakota Today Show to discuss trauma and accessing services. 2. Disseminate information about trauma and accessing care at community outreach events. 3. Create 2 videos discussing trauma treatment, telehealth, and accessing services. 4. Host education events for child-serving professionals in ND. We anticipate serving 120-150 clients and 101-110 professionals annually and 1205 total clients and professionals throughout the five-year period of performance.

The Care Plus New Jersey (CPNJ) Community Treatment and Service (CTS) Center will serve underserved and under-resourced English- and Spanish-speaking children and adolescents ("youth") aged 7-17 who experience traumatic events and their families who reside in three northern NJ counties. Building upon its current CTS Center in Bergen County and aligning with the purpose of the CTS initiative, CPNJ will increase access to effective, evidence-based, and culturally and linguistically appropriate trauma treatment and service systems for 900 youth aged 7-17 and their families in three NJ counties who experience traumatic events. As a current CTS grantee, CPNJ has spent the past five years implementing all required activities and is viewed as the local expert in trauma-informed care. CPNJ has established a system to screen all youth that come through its doors, ensuring those with trauma histories can access EBP models of treatment while also building community capacity and infrastructure to respond to those impacted by trauma. Grant funds through this current procurement will allow CPNJ to meet the following goals: (1) Increase access to effective EVP trauma-focused treatment and services among English and Spanish-speaking youth in Bergen, Passaic, and Essex Counties aged 7-17 and families who experience trauma; (2) Improve the quality of trauma treatment and services for English and Spanish-speaking youth in Bergen, Passaic, and Essex Counties aged 7-17 and families who experience trauma through training, supervision, and support of clinicians; and (3) Provide leadership on youth trauma issues and serve as a resource to help community partners identify, support, and refer to services English and Spanish-speaking youth in Bergen, Passaic, and Essex Counties aged 7-17 and families who experience trauma. Goal 1 will be met through the following objectives: Screen 2100 youth using the Traumatic Stress Screen for Children and Adolescents (TSSCA); Provide assessment, care management, and evidence-based therapy to 900 youth who score 6+ on TSSCA; Partner with 125 youth-serving organizations through collaboration, coordination, and sharing resources; increase the number of referrals made by youth-serving organizations to CPNJ by 5% each year. Goal 2 will be met through the following objectives: six CPNJ clinicians will be trained in Eye Movement Desensitization and Reprocessing (EMDR) to achieve the EMDRIA Certified Clinician status; four EMDR certified clinicians will train to become EMDRIA Approved Consultants.; the creation of an EMDRIA Credit Provider training for Basic EMDR will train an additional 15 clinicians; train 50 CPNJ clinicians on evidence-based Trauma Focused Cognitive Behavioral Therapy (TF-CBT); ten supervisors trained in the Attachment Regulation Competency (ARC) framework will meet two times to conduct the ARC-Based Milieu Program Self-Evaluation Form and share results; and provide 500 hours of supervisory consultation to clinicians on EMDR, TF-CBT, and ARC. Goal 3 will be met through the following objectives: the CTS team will conduct 250 hours of outreach and community education to help community partners understand trauma, its impact on youth development, and CPNJ resources; and conduct 1,500 outreach engagements or training each to help child-serving entities representing schools, child welfare, child protective services, juvenile justice, behavioral health, schools, grassroots entities, religious institutions, and others understand trauma, its impact on youth development, and CPNJ resources. By implementing these goals and objectives, CPNJ will meet all requirements for the CTS initiative, including mental health treatment, coordination with child-serving systems, professional development and training, community outreach and engagement, and collaboration with NCTSI Partners.

The Trauma Services Program (TSP) of Cayuga Counseling Services, Inc. (CCS) will provide evidence-based, comprehensive and multi-disciplinary services to children, adolescents and their families who have experienced trauma with a focus on those who have experienced complex trauma (90% of the 120 children served annually) who are in need therapeutic and other supportive services in Cayuga County, NY. Currently, there are several barriers to accessing services for children who have experienced trauma, most notably the lack of comprehensive, multi-disciplinary program that provides, therapy, care management and peer services to meet the needs of these children and their families. Additionally, our community is lacking regular, comprehensive training for child-serving agencies to be able to identify children who have experienced trauma and refer them to trauma and grief-informed services. The primary goals of the program include: 1. Expanding our current multi-disciplinary team to include new partnerships and additional child-serving entities who engage with children in order to identify those who would benefit from the TSP. 2. Provide effective programming to 120 children annually to mitigate the long-term effects of trauma on children including individual, group and family therapy, care management and peer services. 3. Train program staff on evidence-based treatments that are proven effective for children who have experienced trauma and loss. 4. Provide evidence-based, weekly group therapy in school districts throughout Cayuga County. 5. Coordinate with child-serving systems to engage families and ensure children are identified and referred to trauma and grief-focused services. 6. Provide training to 15 entities annually on the TSP and the services it can provide. 7. Increase the number of trainings on the impact of trauma on youth development to at least 10 child serving agencies in Cayuga County annually. By bringing together community stakeholders and expanding our multi-disciplinary team to include a focus on this population, CCS will ensure the services available are responsive to the needs of the youth and families. Assessments of services will be consistently completed to identify service gaps and enhance service delivery. By implementing the TSU program, Cayuga County, NY will finally have an all-encompassing, collaborative, holistic approach to children who have experienced trauma which will improve engagement for families and mitigate the long-term effects of the trauma experienced by our county's children.

Burke’s FY 2023 National Child Traumatic Stress Initiative – Category III: Community Treatment and Service (CTS) Centers (NCTSI) Grant Program endeavors to improve, enhance, and expand capacity for trauma and grief counseling, case management, and care coordination within the East Texas region. This project shall target underserved and under-resourced children, adolescents, and their families who have experienced trauma and traumatic events in twelve counties: Angelina, Houston, Jasper, Nacogdoches, Newton, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, and Tyler. The NCTSI Program shall serve 120 individuals each year, with a cumulative 500 unduplicated individuals served over the project period. Through use of these funds, Burke shall expand current service delivery capacity through evidence-based, clinical-informed treatment of complex trauma, and enhance current training systems, population health outcomes, and other quality management activities to improve quality and effectiveness of trauma-informed care by adding 2.0 FTE Therapists, 4.0 FTE MH Clinicians, 0.50 FTE Trainer, and 0.50 FTE Project Evaluator. These staff shall reach the historically under-served target population, reduce specific Social Determinants of Health (SDOHs) related to economic instability and access to care, and build upon current therapeutic children and adolescent-specific projects. Project staff will focus on measurable objectives, including increasing screening for trauma at Centralized Intake by 500 per year, reduce trauma symptomology for children who screen positive by 10%, implement outreach events with community partners, coordinate with Texas Christian University’s Karyn Pruvis Institute of Child Development, and train 50 staff members annually on trauma-informed interventions. Burke shall formally partner with eight (8) organizations within the community, including four (4) school districts, two (2) sheriff’s offices, one (1) child welfare agency, and one (1) university. The NCTSI Program will emphasize reaching historically underserved populations through utilization of telehealth services for sustained engagement in services. The Therapists will provide trauma and grief counseling to the population of focus, and the MH Clinicians will work with the Therapists to link consumers with recovery support systems across the continuum of care and to improve retention, maintenance, and daily functioning post-project. The Trainer shall provide education to both grant-funded staff and Burke personnel on trauma-informed evidence-based practices. Finally, the Project Evaluator will endeavor to monitor health outcomes and inequity across the project timeline to address appropriate interventions when needed.

The Terry Reilly Child Traumatic Stress Projects overarching vision is to increase the capacity at TRHS to provide and increase access to effective trauma-focused treatment and services systems in Canyon County for children and adolescents, and their families who experience traumatic events. We anticipate serving 700 unduplicated clients over the five years of the grant. Specific goals for the project include the following: Goals: • Expand access for children and their families to Trauma Informed Integrated Behavioral Health Services that use Evidence-Based Practices for children, adolescents and their families that experience heightened barriers to trauma informed care and behavioral health disparities to improve health outcomes. • Enhance capacity to provide outpatient trauma services to adolescents (under age 18) in Canyon County to reduce incidence of SUD and/or MH crisis among this population. • Expand our ability to coordinate with community level child-serving systems and other community level agencies to increase awareness of, participation in, and access to, trauma and grief treatment and services for children, adolescents and their families with an emphasis on Hispanic families and families living in poverty Specific activities include: • Identify and implement community-based engagement/outreach strategies to increase awareness of, participation in, and access to, trauma and grief treatment and services for at-risk children, adolescents, and their families and those from diverse racial and ethnic communities. • Provide direct evidence-based mental health related treatment and services, including screening, diagnostic assessment, care management, therapy, and prevention for at-risk children and adolescents, including those from racially and ethnically diverse communities, who have had trauma-related experiences. • Coordinate with child-serving systems to provide trauma- and grief-informed services at the local or regional levels. • Develop and implement procedures to ensure that treatment providers are competent and knowledgeable about the impact of complex trauma on youth development.

Project Title: Racial Equity at the Center (REACH): Anti-Oppressive Engagement and Connection to Evidence-Based Trauma Treatments for Child Survivors of Physical and Sexual Abuse Identified through NYC's Child-Serving Systems Project Summary: Safe Horizon's Racial Equity at the Center (REACH) program will provide trauma-informed, developmentally appropriate, evidence-based treatments to traumatized children ages 0-17 identified through NYC's child-serving law enforcement and child welfare systems. Through REACH, Safe Horizon clinicians will screen and treat children and caregivers through all five NYC Child Advocacy Centers, which investigate allegations of physical and sexual abuse, through prevention programs embedded within child welfare systems, and through twelve New York Police precincts that respond to trauma among children exposed to domestic violence. REACH will intervene in the peritraumatic phase of Posttraumatic Stress Disorder (PTSD) with evidence-based mental health treatments, including the Child and Family Traumatic Stress Intervention (CFTSI), Child-Parent Psychotherapy (CPP) for younger children, and Trauma-Focused Cognitive Behavioral Therapy for Racial Trauma (TF-CBT-RT). A groundbreaking innovation will be integrating and adapting evidence-based treatments though new approaches for racial socialization and racial trauma. In partnership with certified CFTSI, CPP, and TFCBT partners, REACH will build the capacity of clinicians, child welfare, and law enforcement partners to more effectively engage families in screening and treatment. REACH will address racial disparities among families of color and aim to significantly increase engagement through development and implementation of affirming, anti-oppressive, and trauma-informed outreach and engagement. Using Safe Horizon’s evidence-informed Brief Trauma Intervention (BTI), which was developed by staff of color and builds significantly on the McKay Engagement Tool, Safe Horizon will significantly reduce engagement disparities for families of color, who are the most likely to encounter barriers in access to critically needed treatment, including systemic racism. For these families, declining services is often motivated by goals of family preservation and fear of involvement with structurally racist social institutions. Therefore, Safe Horizon will collaborate with NCTSN model developers and a Learning Collaborative of Safe Horizon staff to apply racial socialization frameworks to our screening, engagement, and evidence-based treatments. REACH will further develop practices with value for other major cities that seek to address racial disparities, enhance engagement, and improve responsiveness of child welfare and law enforcement. REACH’s goals are: to increase the number of families in child-serving systems who engage in mental health services through development and implementation of anti-oppressive practice; and to reduce child traumatic stress and promote health outcomes among traumatized children and families through evidence-based mental health treatments. Our objectives are: to implement new organic screening as an anti-oppressive strategy with 200 caregivers in Year 1 to 600 in Year 5; and to increase the number of children completing evidence-based trauma treatments from 20 in Year 1 to 60 in Year 5. REACH will train roughly 250 staff in anti-oppressive, evidence-based practices and reach more than 2,000 children and their families over five years. Estimated number of people to be served as a result of the award of this grant: 2,180

FMRS Cares increases access to effective trauma & grief-focused treatment/service systems for children, adolescents & their families, who have experienced traumatic events living in Fayette, Monroe, Raleigh & Summers counties in underserved rural southern West Virginia by expanding evidence-based services to include PC-CARE, Family Acceptance Project (FAP)/TF-CBT & FAP Family Support Model. The program serves 430 clients (75-y1/80-y2/85-y3/90-y4/100-y5). Project goals (interventions/strategies) include: (1) Increase access to effective trauma and grief-focused treatment for target area children, adolescents and their families who experience traumatic events by (A) Expanding workforce capacity to serve the target population by hiring a Project Director, Therapist & Care Coordinator; (B) Coordinating annual Therapist and Bachelors Level staff training in PC-CARE; (C) Providing PC-CARE to the target population; (D) Coordinating annual Therapist training in FAP/TF-CBT for LGBTQI+ children & youth; (E) Providing FAP/TF-CBT to the target population; (F) Adding PC-CARE and FAP/TF-CBT to the advertised continuum of care; (G) Working with LGBTQI+ & African American communities to identify culturally competent referral pathways & (H) Obtaining training/consultation to implement FAP’s Family Support Model (FSM) to mental health practitioners who provide services for children and families to the target population. (2) Increase access to effective trauma and grief-focused service systems for target area children, adolescents and their families who experience traumatic events by (A) Continuing to ensure that all FMRS staff receive Trauma 101 training; (B) Partnering with local child serving systems to obtain initiative referrals; (C) Partnering with PC-CARE developers to adapt/enhance PC-CARE to improve target population engagement and outcomes; (D) Partnering with FAP to implement FAP/TF-CBT & FAP’s Family Support Model to improve caregiver engagement & youth outcomes; (E) Providing FAP general training to FMRS referring entities/partner organizations to increase capacity to help families to support LGBTQI+ youth, especially those who are racially diverse & (F) Working with the Family Acceptance Project to increase community capacity to do upstream prevention to decrease prevalence of family rejection and increase support among the target population. (3) Improve mental health outcomes for target area children, adolescents and their families who experience traumatic events by (A) Empowering clients to have statistically significant improvements in NOMs mental health outcomes at 3-month follow-up & (B) Monitoring disparity group outcomes to ensure equal access/services/outcomes/retention. (4) Sustain access to effective trauma and grief-focused treatment & service systems for target area children, adolescents and their families who have experienced traumatic events by creating a sustainability plan.

Mid-Fairfield Child Guidance Center (MFCGC) NCTSI III project is a collaborative effort of the MFCGC, the Norwalk Public Schools (NPS), the Child Health and Development Institute (CHDI), and Norwalk ACTs. The project is titled: Trauma Informed System of Care: Mid Fairfield School Based Initiative (Elementary School Program Expansion). The purpose of the project is to expand and enhance mental health services in three schools in the NPS. The three schools selected will be high need schools (high percentages of students identified as economically disadvantaged, etc.). The foundation for the project is the incorporation of trauma informed practices in schools to promote an understanding of the impact of current and past experiences on the school aged youth’s current behavior and mental health. This practice promotes positive, pro-active strategies to increase and enhance student engagement which support the development of overall mental health. The proposed program model is based on the multi-tiered system of support (MTSS) framework which promotes increasing awareness of mental health issues through education at the lowest level to providing more intensive direct services for school-aged youth at the highest level of need. The project will also use evidence-based curricula and data-based decision making to provide a clear framework to address mental health and behavior issues while promoting a healthy school climate and culture. The goals of the project are: 1) Increase equitable access to trauma focused services to NPS elementary students. 2) Provide intensive high fidelity wraparound care coordination for NPS students and their families. 3) Increase awareness and understanding of trauma of individuals interacting with school-aged youth to understand and detect the signs and symptoms of trauma. The objectives to accomplish these goals include: the development and implementation of a comprehensive workforce development training plan at the participating schools; promote increased collaboration between the NPS and MFCGC; and provide assistance and training to the three partner schools to ensure project goals are implemented with fidelity. Funds from this project will be allocated to the three partner schools to increase the number of mental health provider and mental health services available to students. During Year 1 of the project, between 55-60 students requiring brief interventions and/or more intensive mental health services will be served and during Years 2-5 between 85-90 students per year will be provided with these services. Between 395-420 students will be served during the 5-year funding period.

Bridges' Support Our Students (SOS) initiative will establish school-based mental health services in 5 local schools which include large Hispanic/Latino, foreign-born, LGBTQ, and other populations at high risk of trauma and resulting emotional and conduct issues. To address these, Bridges will collaborate with Child Health Development Institute (CHDI) to provide a variety of trauma-informed strategies of identification and treatment, and with a network of child-serving local agencies. The population of focus consists of 3 elementary schools in West Haven and a high school and middle school in Milford, both located in the Greater New Haven area of southern Connecticut. West Haven schools have large minority populations, with nearly a third of students speaking a language other than English at home, and nearly a fifth classified as "English Learners" at school. Over a fifth of the West Haven population is foreign born. If we accept the Pew Institute estimate that one-fourth of foreign-born residents are undocumented, over 5% of West Haven is undocumented, as is 2.75% of Milford. The Milford schools are a little over 20% minority, with fewer low-income students. but demographic shift is occurring in both towns; in 12016-2021 the Hispanic population rose by 25% in West Haven and 17% in Milford. Indicators of trauma in the West Haven schools include figures for substantiated child/abuse neglect reports, percentage of teens who considered suicide in the past year, and rate of juvenile arrests that exceed state rates by 70%, 64% and 51% respectively. At substantial risk in Milford are LGBTQ students (at 12%, substantially higher than the state average). Of high school youth who identify as gay, lesbian, or bisexual, 46.8% seriously considered attempting suicide in the past 12 months, over triple the rate for heterosexual youth per national data. Our proposed project will hire 4 full time clinicians to provide school-based services in the target schools. CHDI, the state-designated Performance Improvement Center, will supply staff training and support. Bridges' collaborative network will include Adam's House, an independent grief education center for children; the Milford Rape Crisis Center, Integrated Refugee and Immigrant Services, to support undocumented families; the Milford and West Haven Prevention Councils, Milford-Ansonia inter-agency meetings on investigation/management of child abuse cases; the Juvenile Review Board; and monthly truancy review meetings. Training for school staff will include Trauma ScreenTIME, a CHDI sponsored training on trauma screening in children. Clinicians will be trained in 5 trauma-informed evidence-based practices; the Modular Approach to Therapy for Children with Anxiety, Depression, Trauma and Conduct problems (MATCH-ADTC) which synthesizes elements from several treatments in one flexible model to better address comorbidity complexity; the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) group intervention for 5-12th graders who have experienced trauma; BounceBack, a version of CBITS for younger children; Trauma Focused Cognitive Behavioral Therapy (TF-CBT), a child/parent treatment for youth; and Eye Movement Desensitization and Reprocessing (EMDR), used with children/adolescents with trauma with considerable success. The goals are to increase capacity of the two school systems to provide screening/treatment for youth with traumatic stress, with objectives targeting school personnel trained, students referred to Bridges' clinicians, students receiving services, students who complete CBITS/BB courses, and students who complete a course of individual treatment, including appropriate percentages of Black/Hispanic and LGBTQ students; and increase positive outcomes among youth in the two school systems, with objectives targeting students who see a decrease in symptoms per CPSS-V measures. Projected numbers served are as follows: Year 1 - 100; Years 2-5 - 160; for a total of 740.

The Child and Adolescent Maltreatment Prevention (CHAMP) Network is a partnership between the NYU Silver School of Social Work, the NCTSN Center for Child Welfare Practice Innovation (CCWPI), the NYC Administration for Children’s Services (ACS), and three child welfare prevention agencies, which will expand delivery of trauma-informed care, including Trauma Systems Therapy (TST), to prevent and address the consequences of child maltreatment. The CHAMP Network builds on an existing partnership between the CCWPI, ACS, and child welfare prevention services providers which serve children and families across all five boroughs of New York City, in which approximately 20,000 children were referred to prevention services in 2022. Among this diverse group of vulnerable children, over 90% were children of color. Children and families receiving child welfare prevention services in NYC and beyond are highly likely to experience adverse outcomes related to trauma and maltreatment and are at extremely high risk of future maltreatment. Considering the prevalence of trauma among consumers of prevention services, providers operate as a frontline safety net for traumatized children at risk of maltreatment. However, despite the trauma-related mental health needs in this population, only 43% of NYC families in prevention reported that anyone in their family received a referral to mental health services. Prevention services providers need both trauma-informed, evidenced-based processes and trauma-focused interventions to appropriately meet the needs of this extremely vulnerable population. To address these challenges, five goals define the scope of the CHAMP Network: 1) To improve the safety and mental health of children and families in the five boroughs of NYC determined to be at high risk for maltreatment by ACS, including training 50 CHAMP Network providers in TST and delivering TST intervention to 540 families each year. 2) To closely coordinate screening, assessment, interventions, and services between ACS and TST teams to improve care of children and families in child welfare prevention, including training 50 ACS staff in trauma-informed care using TST and Never Look Away (NLA; an engaging NCTSN curriculum on trauma-informed care based on an animated video series). 3) To improve the competence and knowledge of providers about the impact of complex trauma on youth development, including training providers across the prevention services continuum using NLA and The Rhythm is My Blanket (RMB; an NCTSN curriculum to address racial disparities and biases in clinical care) and establishing a training institute at the Silver School of Social Work to train future child welfare providers in trauma-informed care. 4) To implement a community engagement and outreach strategy to increase awareness among community providers and families of the needs of traumatized children, including training new trainers in NLA and RMB at each partnering agency. 5) To improve the CHAMP Network’s processes for serving children and families in child welfare prevention programs in order to establish the network’s value as a national model, including conducting focus groups with participants, providers, and community leaders to articulate recommendations for dissemination of this approach. Through training and the delivery of TST, NLA, and RMB, the CHAMP Network will serve 810 unduplicated individuals in year 1 and 980 in each subsequent year of the project.

The Arab Community Center for Economic and Social Services of Dearborn, Michigan will implement Trauma Systems Therapy for Refugees with trauma-affected refugee and immigrant youth and their families in outpatient and community-based settings in Dearborn, Melvindale, and Allen Park. The project will receive Trauma Systems Therapy for Refugees training and technical assistance services from a NCTSI Category II Center – Boston Children’s Hospital, Trauma and Community Resilience Center (TCRC). The project will include refugee and immigrant community and school staff outreach and engagement, skill-building groups for traumatized youth, individual therapy, and family therapy. A total of 480 trauma-affected adolescents aged 10 to 17 will participate in the project over five years. The following five-year outcomes are anticipated: 1. ACCESS clinicians and cultural brokers learn, adapt, and implement Trauma Systems Therapy for Refugees (TST-R) evidence-based treatment approach, as measured on Boston Children’s Hospital’s TST-R Training Post-Test 2. 20 school social workers, 30 other school staff, and 25 ACCESS staff, who work daily with resettled refugee children and adolescents report, as measured on Boston Children’s Hospital’s TST-R Community Orientation Post-Test, being more knowledgeable and better equipped to address social environmental and system of care factors that exacerbate youth traumatic stress. 3. Of the estimated 480 refugee and immigrant children and adolescents who receive initial treatment from this project, 384 (80%) will demonstrate, at the end of the 12 group sessions, improved emotional regulation capacities and personal resilience, as measured on the (1) Social Competence Scale and (2) Psychological Sense of School Membership Scale Of the estimated 120 refugee and immigrant children and adolescents (and their families) who receive intensive treatment and care management assistance from this project, 90 (75%) will demonstrate a decrease in experiences of discrimination, family resource hardship, symptoms of depression, or post-traumatic symptoms and an increase in sense of school belongingness, as measured on pre- and post-treatment administration of the Strengths and Difficulties Questionnaire (for youth) and Structured Trauma-Related Experiences and Symptom Screener (STRESS) (for youth and parents).

The Health & Hospital Corporation of Marion County d/b/a Eskenazi Health (EH) is applying for SAMHSA funds through the National Child Traumatic Stress Initiative-Category III: Community Treatment and Service Centers (NCTSI III CTS Center) grant to facilitate expansion of the Sandra Eskenazi Mental Health Center (SEMHC) Children's and School-based Services to increase awareness and access to effective trauma-focused services for children and their families in underserved/under-resourced communities. The newly created SEMHC NCTSI III CTS Center consists of two parts: 1) a dedicated community outreach and training facilitator focused on trauma and utilizing Mental Health First Aid (specifically for children and adolescents); and 2) a dedicated intensive outpatient team comprised of a clinician and a care coordinator that will provide intensive outpatient services in both clinic and school-based environments to those at high-need and identified with trauma history. SEMHC NCTSI CTS Center will serve a total of 2,520 unduplicated individuals during the five-year period. SEMHC, a division of the healthcare safety net system EH, is a Certified Community Mental Health Center per the Family and Social Services Administration of Indiana (FSSA) Division of Mental Health and Addiction (DMHA) and provides treatment for the underserved in Marion County with severe emotional disturbance, serious mental illness, and/or substance use disorder. As a community mental health center, Indiana DMHA requires SEMHC to serve individuals with the highest resource needs and most functional impairment from substance use disorder, mental illness, and severe emotion disturbance. Goal 1: SEMHC's Intensive Children's Outpatient Team (ICOT) will ensure that those in the ICOT program receive evidence-based mental health related services including therapy and skills building. Objective: The trauma-focused ICOT will have provided evidence-based trauma-focused intensive outpatient services to at least 30 children annually, and at least 210 children over the five years of the grant. Goal 2: SEMHC will screen children and adolescents seeking treatment for trauma-related experiences annually, and at least 1,800 children will be screened over five years. Objective: At least 300 children will be screened for trauma-related experiences annually, and at least 1,800 children will be screened over five years. Goal 3: SEMHC will refer screened youth found to have trauma for trauma-informed care services provided through the grant-funded ICOT. Objective: At least 40 children will be referred for intensive outpatient services through the team annually, and at least 315 will be referred over five years. Goal 4: SEMHC 1.0 FTE training facilitator will train organizations, schools, health fairs, and families in Mental Health First Aid, and will provide information regarding mental health, trauma, and how to access mental health services. Objective: At least 60 individuals will be trained in Mental Health First Aid annually through the grant, and at least 510 will be trained over five years. Goal 5: The 1.0 training facilitator will provide outreach to child-serving organizations, conferences, health fairs, and schools regarding services available in the Marion County/Indianapolis area. Objective: The training facilitator will attend at least 10 health or school fairs annually, providing information about trauma-related treatment services, and will attend at least 80 events over five years.

Kristi House, Inc., the Children's Advocacy Center serving large, ethnically diverse Miami-Dade County, proposes to strengthen community capacity for evidence-based, trauma-informed, culturally competent practices for children overcoming serious trauma in Miami-Dade County. C-START (Child Severe Trauma Awareness, Response and Treatment) is focused on providing training in and treatment using evidence-based practices for child trauma, particularly for underserved, racial and ethnic minorities and special populations. With the area's current capacity for mental health services severely outstripped by need, C-START will target critical service gaps and underserved communities. With the partnership of EBP developers and master trainers, C-START will make its impact under three major objectives: 1) service delivery; 2) capacity building; and 3) awareness and education. Service delivery will be carried out by therapists and care workers serving children, adolescents and families. Along with Kristi House, 10 partner-agencies working with ethnic and racial minorities, LGBTQ+ youth and newcomers have committed to C-START to provide evidence-based practices and participate in EBP trainings. Over the five years, we anticipate reaching 3,760 children and adolescents with evidence-based treatment, 95% of whom will be racial and ethnic minorities, newcomers and LGBTQ+ children and adolescents. Capacity-building will take a Community-Based Learning Collaborative approach to spreading EBPs including Trauma-Focused Cognitive Behavioral Therapy, Culturally Modified Trauma Focused Therapy, Risk Reduction through Family Therapy, and Problematic Sexual Behavior Cognitive Behavioral Therapy for school-age children. All EBPs will be taught by national master trainers. Additional experts in child trauma and race; substance use disorders and risky behaviors; Sexual Orientation and Gender Identity Change Efforts; and unaccompanied, refugee, and immigrant minors will expand capacity for treating trauma impacting special populations of youth. Specialized techniques to support clinicians and other care workers such as Motivational Interviewing and Components for Enhancing Career Engagement and Reducing Trauma (CE-CERT) will further fortify the workforce with sustaining support, advanced training and skill building. C-START anticipates training 252 clinicians, care managers and senior leaders in EBPs and several hundred others in mini-trainings on child trauma. Education through C-START will encompass delivery of evidence-based and best practice prevention, education, training and awareness programs for service providers, parents and youth to increase awareness of child trauma and access to services. Outreach will focus on communities where children are at high risk and underserved. NCTSN Core Curriculum College participation by a cohort of educators and trainers will further strengthen the trauma-informed foundation for care in Miami. We expect the Kristi House Education team will reach 4,000 to 4,250 participants a year for a total of 21,000 education course participants over the five-year grant. Input from consumer-clients, partners from other NCTSN sites and workgroups, master trainer faculty and evaluators from the University of Miami will provide input and guidance throughout the project.

ABSTRACT: A BRIGHT Approach to Early Childhood, Parenting, and Substance Use The Institute for Health and Recovery, Inc (IHR), in collaboration with Boston University School of Social Work (BUSSW) and the Supporting our Families through Addiction and Recovery (SOFAR) clinic at Boston Medical Center (BMC), propose “A BRIGHT Approach to Early Childhood, Parenting, and Substance Use” to address the needs of young children suffering from trauma and grief resulting from parental substance and opioid misuse. The program will serve 180 children (24% Black; 49% White; 12% Latino/a; and 15% as mixed race) birth through age 6, (30 in Year 1, 40 annually in Years 2-5) and their parents in recovery from SUD at the SOFAR Clinic. Clinicians and a Peer Recovery mentor will offer BRIGHT and other evidence-based interventions that will result in families affected by substance use and their children affected by the traumas of grief, loss, and separation from parents, to experience increased engagement and joy in the parent-child relationship, while building resilience, mitigating traumatic grief, and optimizing child development. Over 50% of the families served by SOFAR are involved with the child welfare system in MA due to substance use. BRIGHT (Building Recovery through Intervention: Growing Healthier Together), is a unique intervention developed in Massachusetts over fifteen years that builds resilience, recovery and relationship between parents affected by Substance Use Disorders (SUD) and trauma, and their young children, age newborn through 6. Social-emotional competence, built in young children through development of a strong caregiver-child relationship, has been identified as the single most significant component underlying the development of resilience in children. Simultaneously we will offer training in the components of the BRIGHT intervention (scored as an Emerging Practice by the Association of Maternal and Child Health Programs) to build the capacity of SOFAR staff, and staff within Boston Medical Center, as well as our referral sources and child welfare staff, to understand, learn, and replicate key components of the intervention within their practice with recovering families. Goals for this project include: 1) Increase children’s strengths and mitigate effects of parental SUD/MH and trauma; 2) Decrease child trauma by enhancing the quality of the parent-child relationship; 3) Build the capacity of SOFAR Clinic and other BMC staff to provide family-centered, grief focused, trauma-informed care that mitigates the effects of traumatic grief and optimizes child development; 4) Build understanding in the child welfare system of a relationship-based, trauma-informed approach to working with families and young children with histories of substance use, co-occurring disorders and trauma can improve outcome for children; 5) Collaborate with NCTSN- Category II, Treatment and Service Adaptation Centers, to develop, advance, or adapt interventions to improve engagement and outcomes for traumatized young children, including culturally and linguistically appropriate services.

Through our project, CN Guidance & Counseling Services and partners (FCA, EPIC/South Shore, and HCC) will serve Nassau and Suffolk County (NY) children, adolescents, and families largely from underserved / under-resourced communities who have experienced traumatic events through evidence-based practices informed by Child HELP Partnership, a NCTSI Category III Treatment and Service Adaptation (TSA) Center. POPULATION(S) TO BE SERVED through our project include: DEMOGRAPHICS — at-risk children and adolescents, including those from racially and ethnically diverse urban and suburban communities, residing in Nassau and Suffolk counties (for example, according to the NYS Department of Education, 75% (5,145) of the children enrolled in the Hempstead Public School District in our service area speak Spanish). Like CN Guidance, our partners Family & Children’s Association (FCA), EPIC Long Island and South Shore Child Guidance Center (EPIC/South Shore), and Hispanic Counseling Center (HCC) all currently serve many of the most vulnerable residents of Long Island, and together we will use existing referral relationships to identify and address health disparities for disparate populations served. Targeted hotspots will include those facing service gaps, high vulnerability, poor health, and high avoidable ED usage as identified in a robust Community Health Needs Assessment 2022-2024 from NY’s largest healthcare provider, Northwell Health. CLINICAL CHARACTERISTICS — children and youth who have experienced complex trauma (e.g., adverse childhood experiences (ACEs), grief, disaster- and COVID-related, race-based, hate-based, historic, and complex physical and emotional trauma), including those who are at risk for or who have been diagnosed with a mental health disorder or serious emotional disturbance defined by a DSM IV diagnosis. STRATEGIES/INTERVENTIONS our project will implement include trauma-informed approaches to: (a) non-clinical outreach/engagement services to support target populations, (b) short-term / interim clinical services to reduce or preempt longer-term care need, and (c) custom referral pathways to long-term child serving programs. PROGRAMMATIC COMPONENTS will include: Peer Services (both Youth Peer and Family Peer Advocates), Screening, Diagnostic Assessment, Care Management, Therapy, Prevention, Referral Pathways (in/out), and Training of Community Partners. PROJECT GOALS AND MEASURABLE OBJECTIVES of our project include: (1) Increase the number of at-risk individuals (children/family members) receiving evidence-based practices, (2) Improve organizational capacity to provide evidence-based screenings in the community, (3) Increase capacity for providing evidence-based, trauma-informed treatment to individuals who screen positive for traumatic experiences, (4) Conduct outreach activities designed to promote knowledge of available mental health resources in the Long Island region, (5) Promote continuity of care for vulnerable children and families through inter-agency cooperation, (6) Improve daily functioning among at-risk children and families, (7) Monitor and mitigate housing insecurity among individuals and families served through this grant, (8) Address education concerns among those served with grant funding, (9) Assess criminal justice system impacts, (10) Improve the degree of social / community connection among children served throughout the grant period, and (11) Provide quality care to recipients of grant services, in order to promote positive perception of trauma-related treatment NUMBER of people to be served annually = ~300-375 NUMBER of people to be served throughout the lifetime of the project = 1750

The Alliance for Inclusion and Prevention, Inc.’s (AIP) Center for Trauma Care in Schools (CTCS), in partnership with Lynn, MA, Public Schools (LPS), proposes to establish the Collaborative for Trauma and Grief Treatment (CTGT) to increase access to evidence-based treatment for trauma, grief, and related mental health disorders for children and youth in the LPS who experience traumatic events or ongoing traumatic stress. CTGT builds on AIP’s decades of experience developing partnerships to deliver evidence-based practices (EBPs) to thousands of students in Boston and other school districts in MA. CTGT serves the student population of LPS. The SY2022-23 enrollment is 15,433 students, 85% of whom are considered “High Needs,” defined by MA Department of Education as being low-income, English learners, and/or students with disabilities. These students, as well as students in foster care, LGBTQ+ students, newcomer students, and homeless students, are cited by LPS as the most vulnerable students to trauma and its effects. Post-COVID-19 county health assessments for Lynn and surrounding communities document an increase in social isolation, anxiety, depression, and substance use disorders in youth as well as an increase in violence, bullying, and school avoidance. The assessments recommend school-based initiatives to mitigate access barriers, such as lack of transportation and long waiting lists for culturally and linguistically appropriate services. The goals of CTGT are to: 1) Increase access to trauma and grief EBPs for Lynn Public School (LPS) students; 2)?Improve the effectiveness of the school mental health service system to address the range of student trauma/grief-related needs across the three tiers of LPS’s Multi-Tiered System of Supports (MTSS); and 3) Increase understanding across the Lynn school community of the impact of trauma and grief and related disorders on youth development. These goals are achieved through the school-based delivery of the following evidence-based treatments and practices: Trauma Systems Therapy (TST); Trauma and Grief Component Therapy for Adolescents (TGCTA) and Multidimensional Grief Therapy (MGT) for younger students; Cognitive-Behavioral Intervention for Trauma in Schools (CBITS) and Bounce Back for younger students; and Supporting Transition Resilience of Newcomer Groups (STRONG). Progress on goals is measured through the following objectives: Over 5 years: 1a) Train 160 clinicians in LPS to use EBPs for trauma and grief in their school-based counseling work; 1b)?Train 160 clinicians to conduct screening for trauma and grief; 1c) Deliver screenings and evidence-based/informed individual or group treatments and practices for trauma and grief to minimum 4,975 LPS students; 2a) Provide all LPS schools with trauma and grief EBPs throughout each school’s Multi-Tiered System of Supports; 2b) Develop trauma and grief EBP adaptations in response to shared needs of students within sub-groups with identified disparities (homeless, foster, LGBTQI+, and newcomer youth); 3a) Train 90% of LPS teachers (1,080) to understand the impact of trauma and how to reduce its impact on children in the classroom, including for sub-groups with high disparities; 3b) Deliver 60 mental health awareness messages related to youth, emphasis on trauma and grief, to LPS parents/caregivers. CTGT provides screening and treatment to 475 students in Year 1, 875 students in Year 2, 1075 students in Year 3, and 1275 students in each of Years 4 and 5, for a total of 4,975 students served with EBPs. By integrating EBPs for trauma and/or grief at each MTSS tier, CTGT fills the gap for quality supports for LPS students in need of a trauma-informed, culturally responsive school environment.

Summary: Refugee, immigrant, or asylum-seeking (forced migrant) youth experience extremely high levels of traumatic exposure and have high prevalence rates of PTSD and other mental health diagnoses. HAI plans to apply lessons learned as an existing NCTSN Category III site to expand and improve services for this population through the Healing Journeys project. With this project, HAI aims to partner with forced migrant youth ages 0-21 and their families in the Chicago area to (1) identify their goals for health and healing and (2) accompany them on their therapeutic journey to realize these goals through trauma-informed, evidence-based mental health services. HAI requests $600,000 per year for five years to support this project. Population(s) to be served: This project will serve forced youth ages 0-21 who have experienced trauma either in their home country, during migration, or through the resettlement process in the U.S. While HAI’s experience is that these youth possess remarkable resiliencies and strengths, they often carry emotional and even physical wounds, are separated from crucial support networks, including family, and must learn multiple skills very quickly to successfully adapt to their new life. In the past 4.5 years of NCTSN funding, HAI has served over 150 youth from 34 different countries, speaking 22 languages. Strategies & Interventions: Healing Journeys will provide services within the Healing Ethno-Racial Trauma (HEART) Framework, with support of NCTSI Category II site Kennedy Krieger. Interventions include individual and group therapy using evidence-based practices such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Supporting Transition Resilience in Newcomer Groups (STRONG), and Attachment Vitamins. Project goals and measurable objectives: HAI intends to meet the needs outlined above through four interrelated goals: GOAL 1: Improve the mental health outcomes of forcibly displaced youth ages 0-21 who have had trauma and/or grief-related experiences through implementation of evidence-based programming. GOAL 2: Enhance the capacity of child-serving systems in the Chicago area and Illinois to provide trauma- and grief-informed services for forcibly displaced youth and their families. GOAL 3: Increase the capacity of treatment providers to address the impact of complex trauma throughout childhood, with a focus on understanding the impact of ethno-racial trauma, migration trauma, and grief and ambiguous loss on forcibly displaced youth. GOAL 4: Collaborate with community-based partners and forcibly displaced communities in Illinois to increase awareness of, participation in, and access to, trauma and grief-informed treatment and services for forcibly displaced youth and their families. Illustrative examples of the measurable objectives for this project include: Objective 1.1 Through the provision of evidence-based and evidence-informed, culturally and linguistically appropriate, mental health services, at least 85% of forcibly-displaced youth between the ages of 0-21 will show improvement in mental health symptoms by the end of treatment. Objective 2.1 Annually, provide group-based trainings and/or 1-1 consultation to 100 individuals from child-serving systems on providing trauma- and grief-informed services to forcibly displaced youth and families. Direct Service Beneficiaries: Annually, 65 youth will receive mental health treatment and services, of which 50 will be new and 15 will be continuing service from the prior year. Over the five-year project period, a total of 250 unique youth will receive mental health treatment and services.

The University of Chicago Medicine REACT Program Recovery & Empowerment After Community Trauma represents a response to Chicago’s greatest ongoing public health challenge violence. Based in an urban children’s hospital, UCM REACT will address behavioral health disparities by providing African American patients affected by community violence with traditional evidence-based treatment as well as new community- and culturally-driven services. The University of Chicago Medicine (UCM) is a leading academic medical center located on Chicago’s South Side in one of the most racially and economically segregated cities in the US. Many neighborhoods in the UCM Service Area, affected by decades of disinvestment and racialized structural violence, face some of the highest levels of poverty and violent crime in the city. Due to the prevalence of violent crime in their communities and Chicago’s chronic struggles with gun violence, the day-to-day lives and health of many children served by UCM are shaped by community violence. It is not uncommon for patients to have witnessed shootings or to have lost a loved one to violent death. Even when directly unscathed by such events, children and their caregivers frequently worry about their own safety. Despite widespread awareness of the impact of violence, services to support children and families as they cope with it are scarce. Clinical services that specifically address the traumatic effects of violence remain unavailable for the vast majority of affected children. Children’s trauma-related emotional and behavioral difficulties are often misdiagnosed, resulting in them receiving ineffective intervention or no intervention at all. The UCM REACT Program addresses these trauma-related behavioral health disparities by identifying hundreds of patients affected by community violence, whether or not they have sustained physical injuries, and providing access to a range of trauma-focused and trauma-informed services for them and their families. UCM REACT Program clinicians will conduct assertive outreach and trauma psychoeducation with all violently injured patients under 19 presenting to UCM’s pediatric and adult Level 1 Trauma Centers, as well as any patients encountered in a variety of UCM inpatient and outpatient settings, including the Comer Children’s Hospital Pediatric Emergency Department, the Department of Psychiatry Consultation/Liaison Service, and the Comer Children’s Hospital Pediatric Medical Mobile Unit, and Pediatric subspecialty clinics. Following trauma screening, support, and psychoeducation, patients and families affected by community violence will be linked to a weekly interdisciplinary clinic that provides trauma-informed psychological and psychiatric needs assessment and/or to NCTSN-developed interventions, including the Child & Family Traumatic Stress Intervention (CFTSI); Attachment, Regulation, & Competency (ARC) and Child-Parent Psychotherapy (CPP). In addition to these interventions, UCM REACT will develop capacity to offer community- and culturally-driven services for youth and families for whom traditional office-based EBPs are not desired, indicated, or feasible: Dr. Obari Cartman’s manhood development groups for young Black men, MANifest, and Dr. Marva Lewis’ Parent Café curriculum, Talk, Touch & Listen While Combing Hair. It is anticipated that these community-based approaches will promote racial healing and increase the likelihood of subsequent engagement in ongoing REACT Program services. The UCM REACT Program will serve at least 350 children and their families annually (1,750 during the grant period) each year providing screening, support, and psychoeducation for 300 individuals, psychological and psychiatric needs assessments for 40, medication management for 40, trauma-focused EBPs for 125, and community-based, culturally-driven groups for 40.

The Exchange Club Center for the Prevention of Child Abuse of North Carolina, Inc. (The Parenting PATH) will increase access to effective trauma-focused treatment for children, adolescents, and families, who experience trauma and traumatic events through the project “Expanding Access to Trauma Informed Services through Family Centered Treatment to Underserved and Under-resourced Families in Northwest North Carolina”. The population of focus includes families in Forsyth, Davidson, Davie, Rockingham, Stokes, and Surry Counties in North Carolina (NC), families in urban or rural settings; who live in low-income households; who identify as LGBTQIA+; who are historically underserved/under-resourced due to race, ethnicity or preferred language. This project will serve the above named focus population, including: families with children between the ages of 0-3, and families with children ages 4-18 who qualify for Family Centered Treatment (FCT) by meeting any combination of the following criteria: Exposure to trauma, systemic involvement (involvement with Child Welfare, Juvenile Justice, Department of Corrections), experiencing a mental health or substance use crisis, face challenges with family functioning or family reunification. Project Goals and Measurable Objectives include: 1. Enable family stability and permanency (preservation of or development of a family placement) 80% of children will remain in home with caregivers or family members, move to independent living, reunify with caregivers or other family members at six months/closure 2. Enable changes in family functioning that reduce the risk of family dissolution 80% of families will report positive progress at six months/closure toward primary treatment plan goals 3. Reduce hurt and harmful behavior 90% decrease in crisis episodes and hospital inpatient stays during six months of service 90% will not experience behavioral health related emergency room visits during six months of service 4. Promote an emotional and functioning balance in the family 80% will report a decrease or elimination of negative symptoms at six months/closure 80% will report an increase capacity to monitor and manage their behavior at six months/closure 80% will report a decrease or elimination of negative symptoms at six months/closure 5. Enable changes in family member’s behavior 80% will demonstrate utilization of learning coping skills and social skills at six months/closure 80% will report a decrease or elimination of negative symptoms at six months/closure 6. Enable discovery and effective use of family’s strengths to sustain changes 90% will not report requiring FCT services minimally 6 months post discharge A total of 648 unduplicated individuals will be served through Award Funds, with 96 in Year 1, 120 in Year 2, 132 in Year 3, 144 in Year 4 and 156 in Year 5.

Funding Opportunity Number: SM-23-010 Descriptive Title: Northwest Indiana Identification and Management of Pediatric Experiences of Trauma and Underlying Stress (NWI IMPETUS) Project Abstract The Northwest Indiana (NWI) Identification and Management of Pediatric Experiences of Trauma and Underlying Stress (IMPETUS) program seeks to implement routine screening of pediatric traumatic stress and increase access to evidence-based interventions throughout an under-resourced region of Indiana. NWI contains the second largest county in the state, spans both urban and rural counties, and records disproportionately high rates of poverty, food insecurity, and child maltreatment fatalities relative to state averages. IMPETUS recognizes that insecurity, and child maltreatment fatalities relative to state averages. IMPETUS recognizes that pediatric primary care clinics have become the key entry point for trauma-exposed children and families in NWI. Accordingly, the Care Process Model for Pediatric Traumatic Stress (CPM-PTS) will be implemented to empower pediatric healthcare providers to identify and distinguish trauma exposure and symptoms from other behavioral health issues and to more effectively and efficiently facilitate access to evidence-based treatment. IMPETUS will accomplish this by: 1) implementing routine pediatric trauma screening for 9,000 youth per year; 2) providing immediate access to brief trauma-informed secondary prevention interventions and group interventions for 200 families per year; and 3) increasing access to longer-term evidence-based trauma interventions by training 50 NWI clinicians per year to subsequently provide trauma-focused services (TF-CBT and TARGET) to 100 youth per year. In collaboration with two NCTSN Category II TSA Centers, the IMPETUS project team, expert consultants, and community partners are uniquely positioned to provide these services across the rural-urban geographic continuum and to change the trajectories for some of Indiana's most vulnerable youth and families.

The purpose of this grant is to increase access to effective, evidence based treatments for children and families in Douglas and Sarpy Counties affected by traumatic events; and in particular, to reduce racial and ethnic disparities in access to services and provide support for military families. With this trauma response initiative, Project Harmony plans to expand the agency’s Children’s Mental Health Services, creating capacity to provide mental health services to an additional 400 youth annually for a total of 2,000 children over the five-year period. Project Harmony is plans to: • Increase access to trauma treatment and services; and prevention services for children, adolescents, and families who have experienced traumatic events. • Provide trauma treatment (including screening, assessment, care management, therapy, and prevention) for diverse and at-risk children and adolescents. • Hire 3 additional therapists, creating capacity to provide an additional 2,000 children over the five-year period with evidence-based trauma specific treatment practices. • Hire a Clinical Program Manager to provide clinical supervision for the hired mental health therapists as well as an Administrative Assistant to ensure each child and family is well cared for during their visit. • Utilize a Program Grant Coordinator to manage the grant and enhance plans for sustainability of trauma efforts beyond grant funding. • Collaborate with NCTSI - Category II Treatment and Service Adaptation (TSA) centers to develop, advance, or adapt interventions to improve engagement and outcomes for traumatized youth. • Recruit community mental health therapists trained in Evidence-based trauma modalities willing to accept referrals, increasing access for services.

This five-year project (September 2023 to September 2028) will provide evidence-based treatment and services to children, adolescents, and their family members living in the greater Bridgeport, Connecticut area, who have experienced trauma and traumatic events. The 2020 Community Readiness Survey found that 17.2 % of children aged 12-17 and 15% of young adults aged 18-25 in this region of southwestern CT meet these criteria with priority populations including the undocumented, those with cultural or language barriers, individuals with disabilities, and other groups experiencing barriers to care. A community-based organization offering behavioral health, youth development, and other social support services, LifeBridge Community Services (LifeBridge), has provided services to greater Bridgeport’s most vulnerable and disadvantaged populations for over 173 years. With funding from NCTSI III, LifeBridge will make investments in our clinical competencies (cultural and therapeutic) to enhance the quality of our therapeutic care and improve outcomes for patients, thereby addressing the urgent need for quality trauma-focused treatment in Bridgeport. The proposed project has the following goals: 1) To increase access to evidence-based services for urban BILPOC children/youth and their families who experience traumatic events. 2) To improve the standard of care for urban BILPOC children/youth and their families who experience traumatic events. 3) To increase stakeholder engagement and youth and family voice. Project activities include training of LifeBridge clinicians in evidence-based practices for treating children and adolescents who have experienced trauma, as well as training in applying treatment practices so they are culturally relevant to the population served. As a result of this training, the project will provide 350 children and adolescents aged 6-18 with improved behavioral health services and treatment. To improve access to evidence-based services, the project includes an extensive community outreach, social media, and marketing campaign. These efforts will be designed to formalize community referral networks, increase awareness about mental health services, reduce stigma of mental health issues, and to create social cohesion on shared community priorities for addressing mental health and related needs. These activities will include an estimated 300 participants in community events, generate 10,000 social media impressions, and reach up to 140,000 people through other marketing efforts. The project includes a robust monitoring and evaluation component led by an independent team of evaluators from Brandeis University to assess the effectiveness of project activities and their impact on behavioral health outcomes. Project findings will be shared widely with the behavioral health community, as well as other relevant federal, state, and local health agencies.

Catholic Charities of the East Bay’s Healing Youth project will provide direct mental health services to 1,500 underserved Black/African-American, Latinx, and immigrant youth (ages 14-24) impacted by complex and ongoing trauma in Alameda and Contra Costa counties. The program will use evidence-based, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and adaptations to incorporate culturally relevant engagement strategies. Project goals are: (1) To improve mental health for children, adolescents, and their families, who experience traumatic events, and (2) to increase community capacity to respond to complex traumas that affects both individual youth as well as whole communities. Goal 1 Objectives are to (a) provide culturally and linguistically relevant, trauma-informed, and evidence-based mental health services that are based in restorative practice to 1,500 unduplicated trauma-impacted youth and their families in Alameda and Contra Costa counties over 5 years (300 youth served annually); and (b) increase access to effective trauma- and grief-focused treatment and service systems for underserved youth and families in Alameda and Contra Costa counties by expanding the number of culturally and linguistically relevant providers in school- and community-based locations who can provide free services for uninsured and underinsured youth during the 5-year grant period. Goal 2 Objectives are to (a) provide 1,500 hours and 60 sessions of outreach, training, and coaching over 5 years to school staff, teachers, students, families, community members, and other mental health providers on mental health promotion, trauma, restorative trauma-informed responses to student behavior, evidence-based treatment models, and restorative practices-based approach to clinical services; and (b) collaborate with national, state, and local partners to provide and receive training, and share best practices related to culturally relevant, trauma-informed restorative practices. Project activities to achieve these goals and measurable objectives will include clinical trauma treatment, intensive case management, group-based restorative practices, and a variety of coaching, training, and outreach strategies at local, state, and national levels. Project outcomes related to improvements in PTSD symptoms, emotional regulation, social and emotional skills, and other factors will be measured using appropriate assessment and data collection instruments at standard intervals over the life of the project.

Westside Infant-Family Network (WIN) provides critical mental health services to low-income children ages birth to five and their families in Los Angeles County, California, specifically majority Black and Latinx/Hispanic clients on the South and West sides of LA. As part of its Early Childhood Resilience Project (ECRP), WIN requests $598,539 to serve 950 unduplicated individuals (children and their caregivers) over five years with home-based or virtual Child-Parent Psychotherapy (CPP) supported by case management and parent/caregiver support groups. WIN focuses on early childhood because that is the time period at which interventions are most effective and can prevent future toxic stress and mental health issues. WIN’s program model has successfully served almost 6,000 children and their caregivers since 2005. Six community agencies and several foundations united to create WIN to address a growing crisis: infants were suffering from symptoms of depression, toddlers were being expelled from preschool for aggressive behavior, and parents were so depressed they were unable to care for their families and themselves. Levels of trauma as measured by Adverse Childhood Experience (ACE) screenings are high amongst those that WIN serves: 70% of Medi-Cal enrollees report at least one ACE, and 23% four or more ACEs. WIN has found that despite Medi-Cal starting a program with its providers to screen for ACEs, only five percent of families who screen positive for ACEs opt for follow-up mental health services. Through a pilot program with partner clinic Westside Family Health Center (WFHC), a Federally Qualified Health Center (FQHC), WIN learned that health clinics need direct and ongoing support to build their capacity to provide ACEs screenings and referrals. WIN now provides a dedicated Community Health Worker (CHW) to provide ACEs screenings, referrals, and psychoeducation support to take the pressure off of the primary care providers at two of its partner clinics. And through conversations with the L.A. County Department of Mental Health (DMH) and feedback from partners, WIN staff became aware there are few relationship-focused, parental-support services available for parents/caregivers with children ages 0-5. To address this gap, WIN began providing Attachment Vitamins (AV), a 10-week intervention that uses peer groups to help parents/caregivers better understand themselves and their role in their child’s life and establish secure attachment. The AV group intervention allows WIN to still serve the child-caregiver relationship but in less time, on a larger scale, and with peer support, thereby reducing barriers and improving access for families. And to succeed in therapy, families need additional case management support to overcome the many challenges they face. Both CPP and AV are evidence-based practices that help address trauma in babies and young children. WIN coordinates with diverse child-serving partners and systems to provide trauma-informed services through close partnerships and referral networks, including Federally Qualified Health Centers (FQHCs), the LA Department of Mental Health, and community-based health clinics. WIN will use specific community-based engagement/outreach strategies to reach potential clients for this program and increase awareness of, participation in, and access to, trauma and grief treatment and services for at-risk low-income children, ages 0 to 5 and their families in South L.A. Methods include canvassing by WIN’s outreach team, offering community events, and hosting community advisory committees. WIN’s staff are highly qualified and dedicated to ensuring program practices are evidence-based and help improve mental health outcomes. An evaluation team consisting of staff members and outside consultants will monitor project progress, collect performance data, submit required reports, and develop quality improvement plans.

The Lifeline Center for Child Development, Inc. will expand its capacity through the addition of outpatient trauma services for 630 youth, ages 5 to 17 years, in Queens, NY. Children and youth with emotional/behavioral dysregulation as a result of pandemic-related and complex trauma will participate in Trauma Systems Therapy delivered via clinic and home-based services to increase their safety, help them cope with traumatic stress, and improve their emotional wellbeing. The Lifeline Center will focus outpatient trauma services on children and youth living in some of the most diverse and underserved communities in Queens, NY. Two-thirds of Jamaica/Hollis residents identify as Black (66%), half of Corona/Elmhurst identify as Latino (51%), and more than half of Flushing Whitestone residents identify as Asian (54%). Between 42% and 63% of residents in these neighborhoods are immigrants, and up to half have limited English proficiency. As a result, these neighborhoods bore the brunt of the COVID-19 pandemic in NYC, with infection, morbidity, and mortality rates far exceeding other NYC and US regions. Many children and youth in these neighborhoods continue to experience traumatic stress related to the pandemic, including a high rate of loss of a parent or loved one. They experience high levels of anxiety, depression, suicidal ideation or behavior, hyperactivity, aggressiveness, withdrawal, including from school, and risk for drop-out. Schools are under-resourced to address students’ mental health and outpatient clinics have long waitlists. To help close the service gap and make mental health services available to more underserved children and families suffering from the traumatic fallout of the pandemic, the Lifeline Center will expand its current capacity through the addition of an outpatient and home-based treatment component, utilizing Trauma Systems Therapy (TST). TST provides an organizational framework and set of interventions to improve outcomes for children and youth whose level of emotional and behavioral dysregulation puts them at high risk for short- and long-term harm. For the purpose of TST implementation, we will contract the NYU School of Medicine Center for Child Welfare Practice Innovation (CCWPI), a NCTSI-II Treatment and Service Adaptation Center led by Dr. Glenn Saxe, the developer of TST. The Lifeline Center will serve 70 children in Year 1, and 140 in each of Years 2-5, for a total of 630 children and youth and their families. We will also implement an educational campaign to increase the capacity of local schools to support children with trauma, using the CCWPI ‘Never Look Away’ animated training series. As a result of extensive staff training, supervision, and implementing TST with fidelity, the Lifeline Center anticipates achieving the following goals and associated measurable objectives: Increased capacity to provide children and youth with evidence-based trauma-informed clinical and support services; high retention in TST services and 50% completion rate; 80% of children show improved symptomatology, emotion regulation, and environmental stability; 90% of families report high satisfaction with TST services and outcomes; and 150 school staff have participated in trauma training, and 90% of participants show increased capacity to identify and respond to children’s traumatic stress. Lastly, 200 school staff have received information for grief resource directories and other trauma support resources.