florida’s eccs grant trauma informed systems trauma...

Overview of Florida’s Early Childhood Court April 29, 2015

Dr. Mimi A. GrahamFlorida State University Center for Prevention & Early Intervention Policy 1

vImproving Outcomes

for Infants & Toddlers

in Child Welfare

Dr. Mimi A. Graham, Director Center for Prevention & Early Intervention Policy

Florida State University 2014 ACC Football Champions 1

How do we stop the flow of intergenerational trauma?2

Florida’s ECCS Grant

•  Florida Children & Youth Cabinet’s Trauma Informed Care Workgroup composed of 144 state agency employees with local workgroups

• Baby Court Team Initiative–  Local pilots in Escambia

& Pasco counties

Systems Change to Mitigate Trauma & Toxic Stress

Children & Families

with Trauma

Health

Schools

Early Intervention

Child CareJuvenile Justice

Child Welfare

Judiciary

Trauma Informed Care Across All State Agencies and

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Trauma Informed Systems Website: floridatrauma.org

Florida’s Cutting Edge Efforts to Create Trauma Informed

Services Communities• Tarpon Springs: First Trauma Informed

City in the US

• Volusia County: One of 5 Super-communities in the Chadwick Trauma-Informed Systems Project

• Peace4Gainesville: A Trauma Responsive Community Initiative. NPR Broadcast: Alachua County Sheriff & UF Doctor Team Up To Map Childhood

Florida’s Trauma Informed Care WorkgroupA taskforce under the Florida’s Children & Youth CabinetFriday February 20, 2015 • 10:00 am-4:00 pmBetty Easley Center, Room 152 4075 Esplanade Way, Tallahassee, FL 32399See Map: http://www.fws.gov/rcwrecovery/pdfs/BettyEasleyMap.pdf

Building A Trauma Informed Community Leaders from Florida’s cutting edge efforts to create trauma informed communities AGENDA10:00–10:15 Welcome & Introductions Maureen Honan, Department of Juvenile Justice, Detention Services,

Office of the Assistant Secretary Dr. Mimi Graham, Director, FSU Center for Prevention & Early Intervention Policy10:15–11:15 Pioneering Peace: A Community Journey Mark Hopkins, Community Partner, Peace4Tarpon11:15–11:30 Q & A

11:30–12:30 Lunch at DOH Café12:30–1:30 Creating a “Town & Gown” Trauma Responsive Initiative: Our First Steps Teresa Drake, J.D., Professor, University of Florida’s Levin College of Law &

Director, UF Intimate Partner Violence Assistance Clinic 1:30–1:45 Q & A1:45–2:00 Break2:00–3:00 Volusia County: A Supercommunity in the Chadwick Trauma-Informed Systems Project

Chrissy Curtis, MS , Director of Clinical Services, Community Partnership for Children

Susan Bell, MSW, DCF Northeast Region Program Manager. 3:00–4:00 Discussion of Next Steps Preview of New Trauma Informed Care Website

For more information see: http://www.gainesville.com/article/2015150119930http://www.peace4tarpon.org

http://www.peace4gainesville.orghttp://acestoohigh.com/2012/02/13/tarpon-springs-may-be-first-trauma-informed-city-in-u-s/

Baby Court Team Initiative 2012-2015

–  Local Pilots in Escambia & Pasco



What Baby Court Does

• Brings the science of child development into decision-making for infants & toddlers who have been removed from their homes

• Heals multigenerational trauma

• Changes the experience and outcomes of infants & toddlers in the child welfare system

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Judiciary & Child Welfare

Infant Mental Health

Expertise

Baby Court Teams

Improving Outcomes in Child Welfare

9

Early Childhood Systems

F L O R I D A S TAT E U N I V E R S I T YCenter for Prevention & Early Intervention Policy

In collaboration with Florida’s statewidemultidisciplinary team

www.cpeip.fsu.edu

April 2015

ChildhoodFLORIDA’Sarly E

C O U R TImproving outcomes for infants and toddlers in Florida’s dependency court

7. Monthly case reviews

8. Evidence based parenting supports

9. Developmental supports to enhance child well-being

10. Placement & concurrent planning

11. Co-parenting approach

12. Collaborative court team

13. Cross agency training

14. Evaluation

15. Sustainability

Florida’s Early Childhood Court Initiative

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1.  Judicial leadership2.  Trauma informed judge

& systems3.  Continuum of behavioral

health services 4.  Prominent role of IMH

Specialist & Child Parent Psychotherapy

5.  Community Coordinator who provides child development expertise to the judge &team

6.  Frequent parent child contact (visitation)

Core Components:

1. Judicial Leadership

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2.Trauma-informed Judge &

System

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• Learns about trauma & the science of adversity

• Reads the file with trauma lens

• Asks about credentials in trauma & EBP

• Promotes trauma training

• At each juncture, asks, Have I Considered Whether Trauma Has Played A Role in….?

Find Trauma Toolkit at: www.flcourts.org/resources-‐and-‐services/court-‐improvement/judicial-‐toolkits/family-‐court-‐toolkit/ Stein, Zima, Elliott, Burnam, Shahinfar, & Fox, et al. (2001)

90% of childrenknown to the foster care systemhave been exposed to trauma.

3. Continuum of Behavioral Health Services

• Trauma Interventions• Sexual Abuse Treatment• Depression Counseling• Domestic Violence Counseling

• Visit Coaching

The Infant Mental Health Clinician evaluates and makes recommendations to the court about optimal interventions for the parent, the child and the relationship.

Other mental health services may include:

4. Prominent Role of the Infant Mental Health Specialist & Child Parent Therapy

• Highly skilled licensed therapists •  Trained in interventions specific

for children ages 0-5•  Evaluates the child

and the parent-child relationship• Makes recommendations to the

court about optimal interventions•  Provides Child-Parent therapy• Assesses parental capacity and

feasibility of reunification• Attends court to help inform

decisions

11/17/14 12:43 PM

CEBC » Program › Child Parent Psychotherapy

Page 1 of 2

http://www.cebc4cw.org/program/child-parent-psychotherapy/

Scientific Rating:

2Supported by Research Evidence

Child Welfare System Relevance Level:

High

compare (?)This information was printed from: www.cebc4cw.org/progr

am/child-parent-psychotherapy/

Child-Parent Psychotherapy (CPP)

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Child-

Parent Psychotherapy (CPP) has been rated by the CEBC in the areas of: Domestic/Intimate Partner Violence:

Services for Victims and their Children, Infant and Toddler Mental Health Programs (Birth to 3) and Trauma Treatment

(Child & Adolescent).

Target Population: Children age 0-5, who have experienced a trauma, and their caregivers.

For children/adolescents ages: 0 – 5

For parents/caregivers of children ages: 0 – 5

Brief Description

CPP is a treatment for trauma-exposed children aged 0-5. Typically, the child is seen with his or her primary caregiver,

and the dyad is the unit of treatment. CPP examines how the trauma and the caregivers’ relational history affect the

caregiver-child relationship and the child’s developmental trajectory. A central goal is to support and strengthen the

caregiver-child relationship as a vehicle for restoring and protecting the child’s mental health. Treatment also focuses on

contextual factors that may affect the caregiver-child relationship (e.g., culture and socioeconomic and immigration

related stressors). Targets of the intervention include caregivers’ and children’s maladaptive representations of

themselves and each other and interactions and behaviors that interfere with the child’s mental health. Over the course of

treatment, caregiver and child are guided to create a joint narrative of the psychological traumatic event and identify and

address traumatic triggers that generate dysregulated behaviors and affect.

Program Goals:

The program representative did not provide information about the program’s goals.

The California Evidence-Based Clearinghouse for Child Welfare

Information and Resources for Child Welfare Professionals

CPP: Child Parent PsychotherapyEvidence Based Intervention for Children 0-5 with Trauma

Child Parent Psychotherapy• Repair the child’s mental health and developmental progression

• Help the parent & child heal past trauma

• Focuses on restoring the child parent relationship

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01020304050

Intake CompletionChild/Parent Psychotherapy Comparison

Source: Lieberman, Van Horn, & Ghosh Ippen, 2005

Child PTSD Before/After Treatment

01020304050

Intake CompletionChild/Parent Psychotherapy Comparison

Maternal PTSD Before/A2er Treatment

545556575859606162

Pre Post

Tx

Comp

Child Parent Psychotherapy Shows Decrease in Child Behavior Problems (CBCL):

Impressive Results of Child-Parent Psychotherapy



Excerpt from ZERO TO THREE’s Helping Babies from the Bench: Using the Science of Early Childhood Development in Court. Time: 1:35

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Child Parent PsychotherapyA trauma Informed Evidence based Practice for Healing Relationships

20 Quality Child Care & School Readiness

Early Intervention

Medical Home & Health Care

In Home ServicesAttachment Based Parent Training

Infant Mental Health Interventions

Baby Court Team

5. Community CoordinatorLinking Courts with Early Childhood Systems

Recommendation: As close to daily parent child contact as possible.

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For every additional day per week visitation takes place, reunification is 3x more likely.

6. Frequent Parent-Child Contact (Family Time/Visitation)

- Potter & Klein Rothchild, 2002 US DHHS 2005a • Helps ensure safety•  See problems early• Get necessary

supports & services• Gets back on track• Adjusts to changing

family dynamics•  Expedites

permanency

Frequent, open, collaborative communication

7. Monthly Case Reviews

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Continuum of Evidence-Based Practices

8. Evidence-based Parenting Supports for Children Ages 0-3 Circle of Security Trained Group Leaders

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Baby Court Site

Parent Trainers

Judge AlexanderLisa Benitez Richard Fay

Judge Bristol Sunny Kahn +

Judge Clark Magistrate Lord Kimberly Walters

Judge Clayton Kathy Conrad

Judge Duncan Judge Bilbrey ChrisWne Chaffin

Judge Essrig Debbie Buie

Judge Gievers Susan Ellis Cindy Evers

Baby Court Site

Parent Trainers

Judge GoodingLeslie Allen, Selma Bacevac

Judge Hayworth KrisWe Skoglund

Judge Polson Judge Ketchel Karen Adams

Judge Schack Donna Donato

Judge Tepper Roxanne Mayorca

Judge Todd Judge Moore Lisa Negrini

Judge Walker Laurie McCort



9. Developmental Supports for Child Well Being

–  Early Learning Coalitions –  Early Head Start –  Early Steps: Part C Early

Intervention– Home Visiting Programs

• Every change in placement is difficult for a child.

• In Safe Baby Courts, 72% of the children had only 1-2 placements.

10. Placement / Concurrent Planning

Florida’s Rate of Two or Fewer Placements

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11. Coparenting

• Promote and enhance coparenting relationships

• Engage fathers • Create predictability

and security for the child

“Coparenting is a key to reunification. When the child’s coparents work effectively together, outcomes are improved. When they do not, children suffer.” Dr. James McHale

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12. Collaborative Court Team

Judge DCF CDAC (SA)

Lakeview (BH/SA)

Healthy Start

Pathways for Change

(BH/SA) Attorneys Court Admin GAL

Children’s Home

Society

Early Learning Coalition

ACMHC (IMH)

Early Steps

CBC

Lakeview (IMH)

Favor House

(DV)

Escambia’s Early Childhood Court Team

13. Cross Agency TrainingCross-system & cross-discipline collaboration

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Safety Permanency Well-Being

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Desired Outcomes

14. Evaluation: Office of Court Improvement

Heal trauma & stop

intergenerational transmission

Accelerate permanency

Enhance child well-being

Improve relationships in child’s life

Reduce reoccurrence

of maltreatment 32

Baby Court

Accelerate Permanency

Enhanced Well-Being

Enhance Child Well-being

Reduced Reoccurrence of

Maltreatment Monthly Staffings

Community Coordinator Developmental Supports

Child Parent Psychotherapy

Tracks progress

Frequent Visitation

Ensures developmental & family supports

Builds attachment

Heals trauma & promotes

parenting capacity

14. Sustainability: Funding Sources

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Children & Families in Child Welfare

Child Welfare

Family Supports

Home Visiting & Prevention

Medicaid

Early Care & Education

SchoolsSubstance

Abuse Treatment Providers Early

Intervention, Early Steps

Judiciary

Mental Health

Providers

Health Care Organization

s

Baby Court Team: Trauma Informed Systems & Community Agencies Working Together

Time: 0:52

“It’s the most important opportunity for the prevention of health and social problems and disease and

disability that has ever been seen.”- Vince Feletti

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“It’s easier to build strong children than to repair broken men.”

-Fredrick Douglas

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Created by Mimi A. Graham, Ed.D., Director FSU Center for Prevention & Early Intervention Policy, Tallahassee, Florida

[email protected]

Thank you! 37

florida’s eccs grant trauma informed systems trauma...

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