Supporting the NC Child

Treatment Program

A Presentation to the Intentional Death Committee of the NC Child Fatality Task

Force

November 22, 2010

Building Brain Architecture

The early years of life matter because early experiences affect the architecture of the maturing brain. As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all of the development and behavior that follows.

© FrameWorks Institute 2009

Toxic Stress

When interpersonal experiences are disruptive, neglectful, abusive, unstable, or otherwise stressful, children experience toxic stress.

Toxic stress releases chemicals in the body which impede brain development, making it difficult for the neurons to form healthy connections.

Sexual Abuse

Physical Abuse

Domestic Violence

Chronic Poverty

Neglect

Consequences of Child Maltreatment

Healthy Brain

Traumatized Brain

Importance of Trauma Treatment

• TF-CBT scientifically proven effective in reducing symptoms of post-traumatic stress disorder including depression and anxiety

• As stress diminishes, children are able to rebuild healthy circuitry in brain, poising them for success in school and employment

• Provides children with tools needed to redirect energy toward executive thinking activities

• Involves caregivers and positively impacts their depression and anxiety symptoms as well.

• TF-CBT is 20-25 week treatment, $1800/child

Infrastructure CRITICAL For Effective

Service Delivery• TF-CBT has been proven effective, BUT “spray and

pray” of TF-CBT won’t produce good outcomes• Infrastructure critical in producing mental health

benefit for traumatized children and cost benefit for state▫ Quality, skills-based training and ongoing clinical

consultation for fidelity▫ Rostered clinicians▫ Linking of children, DSS, mental health clinicians▫ Quality improvement through tracking clinical

outcomes