The National Child Traumatic Stress Network

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The National Child Traumatic Stress Network

• Ellen Gerrity, Ph.D.
• Associate Director and Senior Policy Advisor
• National Center for Child Traumatic Stress
• Associate Professor, Department of Psychiatry and
  Behavioral Sciences
• Duke University Medical Center
• Mental Health America Webinar
• Upstream Services A Response to Sandy Hook
• April 4, 2013

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Child Traumatic Stressas a Public Health
Problem

• Two of every three children will witness or
  experience a traumatic event before the age of 16
  (Copeland et al., 2007).
• One in five children experience some form of
  child maltreatment (Finkelhor et al., 2009)
• 3.3 million children reported to child protective
  services in 2008 (CDC, 2010).

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What is traumatic stress?

• Exposure to events that involve threats of
  injury, death, or danger where intense terror,
  anxiety, and helplessness is experienced
• Can occur via direct experience or witnessing
  event, or hearing about an event
• Reactions vary with age, but even very young
  children experience intense reactions

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Variety of Traumatic Events

• Trauma may be embedded in daily life, may be
  chronic or acute event
• Child abuse and maltreatment
• Domestic violence
• Community violence and criminal victimization
• Sexual assault
• Medical trauma
• Traumatic loss and bereavement
• Accidents/fires
• Natural disasters
• War/Terrorism/Political Violence

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Common Symptoms of Traumatic Stress

• Children may suffer severe emotional and
  developmental consequences from exposure to
  trauma and violence including
• Sleep problems, including nightmares
• Intrusive thoughts or flashbacks
• Numbing of emotions
• Avoidance of reminders of trauma
• Anger and irritability
• Poor concentration
• Depressive symptoms
• Anxiety and behavior problems

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Long-Term Consequences ofTrauma Exposure During
Childhood

• Without Effective Treatment
• Serious adult psychiatric difficulties, including
  depression, anxiety disorders, and suicidal
  behaviors
• Overutilization of medical services
• ACES study - 4 or more childhood traumas may
  result in risk behaviors, health consequences,
  shortened lifespan

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Adverse Childhood Experiences Study (ACES)
Felitti et al. 1998
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National Child Traumatic Stress Network (NCTSN)

• The mission of the National Child Traumatic
  Stress Network (NCTSN) is to raise the standard
  of care and improve access to services for
  traumatized children, their families and
  communities throughout the United States.

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National Child Traumatic Stress Network

• Funded in 2000 (Childrens Health Act)
• Rapid Change (9/11/Increased Growth/Cutbacks)
• Innovative Collaborative Network Structure
• UCLA-Duke University National Center for Child
  Traumatic Stress (Category I)
• 22 Intervention Development and Evaluation
  Centers (Category II)
• 56 Community Treatment and Service Centers
  (Category III)
• 90 Affiliate (formerly funded) members

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NCTSN Scope

• Trauma mission includes all trauma types, all
  service systems, all professional disciplines,
  all ages, and a strong cultural and family
  perspective throughout activities.
• Includes a wide range of traumatic experiences,
  including physical and sexual abuse domestic,
  school, and community violence natural
  disasters, terrorism, or military family
  challenges and life-threatening injury and
  illness.

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NCTSN Activities

• Range of activities including intervention
  development and adaptation training in many
  forms (Learning Collaborative systems change,
  in-person, web-based) product development
  public awareness evaluation and data analysis
  policy work and service delivery
• Far-reaching family and consumer program at all
  levels of the program
• Embedded cultural competence and translations
  work throughout the development of products and
  training approaches
• Strong collaborative model

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How is NCTSN making a difference?

• Over 350,000 children served through direct
  contact improvements after treatment and
  services
• Hundreds of thousands of professionals trained
• Over 40 evidence-based treatments and promising
  practices developed
• Over 200 products for parents/caregivers, youth,
  professionals, general public, policymakers,
  media
• Network response to national crises, including
  Sandy Hook

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AccountabilityNCTSN Core Data Set on gt14,000
Children

• Diverse group of children with complex histories
  and problems 77 reporting exposure to more
  than one trauma type
• Developmental issues are important to trauma and
  recovery
• Notable functional impairments and clinical
  diagnoses (PTSD, depression, anxiety, academic
  problems)
• Like ACES, of traumas are associated with
  serious outcomes
• High rates of service utilization (child welfare,
  special education, mental health) prior to
  entering treatment - opportunities for early
  intervention
• Effectiveness of the NCTSN Childrens problems
  improve with treatment

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You dont shoot at children.
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NCTSN Sandy Hook Community Support

• Network mobilization
• Death notification
• Crisis Center staffing/Crisis Hotline training
• Governors Commission/School District support
• Sandy Hook students and teachers/Other schools
• Trauma Resources (posted at http//www.nctsn.org/t
  rauma-types/terrorism), including Psychological
  First Aid for Schools
• Federal and State policymaker support
• Healthcare community coordination and training
• Preparedness/Evidence-based practices
• Long term planning

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For more information about the NCTSNand what
was presented today

• Ellen Gerrity, PhD
• 301-379-2145
• ellen.gerrity_at_duke.edu
• www.nctsn.org