Build Child Resilience - In response to the rise in youth behavioral health acuity since the pandemic, increasing strains on the behavioral health workforce, and the distinctive needs of Special Education students, BHcare's Build Child Resilience initiative will work with the Child Health Development Institute and local high-need public and special education schools to bring trauma-focused school-based behavioral health services and training of school support staff to six area schools. The population of focus consists of the students in 4 high-need public schools and two Special Education schools. The Special Education schools are part of Area Cooperative Education Services (ACES), a Regional Educational Service Center which operates 6 schools in southern CT. The school populations are predominantly Black and Hispanic and low income. Indicators of trauma frequency in Derby and the Derby schools demonstrate that rates of substantiated child abuse reports and suspensions or expulsions are more than double the state rate, and 30% of 7-12 graders surveyed having directly seen, heard, or been a victim of violence in neighborhood, community, or school. As for the ACES schools, studies show that children who experience 3 or more adverse childhood experiences in early life have double the odds of entering a Special Education program than children without such exposure. They also show that children with disabilities are more than three times as likely to be maltreated than nondisabled peers. Finally, the difficulty of differentiating features of trauma-related disorders from those of other neurodevelopmental disorders make it more difficult for Special Ed teachers to respond appropriately to trauma without special training. BHcare will hire 4 full-time school-based clinicians, supported by an APRN, who will provide school-based services in the target schools. The principal Category II TSA Center supporting the program will be Connecticut's Child Health Development Institute (CHDI), the state-designated Performance Improvement Center, supplying staff training and support. The foundation of trauma-informed care in schools is the capacity of teachers/support personnel to understand and recognize trauma and refer for treatment. The program includes 3 components for school staff: Training in Trauma ScreenTIME, a CHDI training on understanding/recognizing trauma; adoption of Handle with Care, under which the school receives a notification (a Handle [student] with care note) from police when a child has been identified at the scene of a traumatic event; a training on trauma-informed care for early childhood targeting elementary school teachers, by Child First, a Category II TSA. Clinicians will be trained in 5 trauma-informed evidence-based practices: The Attachment, Regulation and Competency (ARC) Framework for multiple and/or prolonged traumatic stress; the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) group intervention for 5th-12th graders who have experienced trauma; Bounce Back, a version of CBITS for younger children; Trauma Focused Cognitive Behavioral Therapy, a child/parent treatment for youth; and Dialectical Behavioral Therapy is a treatment adapted specifically for adolescents with extreme emotional instability, including self-harm and suicidal ideation. Goals are: (1) to build knowledge/collaboration on evidence-based trauma treatment, with objectives targeting clinician education, school personnel education, and engagement of community partners; (2) to provide evidence-based, trauma-informed clinical services in 6 schools, with objectives targeting students referred for treatment, students screened, and students receiving treatment, including appropriate percentages of Black/Hispanic and LGBTQ+ students; and (3) to improve outcomes among youth engaged in school-based care, with objectives measured by NOMs and OHIO Scales interviews. Projected numbers served with grant funds: Year 1, 95; Year 2, 125; Years 3-5, 150; total of 670.
