The Center for Safe and Effective Trauma Treatment (CSETT) - The Center for Safe and Effective Trauma Treatment (CSETT) will serve as an NCTSN Category II Treatment and Service Adaptation Center dedicated to improving access to evidence-based and evidence-informed trauma treatment for traumatized children who exhibit high-risk behaviors (e.g., aggression, self-harm, running away, substance abuse) or who are at risk of maltreatment from their caregivers. These children and families pose considerable challenges for providers, given the safety risks associated with their care, and knowledge to guide providers is limited because they are often excluded from clinical trials due to their risks. CSETT will serve as a national resource for the safe and effective care of high-risk traumatized children and families by adapting the treatment model Trauma Systems Therapy (TST) and its accompanying Never Look Away Trauma Training Program (NLA TTP), and disseminating them across the service system in four U.S. regions. Project Name: The Center for Safe and Effective Trauma Treatment (CSETT) Geographic Reach and Capacity Development: CSETT will focus on four regions with established TST infrastructure: the South, Northeast, Midwest, and West. Many high-risk children and families in these regions have insufficient access to safe and effective childhood trauma treatments. CSETT will build capacity by establishing new specialized treatment teams, delivering scalable workforce training, and expanding implementation of effective interventions, starting with NCTSN Category III centers in each region. Population of Focus: Traumatized children and adolescents aged 3–18 who exhibit high-risk behaviors entailing harm to themselves or others or who are at risk of maltreatment. Without effective intervention, these children face placement instability, school disruption, psychiatric hospitalization, and continued maltreatment in childhood, and elevated risk over the course of their lives for chronic mental illness, substance use disorders, and reliance on crisis and other intensive services. This population represents one of SAMHSA's highest priorities for improving access to evidence-based treatment. Strategies and Interventions to Increase Capacity: CSETT will leverage established TST programs in five states across four regions—Alabama (South), Ohio (Midwest), Colorado (West), and New York and Rhode Island (Northeast)—partnering with these programs to train the workforce and expand access to effective treatment. Workforce training will be enhanced by adapting the NLA TTP, a scalable six-session animated video curriculum for providers. Access will be expanded with new adapted TST programs in each region. Project Goals: (1) Adapt TST and the NLA TTP to expand access to safe and effective treatment for high-risk children and families. (2) Build workforce capacity by delivering NLA TTP to NCTSI grantees and providers across child-serving systems. (3) Expand access by establishing new TST teams serving the population of focus. (4) Engage children, youth, families, and service providers with clear feedback loops protecting parental rights. (5) Apply evidence-based practice implementation, fidelity monitoring, CQI, evaluation, and sustainability frameworks consistent with gold-standard science. Measurable Objectives: (1) Establish 18 new specialized TST teams across four regions, equipping 180 providers with specialized skills for this high-risk po pulation. (2) Achieve ≥80% fidelity adherence with demonstrated improvements in child outcomes (reduced critical incidents, increased placement stability, improved functioning). (3) Train 2,500 professionals (500/year) via the NLA TTP across mental health, child welfare, juvenile justice, schools, and substance use settings.
