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Child Trauma Services
Children Who Witness Violence program
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Children and adolescents who witness or experience violent events are at high risk for the development of serious mental health problems, including post-truamatic stress disorder. The Children Who Witness Violence (CWWV) program was organized by the Cuyahoga County Board of Commissioners to address the impact that domestic and other violence has on children and families.
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Police departments from the seven communities participating in the CWWV program make referrals at the scene of the violent event by calling the 24/7 hotline operated by the MHS Mobile Crisis Team. MHS provides the immediate crisis intervention and assessment.
Twelve child-service organizations provide post-crisis services. The Institute for the Study and Prevention of Violence (ISPV) of Kent State University conducted a program evaluation.
SAMHSA, the Substance Abuse and Mental Health Services Administration, chose MHS to be a Community Practice Center of the National Child Traumatic Stress Network. The NCTSN was established to create new knowledge about the nature, course, consequences, and treatment of childhood trauma.
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Rosemary Creeden, LISW, has served as Program Manager of MHS CWWV services since it began in 1999. She is shown at left with a participant of Camp Bridges, an innovative trauma-intervention program for children, held each October. Camp Bridges is a collaborative effort of MHS, the Cuyahoga County Department of Justice Affairs Witness/Victim Service Center, and The Elisabeth Severance Prentiss Bereavement Center of the Hospice of the Western Reserve.
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When a police officer calls our 24/7 hotline to refer a child who has witnessed a violent event, MHS staff members go the family’s home. We conduct a comprehensive assessment using standardized rating scales, and provide immediate crisis intervention services. We continue these services for 2-4 weeks to help the child reduce and manage subjective distress, and gain competence in the effective use of coping skills.
Once the acute trauma has been resolved, and the treatment goals have been achieved, we discuss recommended follow-up services with the parent or guardian, and link children who need additional services with one of 12 organizations that provide follow-up therapeutic and supportive services.
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Organizations providing post-crisis therapy and support also assess the child, using the same standardized rating scales that we did upon our first contact with the child. Children are assessed when they begin services with the organization (the child’s 2nd assessment), and when they end these services (the 3rd assessment). The ISPV conducted statistical analyses of data for those children whose parent gave informed consent for research. The Institute’s report was based on data from MHS services to 3,261 children who were referred to MHS from March, 1999 to July, 2001.
During the 2007 fiscal year, MHS provided services for 1,253 children in the CWWV program. The median age of these children was about 8 years. They present with serious crisis concerns, including suicidal ideas or conduct, anger, depression, and assaultive acts. Most have experienced and/or witnessed repeated incidents of violence resulting in physical injuries In more than half of all incidents, a parent was the aggressor.
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History and Funding of CWWV.
The Children Who Witness Violence program was conceived by the Commissioners of Cuyahoga County in the mid 1990's. Commissioners at that time were Jane L. Campbell, Jimmy Dimora, and Tim McCormack. Jane L. Campbell later served as the Mayor of Cleveland, Ohio.
Other key leaders included Bette Meyer, who was Deputy County Administrator; Craig Tame of the County’s Department of Justice Affairs; Elsie Day, who directed the development and growth of the program during its first years; Dr. Lolita McDavid, Dr. Dennis Drotar, and Heidi Garland of Rainbow Babies and Children’s Hospital in Cleveland, Ohio; the Mayor and Police Chief of the Ohio cities of Cleveland, Euclid, Lakewood, and Maple Heights, who wanted their cities to be participants in the pilot project; members and contract agencies of the Cuyahoga County Community Mental Health Board; and staff of Kent State University’s Institute for the Study and Prevention of Violence.
Funding for CWWV program operations has been provided by the:
Board of Cuyahoga County Commissioners,
Buckingham, Doolittle, & Burroughs,
Children’s Trust Fund,
The Cleveland Foundation,
Cuyahoga County Community Mental Health Board,
Cuyahoga County Prevention, Retention, and Contingency Funds,
Family Stability Incentive Program,
Family Violence Prevention and Services Act,
Medicaid reimbursement from the U.S. Centers for Medicare and Medicaid Services,
Ohio Attorney General Victim of Crimes Act,
Schubert Center for Child Development,
Sihler Foundation,
Sisters of Charity Foundation,
Violence Against Women Act, and the
Wellness Block Grant.
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Child Trauma Outcome & Psychometric Studies
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Children who completed services felt less anxious and depressed, and parents reported that their children were less withdrawn and restless. Children younger than age 8 showed significant reductions in measures of anxiety. Older children (8-16 years) reported significant reductions in anxiety, depression, post-traumatic stress, and symptoms of dissociation. Parents and guardians of children 5-18 years old reported that their children were significantly less anxious and withdrawn, and had significantly less behavioral restlessness and hyperactivity.
Click here to learn more.
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An article published in Clinical Child Psychology and Psychiatry is the first "comprehensive description of the impact of recent violence and mental health service needs of children based on child and parent reports using standardized measures gathered at the time of the incident of violence" (p. 189).
Analyses also showed that MHS began face-to-face services with 68% of families within two hours of the referral by police officers. (Some families asked that MHS begin services on the next day.) The majority of children referred to the program participated.
Learn more.
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Analyses showed that children generally responded to traumatic events in one of two ways. Some children showed very expressive behavior – they had temper tantrums, and became whiny or aggressive. The other children became withdrawn, sad, or fearful. The technical analyses showed that the 17-item Pediatric Emotional Distress Scale was a reliable and valid tool for measuring distress in these very young children.
Sixty nine percent of the children had scores on this scale that indicated clinically-significant levels of distress. These results are consistent with those of prior studies showing that very young children are particularly vulnerable to distress from traumatic events.
Learn more.
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The Dimensions of Stressful Life Events (DOSE) scale was found to be a reliable and valid method of screening for possible traumatic reactions to high magnitude stressors. The present study presents further evidence of its ability to predict traumatic reactions in children exposed to domestic violence. The results suggest that scores between 21.5 and 23.5 or higher are indicative of possible traumatic responses in children to high magnitude stressors.
Learn more.
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Copyright ©
Mental Health Services for Homeless Persons, Inc. (MHS)
1744 Payne Avenue; Cleveland, Ohio 44114 U.S.A.
216-623-6555 - TTY/TDD: 216-623-6540
The URL of this page is
http://www.mhs-inc.org/ChildTraumaServices.asp
It was most recently updated on 5 February 2008.
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