11/8/17 CBITS Partners • Connecticut Department of Children and Families Cognitive Behavioral Intervention for Trauma in • Child Health and Development Institute Schools (CBITS) and Bounce Back (BB) in Connecticut • Sharon Stephan (CBITS Trainer) • Wheeler Clinic • Community Based Providers, Schools, School-Based Health Bethany Zorba (DCF) Centers Jason Lang, Ph.D. (CHDI) Danielle Moraes (Optimus Healthcare) Child Health and Development Institute What is CBITS/BB? Our Vision CBITS : School-based, group trauma focused • intervention All children have a strong start in life with ongoing supports to ensure their optimal health and well-being. • 10 group sessions • Plus individual child, caregiver, teacher sessions Our Mission Grades 5-12 • To ensure healthy outcomes for all children in Connecticut by advancing effective policies, stronger Bounce Back: Adaptation for Grades K-5 • systems, and innovative practices. Designed to: • Ø Reduce PTSD symptoms, depression, behavior Our Strategy problems We identify, demonstrate, support and promote effective health and mental health care innovations and Ø Improve grades, attendance, coping skills, peer/ improvements, working closely with providers, parent support policymakers, academic institutions and state agencies. CBITS/BB Eligibility CBITS/BB Implementation in CT • 2014: Cohort 1 started in two school-based health • Schools screen children to assess their eligibility for centers in Bridgeport (CBITS only) CBITS/BB using two assessments (trauma exposure & PTSD symptoms) 2015: Cohort 2 started in New Haven, New London, • and Stamford (CBITS only) To be eligible for CBITS/BB: At least 1 reported trauma exposure • 2016: Cohort 3 started in East Hartford, Norwalk, • Moderate levels of PTSD symptoms (diagnosis NOT • Bristol, New Haven, Hartford, and Enfield (CBITS & required) BB) • 2017: Expansion/new opportunities for providers/ Note: ~ 50% of all children screened to date have • schools screened positive 1
11/8/17 Current CBITS/BB Providers Outcomes to Date Optimus Health Care – Bridgeport 10 agencies • • • Southwest Community Health Center – Bridgeport • Wheeler Clinic – Bristol • 61 sites Integrated Health Services – East Hartford • • Community Health Center – Enfield 139 clinicians trained • The Village for Families & Children – Hartford • Child & Family Agency of Southeastern CT – New London • • Mid-Fairfield Child Guidance Center - Norwalk 768 children served • Stamford Public Schools - Stamford • Clifford Beers Clinic – New Haven • (and more) • Children Served Outcomes to Date N=527 N=62 N=143 N=442 N=33 Children reported an average of 7.9 different types of trauma events prior to treatment FY16 Outcomes Child Outcomes CBITS • 98% of group session activities completed (through SFY16) • Average clinician fidelity rating across groups = 3.6 out of 4 N=452 N=396 • 94% of caregivers satisfied with their child’s Mean PTSD Scores Pre- and Post- BB Group treatment 25 23.1 Bounce Back 20 (SFY17) 14.1 15 10 5 0 Pre Post N=124 2
11/8/17 Behavior Problems by Baseline PTSD Symptoms by Baseline Severity Severity N=129 N=48 N=212 N=107 FY16 Outcomes by Race Functioning by Baseline Severity N=140 N=13 N=41 N=4 N=140 N=204 N=31 Questions? CBITS/BB Implementation in CT • Agency/School commitment • Team-based Contact: Training & clinical consultation • Fidelity review • CHDI: Measurement & feedback system: data on all children • Jason Lang: jalang@uchc.edu served (EBP Tracker) www.chdi.org • Implementation consultation/TA • Agency funding DCF: Bethany Zorba bethany.zorba@ct.gov Clinician certification • Train-the-trainer : Selected clinicians who have • implemented CBITS/BB are trained as CBITS/BB trainers Danielle Moraes: dmoraes@opthc.org • CBITS Welcome Packet: www.chdi.org (go to CBITS) 3
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