Enhance Early Engagement (E3) Training for CAC Victim Advocates

Applications for this training are now closed. Thank you to everyone who applied.  

March 2020 Update: Because of COVID-19, some E3 training sessions have been postponed. Participants will be notified when sessions are rescheduled.

For questions, contact Michelle Miller at mmiller@nca-online.org.

Click Here to view the Family Engagement Fact Sheet 

  • Contains 1 Component(s)

    MDT members play a key role in engaging children and families in mental health care. This webinar describes the Enhance Early Engagement (E3) training project and provides valuable information on barriers families face and strategies to increase engagement through completion of care.

Why E3?

Children’s Advocacy Centers (CACs) across the nation are at the forefront of addressing child maltreatment.  We know that child maltreatment causes significant mental health effects on children, such as post-traumatic stress or disruptive behavior disorders. Further, as demonstrated in National Children Alliance’s (NCA’s) Thriving Kids 2019 report, evidence-based mental health services (also collectively known as evidence-based practices, or EBP) make a huge positive impact on children’s well-being.

Yet not all families served by CACs receive these critical services. Through feedback from caregivers collected under NCA’s national Outcome Measurement System (OMS), we know some families report never receiving information about mental health services for themselves or their children. Thankfully, that number is falling, but even more concerning is that many of the families who do report receiving information about treatment options for children and caregivers still fail to follow up on referrals to these essential services after visiting a CAC. 

Of course, sometimes this is due to concrete barriers—time, transportation, money, or availability concerns. But alarmingly, many family members report not seeking mental health services for themselves or their children because they’re not convinced it’s necessary or important, that non-evidence-based services are just as good, or that they can go it alone. CACs can offer the best mental health services in the world, but if children and families don’t use them, they may never have the chance to fully recover from the trauma of abuse. This is the critical role of the victim advocate1 in the CAC setting: family engagement with treatment starts and ends with advocates.  

1“Victim advocate” is interchangeable with “family advocate” in many CACs.

About the project

Enhancing early engagement of families in mental health assessment and EBP is a priority for CAC leaders through NCA. To address this need, NCA is partnering with the University of Oklahoma Health Sciences Center (OUHSC) on a new training initiative, Enhance Early Engagement Training for CAC Victim Advocates, or E3. E3 aims to increase the proportion of children and their caregivers served by CACs who engage in mental health services.

CACs and their victim advocates helped us design this program to meet their needs and practice styles. In 2019, more than 1,500 victim advocates and CAC directors shared detailed feedback about current practices and remaining needs around family engagement in surveys. Victim advocates indicated the need for structured training in best practices for mental health screening, evidence-based practice identification and referral, and evidence-based engagement strategies. Through E3, CACs can put that knowledge into action and train victim advocates on practices that are most effective at getting children and families the mental health services needed. 

CACs trained through E3 will work toward common goals that all children and families served by CACs will be:

  1. Screened and assessed for treatment needs.
  2. Referred for treatment based on the needs identified through the screening and assessment.
  3. Engaged in that treatment through attendance and participation toward successful completion.
  4. Partnered with the CAC to assess progress and celebrate success.

To bolster the important work victim advocates already do with families, the focus of the current project is to provide training to victim advocates in brief mental health screening, evidence-based practice, identification and referrals, trauma responses, and evidence-based engagement skills. E3 training will be conducted in conjunction with a research project supported by a grant from the National Institute of Mental Health (NIMH;R34MH118486) that will examine the best methods of training and determine if the training provided translates into improved family engagement in mental health services. As in all CAC-based projects, active participation by CAC directors is critical to the success of the training.

What you’ll learn

In this initial project period, three cohorts of victim advocates will receive training: 1) the E3 webinar-based training cohort, 2) the E3 webinar-plus-consultation cohort, and 3) the delayed webinar-based training cohort. Selection of participants into each of the three cohorts is randomized.

E3 webinar-based and E3 webinar-plus-consultation trainees will both participate in three interactive webinars, each two hours long using Zoom online training technology. E3 webinar-plus-consultation trainees will also participate in 10 consultation calls with content experts. Delayed E3 webinar-based trainees will serve as the control group for this project and will deliver services as usual. Although CACs randomized to this group will not receive the training immediately, they will be prioritized to receive the E3 webinar-based training after the NIMH research project is completed and training is offered to all CACs.

Specifically, victim advocates will learn:

  • How research has informed CAC services.
  • The expanded NCA mission to include healing, barriers to this mission, and NCA’s response
  • What family engagement is and why it’s important.
  • How NCA’s 2017 Standard for Accredited Members on Victim Advocacy and Mental Health supports the NCA mission of healing and child well-being.
  • How to use the Mental Health Treatment Roadmap to increase family engagement with mental health treatment participation and completion.
  • The expanded role of the victim advocate to include family engagement in mental health treatment.
  • Strategies from the family engagement research designed to increase family engagement in mental health treatment.
  • The importance of building collaborative relationships with mental health providers.
  • How to administer and utilize the screening instrument to identify treatment needs.
  • The difference between screening and assessment, and how to introduce, administer and discuss results of screening with caregivers to facilitate referral for mental health services.
  • Information on evidence-based treatments so advocates can explain the services to caregivers.
  • Involving multidisciplinary team (MDT) members in the family engagement process.
  • How to identify and refer to a qualified mental health provider for a trauma assessment and for mental health treatment if indicated.
  • Understand the purpose of and how to use desk cards to support family engagement  interventions and mental health treatment to completion.
  • How to collaborate with a mental health provider to monitor and track services and gather metrics to inform treatment progress.
  • How to gather and report metrics to inform service outcomes and to support the evaluation of this training.

Trainees and their project requirements

Victim advocates are the core of the family engagement response, but they can’t go it alone in E3. They’ll also need senior leadership participation both to be trained throughout E3 and, more broadly, to succeed at the project’s real-world goals.

Victim advocate project requirements

Here are the activities that will encompass the project requirements for victim advocates:

  • Complete Child Victim Web as pre-work. (Includes CEUs that support training requirements of NCA’s Standards for Accredited Members.)
  • Engage in three two-hour webinars over a six-week period.
  • Complete assigned homework designed to offer implementation between webinars.
  • Respond to poll questions and chat boxes to give input during the webinars.
  • Complete pre-training measures.
  • Report demographics, screening, and engagement activity data on families.
  • Ongoing completion of OMS Initial Visit Caregiver Surveys and Caregiver Follow-Up Surveys with custom additions for project.
  • Track services provided and submit metrics to document the outcome of those services in support of the evaluation phase of the training.
  • E3 webinar-plus-consultation trainees will engage in 10 one-hour consultation calls between the webinars to support the implementation of their learning.
  • Complete post-training assessment measures.

Senior leader project requirements

A senior leader is a CAC staff member in a leadership role including responsibility for the outcome of services to children and families served by the CAC. This person should have administrative responsibility within the organization with authority to make systematic changes (policies, procedures, budgeting) to support the implementation of the E3 training in their organization and/or across the community. Because operational and systems support for changes to victim advocacy is critical to the success of this training, senior leader participation is required for all E3 training cohorts. For the purpose of this project, the CAC director and/or clinical director should be designated as the senior leader. Here are the activities that will encompass the project requirements for senior leaders:

  • Complete the CAC Directors Mental Health Guide as pre-work and Child Victim Web if not already completed. (Includes CEUs that support training requirements of NCA’s Standards for Accredited Members.)
  • Engage in the initial senior leader welcome/orientation call.
  • Complete and submit pre-training measures.
  • Complete the senior leader webinar.
  • Hold weekly meetings with the victim advocate to gather metrics regarding E3 activities (i.e., homework, number of screening completed, results of screenings, collaboration with mental health providers, referrals made and sessions attended by child and caregiver and outcome of treatment services).
  • Engage in a second senior leader call as scheduled.
  • Collection of OMS Multidisciplinary Team Surveys with custom additions for this project.
  • Completion of the post-training assessment.

Your role in the E3 research

The overarching goal of the project is to pilot test the E3 training’s impact on key mechanisms of change (victim advocates’ knowledge and skills) to improve rates of screening, referral, and access to services. While we hypothesize that the family engagement training information comprising the E3 training project will be beneficial to family engagement outcomes at CACs, a critical part of this pilot project is to perform a study measuring the success of the project in meeting its project goals. For this study, NCA is partnering with OUHSC and subject matter experts to implement and evaluate outcomes of the web-based and consultative training components offered through E3.

CACs participating in E3 have the exciting opportunity to participate in a large national rigorous research study that may help to demonstrate the value of future E3 training to the entire CAC movement. By participating in the training outcomes research component of this project, CACs and their victim advocates will help determine effective training practices and, most importantly, effective practices in engaging families in the use of evidence-based mental health services offered through CACs. Participation in the research associated with this training is critical to truly know what strategies improve outcomes for children and families affected by maltreatment.

The research study will evaluate three levels of training by randomizing CACs to one of three cohorts:

  1. E3 webinar-based training.
  2. E3 webinar-plus-consultation.
  3. Delayed E3 webinar-based training.

The first two groups will participate in training during the project period. The third group—delayed E3 training—is absolutely essential for measuring impact of the training on skills, knowledge, and, most importantly, rates of success in engaging families in evidence-based services. After all, to ensure that a change in a group has been effective, it must be measured against a group that did not experience the same change. Although CACs randomized to this group will not receive the training immediately, they will be prioritized to receive the E3 training upon completion of the research study.

In addition, those CACs who are not initially selected to participate in the research study will have an opportunity to complete training at a future date after the end of the research study.

All three groups will provide data on the same measures to allow for consistent examination of outcomes. Here are the research data responses cohorts will provide at various points in the project:

  • Demographic information from victim advocates and senior leaders at the start of training.
  • Data the CACs ordinarily provide to NCA through other collection methods, such as Member Census data and OMS.
  • Designated mental health screening measure completed by victim advocates with all families for a discrete period of time.
  • Checklist of engagement strategies completed by victim advocates for three different two-week periods over the course of the study. 
  • Key client information (including reasons for coming through the CAC, screening outcomes, referrals made, and attendance in mental health services) completed for all clients in discrete periods three times over the course of the study.
  • Assessment of knowledge regarding mental health screening, evidence-based practices, trauma, and engagement strategies, completed by victim advocates pre-training, immediately post-webinar training, post consultation (for webinar + consultation group) or six months post-training (for webinar only or delayed training groups).
  • Tracking of time spent in training webinars, homework, and consultation calls (if applicable)
  • Cost-related information including salary-wages, time spent on activities related to the training. (for example, screening), and resource use (for example, mileage) provided by senior leaders/directors.
  • Feedback on victim advocates’ perceptions of the E3 training, including the impact training had on their roles and CAC resource use.

Project training requirements 


Important dates and participant information

All dates mandatory for project participants per their assigned cohort and consultation groups.

March 2020 Update: Because of COVID-19, some E3 training sessions listed below have been postponed. Participants will be notified when sessions are rescheduled.

Key dates for all participants
Applications due by Thursday, 10/31/2019, 5:00 p.m. EDT. 
Apply online through Qualtrics at https://nca.az1.qualtrics.com/jfe/form/SV_3ql2o3LLxa6E00R.

Applicants will be randomized to one of three training groups. By applying, you are committing to participate in the training group to which you are randomized.

Webinar for multidisciplinary teams: Thursday, 2/6/20, 1:00-2:00 EST

E3 Family Engagement Training Information Call

Thursday, September 26, 1:00-2:00 p.m. EDT 

Join Michelle Miller, NCA's project coordinator for mental health initiatives, for a webinar and Q&A about the new training program.   Register online

Open Call-in Dates to Address Questions about the Research

Monday, 1/6/20, 1:00-3:00 EST

Wednesday, 1/8/20 2:30-4:00 EST

Friday, 1/10/20 11:00-1:00 EST


E3 Webinar for Multidisciplinary Teams

Tuesday, 2/11/20, 1:00-2:00 EST


Key Dates for E3 Webinar-Based Trainees

Welcome Call and Data Collection Training:  Monday, 12/9/19, 12:30-2:00 EST

Senior leader orientation call: Tuesday, 1/14/20, 1:00-2:00 p.m. EST

Victim advocate orientation call: Tuesday, 1/14/20, 2:30-3:30 p.m. EST

Webinar 1: Tuesday, 2/4/20, 1:00-3:00 p.m. EST

Webinar 2: Tuesday, 3/3/20, 1:00-3:00 p.m. EST

Webinar 3: Monday, 3/16/20, 1:00-3:00 p.m. EST  


Key Dates for E3 Webinar-Plus-Consultation Trainees

Welcome Call and Data Collection Training: Thursday, 12/12/19, 12:30-2:00 EST

Senior leader orientation call: Thursday, 1/16/20, 1:00-2:00 p.m. EST

Victim advocate orientation call: Thursday, 1/16/20, 2:30-3:30 p.m. EST

Webinar 1: Thursday, 2/6/20, 1:00-3:00 p.m. EST

Webinar 2: Thursday, 3/5/20, 1:00-3:00 p.m. EST

Webinar 3: Thursday, 3/19/20, 1:00-3:00 p.m. EST

Consultees will be assigned to one of three group schedules for 10 consultation calls.

Key dates for E3 delayed webinar-based trainees

Welcome Call and Data Collection Training: Monday, 12/16/19, 1:00-2:30 EST

Senior leader orientation call: Tuesday, 1/21/2020, 1:00-2:30 p.m. EST 

 Victim advocate orientation call: Tuesday, 1/21/2020, 2:30-3:30 p.m. EST

Application requirements

CACs must meet the following requirements in order to apply:

  1. Accredited by NCA.
  2. Participates in the Outcome Measurement System (OMS), including Initial Visit Caregiver Surveys, Caregiver Follow-Up Surveys, and Multidisciplinary Team Surveys (all three required).
  3. Has on-site mental health treatment providers who directly provide EBP for child mental health OR has established and demonstrated linkages for mental health providers providing EBPs in their community.
  4. Has a Memorandum of Understanding (MOU) or a data sharing agreement with all referral sources.
  5. Agrees to participate in all research activities outlined under “Your role in the E3 research” and to complete participation in the project regardless of which cohort to which the CAC is randomized. 

Characteristics of successful teams

  • Stability of victim advocates at the CAC;
  • Access to evidence-based therapy services within the CAC or in the broader community;
  • Organized, able to implement procedures to regularly collect and submit data about the families served;
  • Excited to learn about strategies to screen for mental health concerns and link families successfully to mental health services; and
  • Access to technology and reliable internet to be able to be successful with web-based training and submission of project data.

Cost and benefits

  • There are no direct costs to CACs for participation in the project, outside of the time required to complete training and research tasks.
  • Each CAC will be reimbursed $600 total for their participation, $300 in March 2020 and $300 in November 2020, regardless of which of the three groups of the project they are randomized. 

Contact information

With questions about E3 training components, requirements, and project goals, contact:
Michelle Miller, NCA 202-548-0090 x 123 mmiller@nca-online.org

With questions about the E3 research project, contact: 
Jane F. Silovsky, PhD., OUHSC 405-271-8858 Jane-silovsky@ouhsc.edu


Accredited CACs that wish to participate in this family engagement training project must apply. 
Applications for this training are now closed. Thank you to everyone who has already applied.   
For questions, contact Michelle Miller at mmiller@nca-online.org.