Enhance Early Engagement (E3) Training for CAC Victim Advocates


Contact NCA for upcoming trainings: Michelle Miller at mmiller@nca-online.org.

Access the family engagement fact sheet, Help Families Heal

Access research on family engagement, “Enhancing Early Engagement (E3) in mental health services training for children’s advocacy center’s victim advocates: feasibility protocol for a randomized controlled trial”

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) 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, they believe that non-evidence-based services are just as good, or they believe 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 advocate in the CAC setting: Family engagement with treatment starts and ends with advocates.

About the project

Enhancing early engagement of families in mental health assessment and evidence-based practices is a priority for CAC leaders and NCA. To address this need, NCA partnered with the University of Oklahoma Health Sciences Center (OUHSC) on a 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. This training opportunity provides the new and enhanced version that was modified based on feedback from victim advocates and senior leaders from across the country who participated in the original training in 2020 and 2021.

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. 


What you’ll learn

Victim advocates will view five pre-recorded 60-minute webinars (one every other week) and participate in five 90-minute consultation calls that will be scheduled every other week (off weeks of the webinars). Senior leaders and victim advocates will also participate in two 60-minute individual team calls to be scheduled pre- and post-training. The active training phase is delivered over a 11- week period that begins with a pre-training call with individual teams, pre-work for both the senior leader and victim advocate, continues with the active training phase, and concludes with a post-training call with individual teams.

Through the training, 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 and 2023 Standard for Accredited Members on Victim Advocacy and Mental Health support 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 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 the virtual notebook 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:

  • Attend two 60-minute CAC Individual Team Calls with E3 Trainer
  • Take the Pre-Knowledge Test
  • View five 60-minute webinars (one every other week) before the scheduled consultation call
  • Attend five 90-minute consultation calls (successful completion requires that victim advocates attend 80% of calls, which is 4 of 5 calls)
  • Complete assigned homework designed to enhance implementation between webinars
  • Utilize the Monitoring Forms to track number of children and families served, results of screening, interventions, and referrals for mental health services
  • Take the Post-Knowledge Test
  • Complete the Training, Feasibility, and Acceptance Questionnaire
  • Complete the overall Course Evaluation

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 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 Guide to Quality Mental Healthcare as pre-work.
  • Attend two 60-minute CAC Individual Team Calls with E3 Trainer.
  • Hold weekly meetings with the victim advocate(s) to gather metrics regarding E3 activities (i.e., homework, number of screenings completed, results of screenings, collaboration with mental health providers, referrals made and sessions attended by child and caregiver, and outcome of treatment services).
  • Post-training, complete the Training, Feasibility and Acceptance Questionnaire.

Senior leaders are invited and encouraged to view the webinars. Previous trainees reported less implementation challenges when Senior Leaders were involved in all aspects of the training.


Testimonials from victim advocates who participated in the E3 training

E3 training was developed in conjunction with a research project supported by a grant from the National Institute of Mental Health (NIMH;R34MH118486).