Enhance Early Engagement (E3) Training for CAC Victim Advocates

Training Period: October –December 2023

Description:
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.

About The Project
Enhancing early engagement of families in mental health assessment and evidence-base trauma treatment is a priority for CAC leaders through 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 treatment identification and referral, and evidence-based engagement strategies. This training opportunity provides the new and enhanced version which was modified based on feedback from Victim Advocates and Senior Leaders from across the country who participated in the original trainings 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 and collaborate with the CAC to assess/monitor 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 trauma responses, brief mental health screening, evidence-based trauma-focused treatments, identification of treatment needs, referrals for mental health services, and evidence-based engagement skills.

Training Schedule and 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 which 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 with the 1st in October and the 2nd call in December. The active training phase is delivered over a 10- week period from October –December 2023. There are pre-work requirements for Victim Advocates and their Senior Leaders that need to be completed prior to the beginning of the E3 training. Please refer to list below

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 2023 National Standard of Accreditation for Children’s Advocacy Centers on Victim Advocacy and Mental Health supports the NCA mission of healing and child well-being.
• The expanded role of the victim advocate to include family engagement in mental health treatment.
• How to use the Mental Health Treatment Roadmap to increase family engagement with mental health treatment participation and completion.
• 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 evidence-based mental health treatment if indicated.
• The purpose of and how to use the virtual notebook/desk cards/resource material 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 will also need senior leadership participation both to be trained throughout E3, to implement the E3 learning and, more broadly, to succeed at the project’s real-world goals of increasing the number of child victims served through CACs who engage in mental health treatment to completion. 

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 Victim Advocate training requirements of NCA’s Standards for Accredited Members.) http://cv.musc.edu/
• Complete pre-training measures.
• Engage in the initial and follow up individual CAC calls with an E3 trainer.
• View five pre-recorded webinars -one every other week. It is strongly recommended that a 60-minute time block is built into victim advocates’ schedules during webinar weeks to ensure they have time to view the webinars prior to consultation calls.
• Webinar weeks: October 2, October 16, October 30, November 20, December 4, 2023.
• Complete assigned homework designed to support implementation of learning between webinars and to prepare for the interactive calls.
• Victim Advocates will engage in five-90-minute interactive consultation calls to be held every other week to support the implementation of their learning.
• Consultation Call weeks: There will be two options to sign up for Live Group Calls the week following the Webinar Week.  You will be able to choose from the following.  Live Interactive Call Group Tuesdays from 1:00-2:30PM EST: October 10, October 24, November 7, November 28 December 12, 2023.  Live Interactive Call Group 2 Wednesdays from 1:00-2:30PM EST: October 11, October 25, November 8, November 29 December 13, 2023.
• 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 this project, the CAC director and/or clinical director should be designated as the senior leader. For the 1st time, we will have calls for Senior Leaders around preparation/adoption, active implementation, and sustainability: 12:00-1:00PM EST October 12, November 16, and December 14*.

Here are the activities that will encompass the project requirements for senior leaders:

Complete:
The CAC Directors Mental Health Guide as pre-work https://www.nctsn.org/resource...
Child Victim Web if not already completed. http://cv.musc.edu/
• Engage in the initial and follow-up individual CAC calls with an 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, sessions attended by child and caregiver, barriers identified and resolved and the outcome of treatment services).
• Completion of the post-training feasibility assessment.
• Senior Leaders are encouraged to view webinars and are welcome to join consultation calls.

Trainers will be available to answer questions or consult regarding issues throughout the E3 training. Contact can be made via email.

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

Homework to be completed after Web 1:

• Review Desk Cards 1, 2, 3, 10, 11 related to the learning objectives of this Webinar Session (Digital Notebook)

• Consult with your Senior Leader to determine if your CAC has a Safety Plan policy and procedures.  Sample in Digital Notebook

• If your CAC does not have a Safety Plan policy and procedures discuss an action plan with Senior Leader to develop one

Homework to be completed after Web 2:

Watch MI videos:

• The Four Processes of Motivational Interviewing

https://www.youtube.com/watch?v=4Hrz9tLUlUw

• Lifting the Burden in Motivational Interviewing:

https://www.youtube.com/watch?v=SsNgZ47o2I4

• How to do MI: 

• What not to do MI:  

• Review the video on Reflective Listening  

Watch TIES videos:

 TIES Introduction Video 

TIES Demonstration Video

1. Referral to Mental Health for assessment and or treatment
2. Attendance at the 1st appointment  
3. Completed Treatment  
4. Did the child get better
   1. If yes, how is it tracked

Homework to be completed after Web 5:

• Create an Action Plan moving forward bring to Call 5 –what steps will you and your CAC take to:

• Sustaining Changes
• Increasing access to MH services for children and families
• Addressing other gaps identified on your map
• Tracking mental health outcomes

1. Did the child receive a MH assessment
2. Did the child attend the 1st session
3. Did the child complete treatment
4. Did the child get better
5. Did the caregiver attend their own counselling