Transforming Access and Quality of Trauma Treatment in North Carolina

ABSTRACT

Objectives: Transforming access to and quality of mental health treatment for children exposed to serious trauma and adversity in North Carolina (NC) began with a pilot program from 2006 to 2009 followed by legislative annual funding in 2013. The aims were to develop and sustain an implementation platform that 1) focuses on disseminating an array of 5 effective target treatments across NC for children and families exposed to child abuse/trauma;2) promotes sustainability in diverse settings;and 3) utilizes implementation science to assure positive treatment outcomes. Maintaining quality training and coaching of providers serving underserved, vulnerable populations is a critical need during difficult times of Medicaid changes and the COVID-19 syndemic. Method(s) The NC Child Treatment Program (NCCTP) in the Center for Child and Family Health has trained the following number of cohorts of Medicaid-enrolled community mental health providers in trauma-focused CBT (26), parent-child interaction therapy (PCIT, 17), child-parent psychotherapy (8), structured psychotherapy for adolescents responding to chronic stress (SPARCS, 9), and problematic sexualized behavior (1). The NCCTP builds on the National Child Traumatic Stress Network (NCTSN) learning collaborative to create a roster of highly trained providers in each treatment. Strategies used before and during the syndemic include agency teams are provided intense training and engage in quality improvement (QI) activities focused on use of standardized assessments, achievement of fidelity and clinical outcomes, enhancing organizational capacity, stakeholder outreach, data tracking, and provision of ongoing clinical and implementation supports. Result(s) A total of 888 clinicians have been rostered in the 5 treatment models to date across 100 counties (https//www.ncchildtreatmentprogram.org). The data and lessons learned will be presented for client-level clinical outcomes, training, and service transformation generally and specific to the impact of COVID-19 and racial/other disparities. Conclusion(s) The NCCTP has built capacity to improve the health and well-being of traumatized children across our state by increasing access to and supporting the changing and challenging needs of trained, dedicated, community providers. TRA, P, CC Copyright © 2022