2022 Year in Review

This past year we celebrated the conclusion of some of our seminal projects such as our Trauma and Recovery Project, Birth to Three Social-Emotional Innovation Evaluation, and Family Drug Treatment Court Evaluation, and the launch of new projects that seek to strengthen families and the systems that support them such as our Strong Families, Thriving Children, Connected Communities initiative, Wisconsin Child Welfare and Home Visiting Data Project, Coordinated State Evaluation of Famihttps://uwm.edu/icfw/2022-year-in-review/ly Engagement and Health Equity, and JobsWork MKE. As we reflect on the past five years of the Trauma and Recovery Project and the potential of our new initiatives and projects, we recognize and honor the enormous value of the relationships that we have developed over these years that make possible the advancing of our mission to promote the well-being of all children and families by addressing barriers that result in unequal access to the best available care and solutions. As we embark on these new opportunities, we will continue to strengthen those relationships, learn from our partners’ research and lived experience, and aspire to translate what we learn into prevention and intervention strategies that make a real difference in people’s lives. The list of agencies and stakeholders who deserve our gratitude is too long to acknowledge here, but we invite you to check out our project pages where you will find many of our key partners.

As we begin 2023 – our seventh year as the Institute – our aim is to strengthen these alliances and forge new community connections that are necessary to disseminate effective strategies and produce lasting systems and community change. So take a moment to review what we learned and accomplished in 2022, and check out our newsletter, social media, webpage, and SFTCCC signup to learn more about what we are doing and how you can join us.


Meet the New ICFW Team Members

Anthony Gómez

We welcomed new team members and roles to the Institute this year. Learn more about them here.

 

 

 


ICFW Announces New Initiative and Podcast

We are excited to announce the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative and our Overloaded: Understanding Neglect podcast.

The goal of the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative is to reduce the number of family separations for reasons of neglect by building a community focused on collaboratively pursuing policies and practices that support overloaded families and address systemic failings.

The Overloaded: Understanding Neglect podcast represents the important first step of building a shared understanding of the problem and will serve as a foundation for future innovations in practice, policy, and systems change.

Subscribe and listen wherever you find your podcasts or at this link here.

 


ICFW Dissemination in 2022: New Journal Articles and Webinars

 


New Projects and Partnerships


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

 

ICFW Innovations in Prevention Webinar Series Episode 3: “Primary Prevention: Home Visiting for New Parents”

November 14, 2022

This webinar will make the case that all new parents deserve to be offered a home visit by a highly qualified healthcare professional. Research has shown that postnatal visits can have significant prevention benefits, including a reduced risk of child abuse and neglect. A new initiative in Racine and Walworth counties will be described that aims to ensure that all parents with newborns are eligible for a home visit by a public health nurse. Grounded in the principle of progressive universalism, which balances equal access to care with an equitable distribution of resources, this program will be tailored to ensure that each family receives direct care and connections to community services that match their needs.

Watch the webinar recording here

ICFW Innovations in Prevention Webinar Series Episode 2: “Innovation in Prevention: Jackson County Action Initiative for Early Childhood Education”

September 14, 2022

Accessible, affordable and high-quality early childhood education (ECE) can contribute to cognitive, emotional and social development in children helping them grow into thriving, contributing adults. For parents and caregivers, ECE provides them with the opportunity for gainful employment, economic stability and self-sufficiency. The Jackson County Childcare Network (JCCN) identified Jackson County as an early childhood education desert, with capacity to only serve 278 children of the estimated 1000+ children in need of care. This disparity has resulted in an estimated $2.5 million loss in work productivity, parents unable to work to their full capacity, while 17.8% of children in the county live in poverty. The stressful conditions and circumstances associated with the lack of ECE options, un/under-employment, the effects of poverty, and toxic stress all are risk factors for poor child health outcomes, including increased risk for experiencing neglect.

In 2021, the Jackson County Action Initiative (JCAI) was formed to engage the local community to address the ECE crisis in Jackson County and enhance protective factors for families to mitigate negative outcomes and support family well-being. To achieve these goals and address this complex challenge, the JCAI is using a collective impact approach. Collective impact is a network of community members, organizations, and institutions who advance equity by learning together, aligning, and integrating their actions to achieve population and systems level change. In this webinar, you’ll learn about:

  • The importance of early child education in supporting child, family, and community health and prosperity.
  • Challenges around insufficient early childhood education facing rural communities.
  • Core principles from the Collective Impact model and how the JCAI is applying them.
  • Early lessons learned from this ongoing effort.

Watch the webinar recording here

 

ICFW Newsletter, Fall 2022

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.

In This Issue:


Grateful for Community

As we begin celebrating the holiday season this week, we would like to express our gratitude to you for being a part of our journey. Over the past six years, we have built relationships with so many passionate individuals and organizations that are committed to improving the lives of children and families who face complex challenges. We believe that through these relationships, at an individual, organizational, community, and systems-level, we can aspire to and inspire changes that lead to child and family well-being and prosperity.

During this year alone, we have celebrated the final year of our Trauma and Recovery Project, which trained hundreds of therapists and served hundreds of children and families with evidence-based, trauma-focused therapies. We launched our Strong Families, Thriving Children, Connected Communities initiative that aspires to reduce family separations for reasons of neglect by building a collaborative community. Through that initiative, we have hosted a half dozen roundtables with hundreds of Children’s Wisconsin colleagues and Community and Lived Experience partners, and released our first podcast series, Overloaded: Understanding Neglect, by highlighting the voices and expertise of those that have worked tirelessly by our sides over these past six years.

We are deeply grateful for you and your partnership, and look forward to what will come in the years to come. We wish you a holiday season full of community, happiness and hope.


Program Design and Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.


Building Brains with CARE Community of Practice

By Meghan Christian

Throughout the summer, we were finally able to conduct our Building Brains with CARE Community of Practice with Newcap. In response to the challenges presented by COVID, it was a truly multimedia learning experience. The group was larger than the initial design, but Newcap staff in the Fox Valley area and ICFW Clinician Meghan Christian just completed a six-session virtual Community of Practice that followed an initial in-person session back in April 2022. This format celebrates learning and gaining mastery in concepts and new skills.

ICFW clinicians and participants used Zoom to virtually engage with each other over the past four months to revisit and complement in-person information. In the Community of Practice, skill-building time was cultivated based on different interests, findings and sharing by the participants. Identification of common trauma reactions and skills they can use within their relationships that support resilience and healthy communication were practiced. Family consultations and resource networking also occurred.

As with all efforts from ICFW, evaluation and iteration are continuous. As indicated in the exasperated opening to this article, change is also continuous. In the next iteration of Building Brains with CARE it is being used as a base for two new ICFW community education and engagement efforts, Building Brains with Community and Building Brains with Relationships. Upcoming dates for those to follow.

If you are interested in our workshops, please visit our website and check out our Training page or contact Meghan Christian at mchristian@childrenswi.org.


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Recent ICFW Publications

Goldstein, E., Topitzes, J., Brown, R. L., & Jussel, A. B. (2022). Mental health among university employees during the COVID-19 pandemic: The role of previous life trauma and current posttraumatic stress symptoms. Psychological Trauma: Theory, Research, Practice, and Policy.

Marcus, L. Topitzes, J., Pathak, D.R., Cho, Y., Hirko, K., Houang, R., Kwarteng, J., Hamilton, A.S., &  Velie, E.M. Association of childhood socioeconomic position and race with adverse childhood experiences in a population-based sample of women. American Public Health Association Annual Meeting, Boston, MA, November 6th-9th, 2022.

Topitzes, J. (2022). Understanding trauma and its effects: Applications to criminal justice settings I & II. Justice Point and the Difference Principle, Milwaukee, WI (virtual), October 21st, 2022.

Topitzes, J., Ruffalo, L., Barry, C., & Potter, T. (2022). Opportunities to address trauma. Wisconsin Department of Children and Families Work 2022 Programs Conference: A world of opportunities, Elkhart Lake, WI, October 25-26, 2022.

Zhang, L., & Topitzes, J. (2022). The Association between Family Physical Environment and Child Maltreatment. Children and Youth Services Review, 106551.


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


New Podcast – Overloaded: Understanding Neglect

By Luke Waldo

We are excited to announce our first podcast series, Overloaded: Understanding Neglect. Neglect is a complex and wicked problem, but it’s one that we believe is preventable if we work together to reimagine how we support families overloaded by stress. Neglect is a public health crisis, as it’s the most common reason that children are separated from their families by the government. 37% of all US children experience a CPS investigation, 13% of all children have confirmed/substantiated maltreatment, and children of color are disproportionately represented in foster care. In Wisconsin, nearly 70% of children in foster care are separated from their families due to neglect.

The Overloaded: Understanding Neglect podcast represents the important first step of building a shared understanding of the problem and will serve as a foundation for future innovations in practice, policy, and systems change. Join host Luke Waldo, Director of Program Design and Community Engagement at the Institute for Child and Family Well-being, as he explores these issues with research and policy experts Tim Grove (Wellpoint Care Network), Jennifer Jones (Prevent Child Abuse America), Bryan Samuels (Chapin Hall), and Dr. Kristi Slack (University of Wisconsin), Lived Experience expert Bregetta Wilson (Wisconsin Department of Children and Families) and five Children’s Wisconsin child welfare and child maltreatment prevention experts. Through these conversations, we developed a compelling narrative that seeks to build a shared understanding of the realities of overloaded families, so that we might find solutions that reduce family separations for reasons of neglect.

Join the conversation wherever you listen to your podcasts.

Apple Podcasts
Amazon Music
Google Podcasts
Spotify

Learn More:

For upcoming Overloaded: Understanding Neglect “Book Club” discussions, check our upcoming events and social media.


Strong Families, Thriving Children, Connected Communities Initiative

By Gabriel McGaughey

Children thrive when they have regular interactions with responsive, caring adults. Families experiencing significant stressors related to financial insecurity, housing instability, or the impact of systemic and interpersonal trauma can be overloaded with stress, interrupting those interactions. In the United States 1 in 3 of all children will experience a Child Protective Services (CPS) investigation, 1 in 10 will have confirmed or substantiated instances of maltreatment, and in Wisconsin 70% of all children in foster care were separated from their families with neglect cited as a removal reason.

We believe that neglect is preventable. The goal of the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative is to reduce the number of family separations for reasons of neglect by building a community focused on collaboratively pursuing policies and practices that support overloaded families and address systemic failings. SFTCCC launched in early 2022 and is focused on building a shared understanding of the root causes of neglect to better identify critical pathways towards prevention.

Critical Pathways are specific problem/priority spaces that are focal points for elevating or designing specific and actionable system-level solutions.  Through a progressive series of six roundtables so far this year, we’ve worked with staff at Children’s Wisconsin, community members, and people with lived experience to identify systemic challenges, risk factors, and barriers to supporting families overloaded by stress.

In the next roundtable on December 7th, we invite anyone interested to learn more about the themes we’ve discovered so far, as we look to cultivate a deeper understanding of how issues like poverty, systemic racism, social isolation, and other issues lead overloaded families to child welfare involvement. In early February 2023 we’ll be hosting a virtual data walk to look at how these specific themes overlap with evidence from research and other data sources. Even if you haven’t been to any SFTCCC events before, we welcome all new interested parties to participate!

Quick links:

Register for the SFTCCC Community Roundtable here.

Complete the SFTCCC Survey here.

If you are interested in learning more, participating in a Roundtable, and/or joining this initiative, please visit the SFTCCC project page or sign up here.


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

Listen or Register Now

Archived Recent Events

Podcast Episodes and Show Notes

In today’s bonus episode, we brought together some of our Overloaded: Understanding Neglect experts to thank them and celebrate our collective effort that led to this podcast series. But before we went out to celebrate, we sat down to discuss two topics that have become even more relevant, more top of mind for many of us. First, we explored the Legislation and Policy that have been passed, renewed or begun implementation this year. Then, we discussed the challenges and opportunities that we face with our Workforce within our child welfare and maltreatment prevention systems.


In today’s episode, our last in this series, we will be looking back at our previous seven episodes in an effort to elevate our key lessons learned to present a blueprint towards our ultimate goal of supporting overloaded families and reducing family separations for reasons of neglect. We will be looking at them through the lens of the systems change drivers that we have explored over the past many episodes, by looking at the impact of mental models – our beliefs and biases that influence our behavior – and the relationships and power dynamics that connect or divide us in our communities and systems, and how they influence the important policies, practices and allocation of funding and resources that support our systems change strategies and efforts.


In today’s episode, we will be looking at how we might move further upstream from our current child welfare system, with the intent of revealing current strategies, efforts and opportunities to prevent adversity from occurring for children and families. As we discussed in our previous episodes, we will be looking at the impact of mental models – our beliefs and biases that influence our behavior – and the relationships and power dynamics that connect or divide us in our communities and systems, and how they influence the important policies, practices and allocation of funding and resources that support our prevention strategies and efforts.

As you will hear today, there are many prevention strategies that currently exist that we believe, if employed more frequently and effectively, can dramatically lessen the overload that too many families in our communities are carrying. In turn, they can be the nurturing, responsive parents that their children need and deserve; and we can reduce family separations for reasons of neglect.


Today’s episode intends to provide a framework of systems drivers along with some concrete examples of how we might move our child welfare system towards a child and family well-being system. We hope that it provides an initial framework along with some inspiration as to how each of us has the power to influence systems change through the seemingly small acts of compassion and challenging our own biases. Through those small acts real change begins, especially in a system and society where historical inequities and trauma have deep roots that persist today.

How might we challenge those inequities in our policies and practices within our own organizations and communities? How might we share power, leadership and decision-making with those that we serve? And how might we learn from the policies and practices that have allowed families to fall or be separated before we actively supported them? Join us today to hear our experts share their experience with those questions.


In our first four episodes, we explored neglect, three of its underlying root causes in the forms of trauma, systemic oppression, and poverty, and their compounding challenges like housing instability, mental illness, and addiction that further overload families with stress, and can lead to child welfare involvement and family separation. Moving forward, we will shift our focus from the challenges that overloaded families experience to the challenges and opportunities that our complex systems, organizations, and communities face as we aspire to reduce family separations for reasons of neglect.

To begin this shift, we will explore the child welfare system over a two-part episode, beginning today in part 1 as we look more closely at how the system is designed and functions, how policies, which are often created by those furthest away from the most affected communities, dictate practice and resources, and how we are failing overloaded families by not effectively addressing the underlying root causes of neglect that we explored in our first few episodes.


Children thrive when they have regular interactions with responsive, caring adults. Families experiencing significant stressors related to financial insecurity, housing instability, or the impact of systemic racism and trauma can be overloaded with stress, interrupting those interactions. Over time, and without adequate supports, overloaded families can become vulnerable to adverse experiences, ranging from toxic levels of stress to involvement in the child welfare system, and even family separation for reasons of neglect. How might we support and empower overloaded families, so that they may overcome these challenges? How might we see families for their strengths and potential rather than as defined by their darkest moments?


Poverty, like neglect, is a constellation of complex challenges. We are too often investigating families for child maltreatment because other systems are failing. When this happens, a family that may have been experiencing temporary financial insecurity becomes more vulnerable to compounding factors such as homelessness and mounting stress. It’s in these moments that a family becomes vulnerable to a child welfare investigation and potential family separation. So how might we begin to address financial insecurity before it becomes poverty? How might we support families experiencing poverty before it leads to child neglect?


In Wisconsin, family separations disproportionately impact Children of Color. In 2020, Children of Color made up about 31% of Wisconsin’s child population, but 56% of the foster care population in out-of-home care. Nationally, 53% of Black children will experience a Child Protective Services’ investigation before their 18th birthday. In this episode, we explore these disparities and impacts of systemic oppression on children and families, and how these experiences intersect with trauma.


How do we define neglect? How is neglect interpreted and operationalized by our child welfare system, and how many children and families are separated because of it? What are the underlying root causes of neglect that overload caregivers with stress? In this first episode, host Luke Waldo explores these questions and the complexity of neglect with our research and policy, child welfare and child maltreatment prevention, and lived experience experts.


Podcast Contributors

Luke Waldo
Podcast Host and Executive Editor
Director of Program Design and Community Engagement

Luke Waldo is the Host and Executive Editor of the podcast Overloaded: Understanding Neglect, and the Director of Program Design and Community Engagement for the Institute for Child and Family Well-Being.

Luke has dedicated his career to child well-being in Europe, South America and his native Milwaukee where he has worked with children and families adversely impacted by forced migration, homelessness, family violence, and abuse and neglect. He has over two decades of experience working in the complex systems of domestic violence, childhood trauma and well-being, homelessness, education and maltreatment prevention, with a particular focus on engagement and innovative solutions to personal and community challenges. Luke has trained hundreds of child well-being professionals in the areas of domestic violence, toxic stress, adverse childhood experiences, childhood resilience, social innovation and systems change. Prior to joining ICFW’s leadership team, Luke led the Family Support Program, which serves families involved with the child welfare system by providing strengths- and evidence-based interventions.

Luke believes in the power of storytelling, scientific evidence, and their potential to catalyze better outcomes for children and families when brought together effectively.

Luke earned his Master of Science in Cultural Foundations of Education from the University of Wisconsin-Milwaukee. He holds a Bachelor of Arts degree in Psychology and Spanish from the University of Wisconsin-Eau Claire.


Gabe McGaughey
Podcast Contributor and Interviewer
Co-Director for the Institute for Child and Family Well-being

Gabriel McGaughey serves as the director of well-being for Children’s Hospital of Milwaukee Community Services. In this role, he hopes to push child welfare and other public systems toward a more holistic approach to working with children with the goal of improving their immediate health and long-term well-being.

Previously, Gabriel served as the director of Children’s Child Welfare program, overseeing the implementation of a new program design. With more than 16 years of experience, he has worked at every level of social work from field work at group homes and prevention programs to data analytics and administration. Gabriel joined Milwaukee Child Welfare in 2003 as a case manager, eventually taking on a supervisory role. In 2007, he moved into quality improvement where he created analytic processes to better understand the needs of children and families in foster care.

Gabriel holds bachelor’s and master’s degrees in social work from the University of Wisconsin-Madison.


Carrie Wade
Technical Production and Original Music for Overloaded: Understanding Neglect
Librarian at Harvard Medical School

Carrie Wade is a research librarian, sound artist, and musician based in Boston, Massachusetts. She records and performs under the name Vadi. When this podcast recording began, Carrie worked as the Health Sciences Librarian at UWM before moving into her current role at the Countway Library at Harvard Medical School.

Podcast Guests

Tim Grove
Wellpoint Care Network
Senior Consultant

Tim Grove, MSSW, is a senior consultant at Wellpoint Care Network (formerly SaintA), a human services agency whose mission it is to facilitate equity, learning, healing and wellness for all. He has over 25 years of professional experience in a variety of direct care, administrative and executive positions. Tim created, developed and lead Wellpoint’s Trauma Informed Care (TIC) initiatives. He created a TIC training curriculum centered around the Seven Essential Ingredients, or 7ei, of understanding and practicing TIC. Tim and the training team at Wellpoint have used the 7ei framework to train more than 60,000 people from diverse disciplines over the past 15 years.
Tim is an Affiliate of the Institute for Child and Family Well-being.

Tim is a Mentor with Dr. Bruce Perry’s Neuroseqential Network and a Master Trainer in Dr. Rob Anda and Laura Porter’s ACE Interface curriculum. Tim and the Wellpoint team’s work has been highlighted and published in a number of magazines, journals and newspapers. He was the lead project manager of a three year research study on the effectiveness of 7ei in child welfare outcomes which demonstrated positive effect on creating placement stability and permanency for kids. Tim is recognized nationally as a trauma informed care expert and was interviewed by Oprah Winfrey for a 60 Minutes segment on trauma and resilience.


Ashlee Jackson
Children’s Wisconsin’s Family Support Program – Milwaukee
Family Support Specialist I

Ashlee Jackson is a Family Support Specialist II at Children’s Wisconsin in Milwaukee. She has worked for Children’s for 8 years, 6 of those as a Family Support Specialist, and 2 in our Prevention Program as a Home Visitor. She also has volunteer experience supporting families at the La Causa Crisis Nursery. Ashlee graduated with her BSSW from UW-Milwaukee.


Jennifer Jones
Prevent Child Abuse America
Chief Strategy Officer

Jennifer Jones, MSW, serves as the Chief Strategy Officer at Prevent Child Abuse America (PCA America) where she develops, implements, and advocates for an integrated strategic framework to help grow PCA America’s leadership role consistent with national prevention priorities, and serves as the lead on regional and national strategic partnerships. Prior to her role with PCA America, Jones was the Director of the Change in Mind Institute and the Co-Director of the Safety and Resilience Impact Area at the Alliance for Strong Families and Communities. Jones led all aspects of the Institute, including raising $1.7 million for the Texas Change in Mind Learning Collaborative and National Impact Study. Jones also served as the Project Director of the Child Safety Forward Initiative, a three-year Department of Justice cooperative agreement working with 5 jurisdictions to develop community-led, systematic solutions to reduce child fatalities caused by child maltreatment. Jones worked closely with the Alliance policy team, other national organizations and congressional representatives to advance brain science infused policy and trauma-informed care legislation. Preceding her role at the Alliance, Jones served as the Associate Director of the Wisconsin Children’s Trust Fund (CTF). In her last two years at the agency, Jones served as Interim Executive Director, at the Board’s request, and coordinated all activities related to the Governor-appointed Child Abuse and Neglect Prevention Board, including managing all operations, and overseeing the agency’s budget and grantmaking functions. Before her positions with the Children’s Trust Fund, Jennifer served as the communications specialist in the Secretary’s Office at the Wisconsin Department of Children and Families and as a child welfare policy advisor in the Wisconsin Division of Children and Family Services. Jones is an affiliate of the Institute for Child and Family Well-Being, a joint project of Children’s Wisconsin and the University of Wisconsin-Milwaukee. Jones is also a member of the National HOPE (Healthy Outcomes from Positive Experiences) Advisory Board and serves on the Board of Directors of the Hunger Task Force. Jennifer received her master’s in social work from the University of Wisconsin-Madison and bachelor’s in social work from Marquette University.


Hannah Kirk
Children’s Wisconsin’s Healthy Start Program Milwaukee
Healthy Start Supervisor

Hannah Kirk is the Healthy Start Supervisor in Milwaukee, and was previously a Family Case Manager Training Specialist with Children’s Wisconsin, who partners with the Division of Milwaukee Child Protective Services.

Hannah has dedicated her professional career to Child Welfare within Milwaukee County, where she has worked extensively with children who have adverse childhood experiences. Hannah has a decade of experience in child welfare, where she has served children and families extensively with strengths-based and evidence-based interventions. Hannah has trained several child welfare case managers at Children’s Wisconsin over the last four years, supporting service implementation, and highlighting the importance of community engagement.

Hannah earned her Masters of Social Work from the University of Wisconsin-Milwaukee in 2021 and served as an intern with the Institute. She holds a Bachelor of Science degree in Criminal Justice from the University of Wisconsin-Oshkosh.


Bryan Samuels
Chapin Hall
Executive Director

Bryan Samuels is the Executive Director of Chapin Hall at the University of Chicago, a nonprofit policy research institute focused on connecting research to action. Under Bryan’s leadership, Chapin Hall is actively working in more than 40 states in building knowledge and creating solutions with and for public system partners, community leaders and members, and families—all with an aim to improve the wellbeing of children and youth and ensure all families thrive.

Across his career, Bryan’s work has centered on identifying and addressing inequities using evidence in policymaking. Key accomplishments include the creation and application of a well-being framework based on the best developmental understanding of normal childhood development; formation of a shared and actionable understanding of the effects of exposure to violence, trauma, poverty, and adverse childhood experiences on the mental, emotional, behavioral, and physical health of children; and emphasis on the importance of building the capacity of public and private child- and family-serving systems and organizations to focus on and produce positive outcomes.

Bryan was appointed by President Obama as the Commissioner of the Administration on Children, Youth, and Families (ACYF), where he served from 2009 to 2013 and leveraged the work of federal departments including Health and Human Services, Justice, and Education, among others, on behalf of children in foster care, youth experiencing housing instability, and families impacted by domestic violence. He received his B.A. in Economics from the University of Notre Dame in 1989 and his M.P.P. from the University of Chicago-Harris School in 1993.


Dr. Kristen Slack
University of Wisconsin School of Social Work

Dr. Kristen Slack’s research focuses on understanding the role of poverty and economic hardship in the etiology of child maltreatment, with a particular emphasis on child neglect. She is also interested in the caseload dynamics of child welfare systems in relation to other public benefit systems, and in community-based programs designed to prevent child maltreatment. Her work advances approaches to better coordinating services and benefits to effectively address the economic needs of families at risk for child maltreatment, and improved assessment strategies for identifying risks and protective factors related to child neglect. Her current research is supported by the Centers for Disease Control and Prevention and the Wisconsin Child Abuse and Neglect Prevention Board. Dr. Slack has been published in dozens of academic journals, authored dozens of reports and manuscripts, and been primary investigator on over 20 federally-funded research projects.

Dr. Slack is also the founder of Prof2Prof, a free platform for professionals and doctoral students in academia to showcase their work, network, and find resources for college teaching, research, higher education administration, and student affairs services.


Theresa Swiechowski
Children’s Wisconsin’s Family Support Program – Merrill
Family Support Supervisor

Theresa Swiechowski is a Family Support Supervisor for Children’s Wisconsin’s Northwoods Family Resource Centers, where she has worked for 7 years in various roles. She is a UW Oshkosh graduate with a bachelor’s degree in Human Services. After moving around a bit from Oshkosh to the state of Maine, she and her husband returned to her hometown of Merrill, Wisconsin to raise their 5 children. The balance of work and family is always a challenge for families and theirs was no exception. Theresa’s career, although weaved in and out of raising her kids, has always been working in the human service field but mainly in case management involving mental health, addiction, and parent education. Over the years, she has seen those that were faced with the most difficult obstacles, build resilience and become super heroes of their own stories.


Soua Thao
Children’s Wisconsin’s Family Preservation and Support Program – Wausau
Home Visitor

Soua Thao has been a Home Visitor for Children’s Wisconsin for 16 years. She serves parents of young children from before they have their child up to their child’s fifth birthday. Soua works primarily with Hmong families in Central Wisconsin. Over the past 18 months, I have had the pleasure of getting to know Soua as she has worked with me as a champion for elevating the voice of the families that she serves to better design and improve our programs. I was thrilled when she accepted our invitation to participate in this podcast as she brings so much experience and understanding of the families that she serves, their strengths, the challenges that they face, and the opportunities that our programs and systems have to support and empower them further.


Bregetta Wilson
Wisconsin Department for Children and Families
Lived Experience Coordinator

Bregetta Wilson, MS, LPC-IT, is a positive person, an advocate, community leader, and change agent. She has been working for and with families for the last eighteen years. Bregetta has worked with Pew Charitable Trusts and National Organization Foster Club on Capitol Hill to bring awareness and issues regarding children and families on behalf of Wisconsin. She is a recipient of the Black Excellence Award for her work around Child & Youth Advocacy. Bregetta’s current role within the Department of Children and Families includes working with Lived Experience Partners to elevate the voices of families and children within system and policy change.

Through her organization Embrace Improve Empower, LLC. Bregetta supports organizations with mental health and community engagement efforts. She is a contracted psychotherapist for the Multicultural Trauma and Addiction Treatment Center of Wisconsin, providing mental health services to families in Wisconsin.
She is active in her community around social justice efforts and serves on the boards of the YWCA of Southeast Wisconsin, Rubies and Milwaukee Center for Children and Youth; she is a member of Professional Dimensions, a network of women professionals in Milwaukee and an Alum of Forward48.

A graduate of Alverno and Cardinal Stritch University, she resides in Milwaukee with her fiancé, three children, and pet Husky. Bregetta enjoys going to Orangetheory, dancing, traveling, collecting crystals, practicing holistic aspects of healing, and spending time with family and friends.


Julie Woodbury
Children’s Wisconsin’s Family Preservation and Support Program – Black River Falls
Family Preservation and Support Manager

Dr. Julie Woodbury has been actively involved in the education of families and youth for more than 30 years. Her focus has been on teaching resilience to emerging adults through youth education and development, staff management, and leadership. Julie has been with Children’s Wisconsin for 6 years and is currently a Family Preservation and Support Manager in Black River Falls, Wisconsin. Dr. Woodbury supervises the delivery of child abuse prevention services to Children’s Wisconsin clients in the Western Wisconsin area. She holds a Bachelor of Science Degree in Technical Management, a Master’s Degree in Public Administration with an emphasis on Non-Profit Organizations, and a Doctorate in Education.

ICFW Innovations in Prevention Webinar Series Episode 1: Wisconsin Child Abuse Prevention Board

August 17, 2022

Innovation, the process of trying new ideas to solve new or under addressed challenges has long been central to child maltreatment prevention. The ICFW Innovations in Prevention webinar series focuses on elevating innovations in Wisconsin, serve as a platform to share new ideas, and make connections across communities. This webinar focuses on the primary prevention of child maltreatment tactic referred to as the Family Strengthening approach. Rebecca Mather from Wisconsin’s Child Abuse Prevention Board provides a presentation focuses on:

  • The dynamics and internal resources of the individual family as well as the community and social environment that surrounds it
  • The Protective Factors Framework and how it is integrated into primary prevention, highlighting specific projects to support and strengthen families.
  • A review of the Five for Families model and how it aligns with the Protective Factors Framework to support families.

Resources:

Wisconsin Child Abuse Prevention Board website

Five for Families website

Watch the webinar recording here

ICFW Newsletter, Summer 2022

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.

In This Issue:


Program Design and Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.


Innovation and Child Neglect Prevention

By Gabriel McGaughey and Rachael Meixensperger

Families who experience stressors including housing instability, financial insecurity, or trauma, can become overloaded, leading to an increased level of need, child welfare involvement, and possible neglect. In 2020, 64% of family separations were due to neglect nationally (AFCARS Report #28, 2021), with many of its risk factor tied to issues of poverty, with a minimal number of evidence-based interventions available for communities to implement. To address this unmet need, innovative communities have been able to design high quality, evidence-informed, programs to reduce the sources of stress in families’ lives that contribute to neglect. These innovations not only provide potentially scalable solutions but can also inform how communities might approach addressing the unmet needs of families.

Neglect is a complex challenge, which often presents as a constellation of concurrent issues, that have come to a crisis point by the time a family has contact with the child welfare system. The Family First Prevention Services Act (FFPSA) provides flexibility in funding to be used for specific evidence-based interventions in the IV-E Prevention Services Clearinghouse that reach ‘candidates for foster care’ to prevent separations once a family has contact with child protective services. The Title IV-E Prevention Services Clearinghouse fails to specify which interventions target neglect, but at the time of this writing, only three of one hundred and seven programs in the Clearinghouse include “economic and housing stability” as target outcomes.

To fill this gap, many organizations and communities work to support families overloaded by economic stress utilizing often limited resources to create new solutions that work within their community. Social innovation is the creation and implementation of proposed solutions that promote change. Successful innovation is context specific and requires consideration of specific characteristics of communities and community members. Different communities have specific needs and perspectives that must be accounted for to truly cultivate change. How do innovative communities support innovations to support families overloaded by stress?

Evidence Informed: Drawing on principles rooted in brain science and/or trauma informed care principles, communities strive to develop innovations that meet their specific context while still being rooted in the best available evidence. Integrating these principles into innovation, or improvement, efforts will provide a foundation for scaling successes, and advancing programs towards being evidence-based.

Co-creation: Participation of individuals and families with lived experience, or context experts, in the change process provide crucial insight into the factors that impact their communities and into what works and what does not work. Without the co-creating of solutions with context experts, content experts may enter the field with preconceived notions of community needs and solutions. While co-creation may be new, and at times feel slower than prior practices, the learning and insights present with co-creation contribute to more efficient solutions.

Resources: Prevention services get a fraction of the funding compared to child welfare, often limiting the number of resources available to support improvement and innovation efforts at scale. Operating in this scarcity environment can make taking the time for an innovation process feel like a luxury. However, scaling to pilots, or larger implementations of ideas, can be inefficient, even generating negative attitudes towards current and future change efforts from staff, stakeholders, and families. Funders can support infrastructure for innovation in prevention through targeted innovation grants, clarity and simplification of rules, training, and encouraging collaboration instead of competition. Organizational culture can provide the scaffolding for innovation by providing time, elevating shared learning as an outcome, and supporting scaling of innovation with ongoing quality improvement support.

Evaluation: The first ‘real world’ interaction most innovations have are as prototypes, small scale tests of ideas that inform if an idea may warrant eventual pilot testing. Approaches to evaluating prototypes can be different compared to quality improvement efforts with set assessment tools and metrics. The challenge for innovators is to select the prototype evaluation approach that best suits their situation and capacity. Taking evaluation approaches that fit the small scale and provide rapid feedback from participants, both those providing and receiving the service, is essential to thoughtful iteration and innovation.

Strategic learning: Learning is an outcome. Strategic learning is about deliberately gathering lessons learned in near real time to inform strategic decision making. Strategic learning serves multiple purposes, including creating institutional memory, supporting just-in-time iteration, and clarifying our hypotheses about our work. Innovators can use tools and processes from Strategic Learning to help clarify thinking, develop or refine a theory of change, and support rapid iteration.

Neglect is a prevalent wicked problem with few available options for communities to address it, requiring new evidence-informed innovations that can work in unique community contexts. At times, there is a hesitation to implement innovation due to existing struggles in current programs and the strong emphasis on the need to utilize evidence-based interventions. Evidence based interventions are important tools, however the current scope of interventions is insufficient. Innovation is all around our work, as people strive to work together to address the complex problems that overload families. By creating a clearer path to support innovation in preventing neglect, sharing lessons learned, while remaining rooted in evidence-informed principles, we create conditions to foster practices that may be the evidence-based interventions to support overloaded families of tomorrow.

Communities need more interventions to address neglect and its root causes.

Learn More:

Center on the Developing Child at Harvard
Tamarack Institute
Greater Good Studio
Here 2 There Consulting
Social Workers Who Design


Building Brains with CARE Update

By Meghan Christian

Developing effective programs relies on framing learning as an outcome. One of ICFW’s longest running workshops, Building Brains with CARE, is getting the rebuild treatment this year in response to the needs of our program and community partners. Now, two different workshops will take its place. Building Brains with Relationships will focus on building communication skills rooted in evidence-based interventions such as Motivational Interviewing and Parent-Child Interaction Therapy to support executive functioning skills such as self-regulation, person-to-person. Building Brains with Community will engage community members of various personal and professional backgrounds in illuminating critical pathways to improve community well-being through program design and practice innovation, people-to-people. With great hope for the future, ICFW expects to offer each workshop in person on a quarterly basis with registration being handled on Eventbrite. Be on the lookout for these workshops in the near future.


Parenting With PRIDE Implementation

By Leah Cerwin

At Children’s Wisconsin, the ICFW partnered with Child and Family Counseling to offer our 8-week virtual group for caregivers and a child in their care: Parenting with PRIDE. This group was facilitated by mental & behavioral health clinicians in consultation with Well-Being Lead Clinician Leah Cerwin, and ICFW Master’s Level Intern Joe Moreno.

The group includes components from evidence-based Parent-Child Interaction Therapy (PCIT), offering caregivers and children the opportunity to learn with one another in a supportive virtual environment, and helps parents/caregivers of younger children manage challenging behaviors such as not listening, difficulty with transitions, acting out, and handling big emotions. Parents and their children learned about strategies that promote positive behaviors, enhance parent-child relationship, and decrease undesired behaviors through engaging activities and live coaching feedback with a PCIT-trained therapist.

Child and Family Counseling offered two groups this summer, and both showed success in lowering externalizing behaviors in children and improving parental confidence in caregivers. Linda Chaplin, former ICFW intern and current Qualified Treatment Trainee at Children’s Wisconsin, who delivered Parenting with PRIDE to one of these cohorts shared the following progress that one family made during the eight weeks.

At intake, Mom and Dad shared that their child was having tantrums at least once or twice a day during the week, and more often on weekends. He hated being told no, and would throw things at his parents and the dog when he was angry.

Mom and Dad were excited to use the skills and both jumped right in. As shown by the ECBI scores (see chart above), their child responded right away. After our last session, Mom wrote, “We feel confident that we have the tools we need to continue to manage our child’s periodic tantrums, bedtime routine, etc. Thanks again for all the support.”

It was so rewarding to see them go from being so unsure and really questioning how to handle some challenging behaviors to feeling confident, engaged and more connected as a family.

If you are interested in learning more about the Parenting with PRIDE model or our Translational Design workshops, please contact Luke Waldo at lwaldo@chw.org.


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Recent ICFW Publications

Secondary traumatic stress among home visiting professionals

Janczewski, C. E. & Mersky, J. P. (2022). Secondary traumatic stress among home visiting professionals. Psychological trauma: theory, research, practice and policy.

Working with clients with histories of trauma can put helping professionals at risk of experiencing secondary traumatic stress (STS). This study found that one in ten home visiting professionals experienced PTSD symptoms as measured by an STS assessment. Higher levels of adverse childhood experiences among professionals were associated with higher levels of trauma symptoms. Findings also suggest that staff who work in organizations with positive work environments experienced lower levels of STS. Given the association between STS and workers’ personal histories of adversity, more research is needed to understand the connection between primary and secondary exposure to traumatic events.

Learn more about this study.


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


Changing Course: Considering Systems Change within Social Work Practice

By Andrea Bailey and Rachael Meixensperger

Greater than reduced perceptions of social work as direct or clinical practice, the reach of this field encompasses much more than clinical practice interventions. While clinical social work is an integral component of the profession, it only represents a portion of the work being done. Dimensional in its composition, social work is most readily divided into three levels: micro, mezzo, and macro. Micro social work focuses on individuals or families while mezzo social work focuses on groups or organizations. Macro social work, sometimes referred to as systems social work, differs from micro and mezzo in that its primary focus is on large-scale change. While designating the work into these levels is helpful in defining scope and practice within each station, have these categories unintentionally created a divided practice that values micro-level interventions, while forgetting to enact change within unjust systems creating them? As professionals who abide by a code that values justice and the dignity and worth of the people we serve, to abide by our own standards of ethics we need to take action to undo these oppressive systems.

Unfortunately, the disproportionate focus on clinical social work has obscured or minimized much of the invaluable work that is being done on a macro level. Macro social work often includes community-based research, community organization, program administration, philanthropy, political advocacy, and policy practice (Iverson et al., 2019). These areas of social work target larger systems in society. Presently, many established systems uphold and sustain toxic environments which social workers must work to deconstruct. Unseen by those who are not affected by such systems, social workers have the unique opportunity to see, with unmistakable clarity, the patterns and repetitive outcomes invisible to so many. This work, inherent to the ethic of social work practice, is done to mitigate devastating systemic impacts on the lived realities of those social workers have committed to support.

Throughout our time as students, we have observed the shifting gaze, the lowering of heads, and the collective posture, when the concept of ‘macro practice social work’ is mentioned in a lecture. From the classroom to conversation amongst peers, this disengaged sentiment seems to play on repeat. Curious, we asked fellow MSW students what comes to mind when they think about macro practice within social work. Responses ranged from paperwork, to community advocacy, to quality assurance, and eventually landed on policy. The responses from our peers, while accurate in their own nebulous and disconnected way, fail to inspire connection and imagination for pathways forward that empower individuals, families, and communities, and change systems culpable of harm. So, what is needed to reimagine macro practice in a way that inspires students and social workers alike, to engage in systems change efforts?

Consider the lack of literature and social work research aimed at identifying and dismantling inequitable systems. A recent content analysis of literature focused on social work interventions at an institutional level, revealed that the majority of literature discussing social work practice focused on micro-level interventions (Corley & Young, 2018). In their research, Corley and Young (2018) implore, “Glaringly absent from these articles were calls for institutional change that challenged structural inequalities.” Likewise, consider the fractional percentage of students in academic contexts pursuing macro level practice in their careers. Social work education has, and continues to, lack adequate macro level curriculum and practice opportunities as the focus remains on clinical and direct service social work. It is necessary that social work education places an increased focus on macro level social work by increasing curriculum and practice opportunities to allow social workers to challenge systemic issues. Social work is comprised of and inhabits layers of intervention. Rather than dichotomizing macro and micro interventions, recognizing they are dynamic and integral components to the field’s overall integrity is pivotal.

As future social workers, the very ethic of our profession requires action—action to advocate, defend, support, and empower those whose care we oversee. While direct practice is essential within our field, failure to act on a macro level is passive inaction. We must exhort one another to seek change, not just in care for those harmed by toxic environments, but in the systems that are creating those environments. This is just one of many steps needed to build trust in our communities and break down strongholds of racism in social work practice. Moving forward, let us seek skilled direct practice interventions that provide the needed care for today; but even more, let us recognize our obligation to change the systems that will better tomorrow.

References:
Corley, N. A., & Young, S. M. (2018). Is Social Work Still Racist? A Content Analysis of Recent Literature. Social Work, 63(4), 317–326. https://doi.org/10.1093/sw/swy042

Iverson, M., Dentato, M. P., Green, K., & Busch, N. (2019). The continued need for macro field internships: Support, visibility and quality matter. Journal of Social Work Education, 57(3), 478–488. https://doi.org/10.1080/10437797.2019.1671265


Strong Families, Thriving Children, Connected Communities Initiative

By Gabriel McGaughey

The goal of the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative is to reduce the number of family separations for reasons of neglect by building a community focused on collaboratively pursuing policies and practices that support overloaded families. SFTCCC is a developmental strategy that allows for tactics to be developed and adapted over time based on lessons learned, stakeholder feedback, and emergent opportunities. This approach can result in multiple concurrent activities across the three core phases of Building a Shared Understanding, Implementing a Critical Path Strategy, and Advancing Innovation, Systems, and Policy Solutions.

Currently, SFTCCC has been focused on Building a Shared Understanding through five Roundtables so far in 2022. These roundtables are one-hour or 90-minute long interactive sessions, that include a brief overview of the impact of stress on family functioning, small group discussions, and sharing of insights from your experience to identify challenges and develop pathways forward. Roundtables have included participants from across Children’s Community Services programs and a group of Lived Experience partners. We will be hosting an open community roundtable on September 16th from 10:00-11:30am. To keep this an interactive event, we will have limited slots, so please register here. Given that not everyone will be able to attend a roundtable, we’re also providing an opportunity to provide feedback through the SFTCCC survey, which takes the most common themes from roundtables so far and asks you to prioritize important risk factors, systemic challenges, opportunities, and contribute anything you may think is missing.

Themes from each roundtable are drafted into a report and shared with participants, and through surveys and future roundtables, will be prioritized to create the foundation for the SFTCCC’s critical pathways. Critical Pathways are specific problem/priority spaces that are focal points for elevating or designing specific and actionable system-level solutions. Developing pathways helps focus attention on the changes we want to achieve together, fosters cross systems relationships, and helps clarify shared intent. This approach provides the flexibility to connect existing efforts, invites new contributions, promotes shared learning, and roots efforts in evidence and lived experiences. This flexibility is key to building community around complex challenges that can present differently in different communities, but share root causes and impact.

SFTCCC in many ways represents an operationalizing of many of the efforts around advancing or transforming child welfare systems into a child well-being system. Core principles, such as including those with lived experience in the process, reframing how we talk about prevention, and using the best available evidence are central to SFTCCC. We believe that this initiative can uniquely contribute to the robust national dialogue by engaging providers, supporting promising practices that address root causes, and supporting innovation.

Quick links:
Register for the SFTCCC Community Roundtable here.

Complete the SFTCCC Survey here.

If you are interested in learning more, participating in a Roundtable, and/or joining this initiative, please visit the SFTCCC project page or sign up here.


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

Translational Design: An Introduction

The Institute for Child and Family Well-Being was proud to host the Translational Design: An Introduction workshop led by Luke Waldo, ICFW Director of Program Design and Community Engagement, on August 3rd from 10:00-12:00 CST.

Why?

Children thrive when they have regular interactions with responsive, caring adults. Families experiencing significant stressors related to financial insecurity, housing instability, or the impact of systemic and interpersonal trauma can be overloaded with stress, interrupting those interactions. Over time, and without adequate supports, overloaded families can become vulnerable to adverse experiences, ranging from toxic levels of stress to involvement in the child welfare system, and even family separation for reasons of neglect.

A staggering 36,000 randomized controlled trials are published each year, on average, and it typically takes about 17 years for findings to reach clinical practice. Our understanding of brain science and human development has advanced dramatically in the past 20 years, and many of our evidence-based interventions have not caught up, so we must design and adapt solutions to ensure that they are effective. What’s in it for you?

What’s in it for you?

The Introduction to Translational Design workshop is an interactive presentation of:

  • The impact of stress on childhood development and family functioning;
  • Engaging content and context experts in the design and improvement processes;
  • Identifying and framing the challenges that overloaded families face;
  • Brainstorming and designing solutions to the challenges that the overloaded families face;
  • Approaching learning as an outcome; and
  • Design and strategic learning tools.

How?

Through an introductory session that explores why translational design is essential to balancing the latest brain science with the strengths and needs of your local context, participants will begin framing their programs through these questions:

  • How might we center the voice and experience of overloaded families so that we may better understand their strengths, challenges and needs?
  • How might we design our services so that they translate the latest science into the greatest possible impact on reducing the burden on overloaded families?

Watch the workshop recording here.

Innovation and child neglect prevention

By Gabriel McGaughey and Rachael Meixensperger

Families who experience stressors including housing instability, financial insecurity, or trauma, can become overloaded, leading to an increased level of need, child welfare involvement, and possible neglect. In 2020, 64% of family separations were due to neglect nationally (AFCARS Report #28, 2021), with many of its risk factor tied to issues of poverty, with a minimal number of evidence-based interventions available for communities to implement. To address this unmet need, innovative communities have been able to design high quality, evidence-informed, programs to reduce the sources of stress in families’ lives that contribute to neglect. These innovations not only provide potentially scalable solutions but can also inform how communities might approach addressing the unmet needs of families.

Neglect is a complex challenge, which often presents as a constellation of concurrent issues, that have come to a crisis point by the time a family has contact with the child welfare system. The Family First Prevention Services Act (FFPSA) provides flexibility in funding to be used for specific evidence-based interventions in the IV-E Prevention Services Clearinghouse that reach “candidates for foster care” to prevent separations once a family has contact with child protective services.  The Title IV-E Prevention Services Clearinghouse fails to specify which interventions target neglect, but at the time of this writing, only three of one hundred and seven programs in the Clearinghouse include “economic and housing stability” as target outcomes.

To fill this gap, many organizations and communities work to support families overloaded by economic stress utilizing often limited resources to create new solutions that work within their community. Social innovation is the creation and implementation of proposed solutions that promote change. Successful innovation is context specific and requires consideration of specific characteristics of communities and community members.  Different communities have specific needs and perspectives that must be accounted for to truly cultivate change. How do innovative communities support innovations to support families overloaded by stress?

Evidence Informed: Drawing on principles rooted in brain science and/or trauma informed care principles, communities strive to develop innovations that meet their specific context while still being rooted in the best available evidence. Integrating these principles into innovation, or improvement, efforts will provide a foundation for scaling successes, and advancing programs towards being evidence-based.

Co-creation: Participation of individuals and families with lived experience, or context experts, in the change process provide crucial insight into the factors that impact their communities and into what works and what does not work. Without the co-creating of solutions with context experts, content experts may enter the field with preconceived notions of community needs and solutions. While co-creation may be new, and at times feel slower than prior practices, the learning and insights present with co-creation contribute to more efficient solutions.

Resources: Prevention services get a fraction of the funding compared to child welfare, often limiting the number of resources available to support improvement and innovation efforts at scale. Operating in this scarcity environment can make taking the time for an innovation process feel like a luxury. However, scaling to pilots, or larger implementations of ideas, can be inefficient, even generating negative attitudes towards current and future change efforts from staff, stakeholders, and families. Funders can support infrastructure for innovation in prevention through targeted innovation grants, clarity and simplification of rules, training, and encouraging collaboration instead of competition. Organizational culture can provide the scaffolding for innovation by providing time, elevating shared learning as an outcome, and supporting scaling of innovation with ongoing quality improvement support.

Evaluation: The first ‘real world’ interaction most innovations have are as prototypes, small scale tests of ideas that inform if an idea may warrant eventual pilot testing. Approaches to evaluating prototypes can be different compared to quality improvement efforts with set assessment tools and metrics. The challenge for innovators is to select the prototype evaluation approach that best suits their situation and capacity. Taking evaluation approaches that fit the small scale and provide rapid feedback from participants, both those providing and receiving the service, is essential to thoughtful iteration and innovation.

Strategic learning: Learning is an outcome. Strategic learning is about deliberately gathering lessons learned in near real time to inform strategic decision making. Strategic learning serves multiple purposes, including creating institutional memory, supporting just-in-time iteration, and clarifying our hypotheses about our work. Innovators can use tools and processes from Strategic Learning to help clarify thinking, develop or refine a theory of change, and support rapid iteration.

Neglect is a prevalent wicked problem with few available options for communities to address it, requiring new evidence-informed innovations that can work in unique community contexts. At times, there is a hesitation to implement innovation due to existing struggles in current programs and the strong emphasis on the need to utilize evidence-based interventions. Evidence based interventions are important tools, however the current scope of interventions is insufficient. Innovation is all around our work, as people strive to work together to address the complex problems that overload families. By creating a clearer path to support innovation in preventing neglect, sharing lessons learned, while remaining rooted in evidence-informed principles, we create conditions to foster practices that may be the evidence-based interventions to support overloaded families of tomorrow.

Communities need more interventions to address neglect and its root causes.


Resources For Social Innovation

Center on the Developing Child at Harvard
Tamarack Institute
Greater Good Studio
Here 2 There Consulting
Social Workers Who Design

ICFW Newsletter, Spring 2022

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.

In This Issue:


Program Design and Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.


Minecraft® Social Skills Design and Implementation Prototype

By Meghan Christian

A virtual game-based, social skills group recently completed its second prototype iteration with the goal to improve social and emotional skills such as social communication, cooperation, problem solving, and self-control. For 8 weeks, children ages 7.5-13 years old gathered on Zoom and the Minecraft® education edition platform along with facilitators Melissa Sobish, Mental Health Consultant, and MSW intern Brianna Schneeburger. First, a brief conversation took place on a specific social skill. Then the group played Minecraft® together; this provided space for practice which lays down neural pathways towards the development of the skill. In order to practice shifting focus, attunement, and frustration tolerance, the group was brought back together at the end to discuss what had occurred.

Based on the Lived Experience of participants and After Action Reviews with staff, several changes were tested in this iteration of this Minecraft® social skill group. The group size was reduced from 9 to 5 participants. This time around each participant attended every week! The group time was increased from 60 to 75 minutes and was lengthened from 6 to 8 weeks, and a co-facilitator was added. The Strengths and Difficulties Questionnaire (SDQ) parent and self (for 11+) versions was administered as a standardized assessment pre and post group. The post group assessment was turned into a Survey Monkey versus attaching to an email. A small incentive was offered for the return of post group assessments.

Lessons Learned

  • A group size similar to the 1st group is optimal in order to maximize socializing opportunities and ability to accept referrals across a maximum amount of Wisconsin counties. Two facilitators makes a larger group (around 10 participants) much more doable. Participants liked that facilitators were playing together with them. This would suggest steering away from group sizes in the dozens.
  • Parents want information on how they might incorporate group topics and practice into home life sent along with the weekly group updates.
  • According to SDQ results, difficulties persisted in more or less all the same areas for participants, however 60% of parents reported the impact of difficulties was less.

Promising Outcomes

  • 80% of parents and participants provided feedback in a survey. All (children and parents alike) were glad they joined the group. The majority of parents said their child was communicating, managing emotions and/or navigating social situations better. Half of participants reported using what they learned in real life weekly or more with the other half using the information several time times since starting group. Participants noted feeling successful, powerful, and hopeful.
  • Children often preferred to continue interacting with each other in the game world after group time had ended.
  • An integrity checklist was developed by the facilitator so future facilitators may replicate the group.
  • 100% of requested assessments were returned.

Resources Needs

  • Iterate to incorporate best practices into a single group.
  • Melissa Sobish (facilitator) is interested in leading another iteration. ICFW expects this could happen starting in early September. An intern would need to be identified to co-facilitate.
  • Development of relationships with interested partners to begin targeting scalability and sustainability.

Learn More:

Minecraft® to Build Our Children’s Social Skills


Parenting With PRIDE Design and Implementation Prototype

By Leah Cerwin

As a result of earlier prototype designs and testing conducted by the Institute for Child and Family Well-being (ICFW), Children’s Wisconsin’s Child and Family Counseling programs are currently providing Parenting with P.R.I.D.E., an 8-week virtual therapy group for parents/caregivers and a child in their care. This group is being facilitated by licensed mental and behavioral health clinicians and masters-level student interns, and includes components from the evidence-based intervention, Parent Child Interaction Therapy. We are proud of the efforts that went into designing, testing, and now implementing within one of our Children’s programs so that we may provide the best and safest care to the children and families that we serve.

If you are interested in Parenting with PRIDE for yourself and your child, call Children’s Wisconsin Mental and Behavioral Health Access Department at 414-266-3339.

If you are interested in learning more about the Parenting with PRIDE model or our Translational Design workshops, please contact Luke Waldo at lwaldo@chw.org.


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Recent ICFW Publications

ICFW recently published two studies that underscore the mental health needs of low-income women receiving home visiting services in Wisconsin.

Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women

Choi, C., Mersky, J. P., Janczewski, C. E., & Goyal, D. (2022).  Journal of Affective Disorders, 301, 44-51.

This study of 899 women showed that most women who experience postpartum depression also report prenatal depression, and that a history of abuse and low social support predicted poor mental health outcomes over time.

Learn more about this study.


Intergenerational Pathways Linking Mothers’ Adverse Childhood Experiences and Children’s Social-Emotional Problems

Zhang, L., Mersky, J. P., & Plummer Lee, C. (2022).  Child Abuse & Neglect.

This analysis of 831 participants in the Families and Children Thriving Study revealed that mothers with higher ACE scores were more likely to have children with social-emotional difficulties. These intergenerational effects were largely explained by the negative effects of ACEs on mothers’ mental health.

Learn more about this study.


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


Strong Families, Thriving Children, Connected Communities Initiative

By Luke Waldo

The goal of the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative is to reduce the number of family separations for reasons of neglect by building a community focused on collaboratively pursuing policies and practices that support overloaded families and address systemic failings. SFTCCC is a developmental strategy at its core, recognizing that more can be accomplished through shared learning and action to address the drivers of systems change that either hold the conditions that contribute to neglect in place or provide scaffolding for progress. This strategy includes three core phases:

  • Building shared understanding
  • Implementing a critical path strategy
  • Advancing innovation, systems, and policy solutions

Each phase can happen concurrently as we work to build community around preventing family separation for reasons of neglect. Over the past few months, we have worked to build a shared understanding by building consensus around shared language for the root causes that impact families, systems, and the decisions that may lead to family separation. We hosted two Roundtables with over 75 participants representing all Children’s Wisconsin Community Services’ programs and regions from Southeastern Wisconsin to the Northwoods. Through these Roundtables, we explored:

  • Individual and Systemic challenges that overload families with stress and create conditions for neglect and family separation;
  • Opportunities and existing practices, policies, and systems collaborations that we can leverage to reduce stress and keep families together;
  • Barriers to those opportunities that may limit their impact.

We have also hosted presentations and meetings with organizational and systems partners that are committed to preventing child maltreatment to share our vision for this initiative and to learn about our partners initiatives, so that we might more effectively collaborate and support one another.

We will be hosting additional Roundtables, presentations, and meetings throughout this year to continue to build a shared understanding. If you are interested in learning more, participating in a Roundtable, and/or joining this initiative, please visit the SFTCCC project page or sign up here.


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

Building Brains with CARENewcap – April 6th

Fulfilling the Promise Conference Presentation – Parenting with PRIDE – April

UWM Guest Lecture on PCIT – Leah Cerwin – April

SFTCCC Roundtable with Children’s Leaders – April

SFTCCC Roundtable with Children’s Well-being Programs – June 3rd

 

Advancing research on perinatal depression trajectories

Choi, C., Mersky, J. P., Janczewski, C. E., & Goyal, D. (2022). Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women. Journal of Affective Disorders, 301, 44-51.

Abstract

Objectives: The current study aimed to describe and predict perinatal depression trajectories in a sample of low-income women from the first trimester of pregnancy to six months postpartum.

Methods: The study sample consisted of 899 women in Wisconsin who received home visiting services. Eligible participants were screened for depressive symptoms by home visitors using the Edinburgh Postnatal Depression Scale at least three times across four time periods from the first trimester of pregnancy to six months postpartum. Growth Mixture Modeling was applied to identify distinct trajectory classes, and multinomial logistic regressions were performed to analyze predictors of class membership.

Results: Mean depressive symptom scores in this racially/ethnically diverse sample of low-income women decreased significantly over time from a high of 8.1 at time1 to a low of 6.8 at time4. Four classes were identified, including a low-stable group (78.2% of sample), a high-stable group (10.6%) along with decreasing (7.1%) and increasing (4.1%) trajectories. Women with a history of abuse and mental health difficulties were more likely to be classified in the high-stable and decreasing depression groups than the low-stable group. Low social support was linked to an increasing trajectory that resulted in high levels of postpartum depression.

Conclusions and implications: Although most women exhibited stable and positive trajectories, more than one out of five presented with either persistently or intermittently high depression scores. Taken together, the findings underscore the importance of depression screening throughout the perinatal period and identifying factors that may be used to target resources to at-risk populations.

Link to publication

Intergenerational effects of mothers’ adverse childhood experiences on children’s social-emotional development

Zhang, L., Mersky, J. P., & Plummer Lee, C. (2022). Intergenerational Pathways Linking Mothers’ Adverse Childhood Experiences and Children’s Social-Emotional Problems. Child Abuse & Neglect. 

Abstract

Despite the persistent hypothesis that adverse childhood experiences (ACE) have intergenerational implications, empirical research documenting the effects and the mechanisms of transmission remains underdeveloped. This study examined the intergenerational effects of mothers’ adverse childhood experiences on their offspring’s social-emotional development and whether the association was mediated by mothers’ mental health, adult adversity, and perceptions of paternal involvement. The study sample included 831 mothers (19–49 years old, 47.5% White) with children aged 12–48 months who participated in a longitudinal investigation of low-income families in Wisconsin. ACEs were assessed by home visitors, and two waves of survey data were collected by researchers to assess demographics, mediators, and social-emotional outcomes. A path analysis showed that the association between maternal ACEs and children’s social-emotional problems was fully mediated, with postpartum mental health acting as a primary mechanism. Implications for intervention and future research directions are discussed.

Link to publication

ICFW Newsletter, Winter 2022

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.

In This Issue:


Meet the ICFW

Meet Our Translational Design Coordinator – Megan Frederick-Usoh

The ICFW recently created a new position, Translational Design Coordinator, to support both a strategic and operational evolution within our design and capacity-building projects. We are excited to announce that Megan Frederick-Usoh has recently joined our team in this new role.

Megan has over 16 years of experience in public health and child welfare. She has worked in both the for-profit and non-profit sectors in foster care, injury prevention and with adults with intellectual and developmental disabilities. Megan began her tenure with Children’s Wisconsin in 2019 as a Treatment Foster Care Recruiter and Educator, with an additional focus on program evaluation. She earned a Bachelor of Arts degree in Psychology, Political Science and Criminal Justice from the University of Tennessee, Honors College-Knoxville.


Meet Our Predoctoral Fellows

The ICFW recently launched a predoctoral fellowship training program that will provide mentorship and funding to doctoral students whose research can be applied to promote better and more equitable outcomes for children and families. We are proud to announce the selection of two predoctoral fellows for 2022: Darejan Dvalishvili and Anthony Gómez.

 

Darejan Dvalishvili is a predoctoral fellow at the Institute for Child and Family Well-Being. She is completing her Ph.D. in social work at Washington University in St. Louis. Her research focuses on intersections of poverty, child maltreatment, and adverse childhood experiences. Following her work with UNICEF and other international and local non-profit organizations, her interests include exploring the impact of various economic interventions on children’s wellbeing both in the US and globally. Darejan earned an MSW from Columbia University (New York, US) and an MD from Tbilisi State Medical University (Tbilisi, Republic of Georgia).

 

 

 

Anthony Gómez is a predoctoral fellow at the Institute for Child and Family Well-Being. Anthony’s research broadly focuses on child and family well-being, and its relationship to the child welfare system. Driven by professional experience working in early education and child welfare, he is interested in understanding how service systems can better fulfill the material and emotional needs of parents and caregivers, and in turn, how such support can improve parenting, mental health, and child development outcomes. Anthony holds a master’s degree in social welfare from UCLA and is currently a doctoral student at the UC Berkeley School of Social Welfare.

 

 


Meet our Parent Child Interaction Therapy (PCIT) Trainer Team

During the past month, our Parent Child Interaction Therapy Trainer Team of Dimitri Topitzes and Leah Cerwin has begun delivering the PCIT International Within Agency Trainer (WATer) training to our team member, Meghan Christian. Dimitri became a Certified PCIT International Regional Trainer in 2020, a distinction held by less than fifty PCIT therapists globally, and Leah became a Within Agency Trainer in 2019. We are excited to add Meghan to our training team, so that we may train more clinicians within Children’s and across the state in order to provide greater access to this effective therapy for children and their caregivers.


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Recent ICFW Publications

Effects of COVID-19 on Home Visiting Services for Vulnerable Families

ICFW faculty published a multi-state study that documented the toll of the pandemic on home visiting programs that offer services and support to new and expectant parents. Compared to pre-pandemic levels, post-COVID enrollments decreased by 33–36% and total visits fell by 15–24%. These findings are especially concerning given the vital role that these programs play in supporting children and families from more vulnerable and marginalized populations.

Learn more about this study.


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


Strong Families, Thriving Children, Connected Communities Initiative

Children thrive when they have regular interactions with responsive, caring adults. Families experiencing significant stressors related to financial insecurity, housing instability, or the impact of systemic and interpersonal trauma can be overloaded with stress, interrupting those interactions. Families that are experiencing this overload of stress are at greater risk for having neglect identified as a threat to their child(ren)’s safety. If we ensure that communities are equipped to ease the burden on overloaded families, we make resilience a real possibility.

Neglect is cited as the primary or contributing reason for 73% of family separations into foster care nationally and 68% here in Wisconsin. Neglect is frequently defined as the failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm[1]. Children who experience the trauma of family separation for reasons of neglect are more likely than not to return home. Overloaded families are left vulnerable by systems that are misaligned to meeting their basic necessities. Poverty, trauma, and systemic racism are some of the deep seeded root causes to this inequity. We believe that there are pathways forward to preventing a significant portion of these separations from happening.

The conditions that lead to family separations for reasons of neglect are complex, extending beyond any single system or solution. The goal of the Strong Families, Thriving Children, Connected Communities (SFTCCC) initiative is to reduce the number of family separations for reasons of neglect by building a community focused on collaboratively pursuing policies and practices that support overloaded families and address systemic failings. SFTCCC is a developmental strategy at its core, recognizing that more can be accomplished through shared learning and action to address the drivers of systems change that either hold the conditions that contribute to neglect in place or provide scaffolding for progress.

Children’s ICFW team will strive to support programs, organizations, and communities to collaborate on solutions and generate knowledge to address these complex challenges families overloaded by stress face before safety threats emerge. By elevating the latest thinking and resources we hope to foster a community of changemakers, support shared learning, expand their networks, and inspire innovation and collaboration.

To learn more and sign up to get involved, please visit the SFTCCC project page.

[1] For a further discussion about what constitutes child neglect, see Child Welfare Information Gateway’s Acts of omission: An Overview of Child Neglect at https://www.childwelfare.gov/pubs/focus/acts


Voice of Lived Experience in Program Design and Improvement

By Luke Waldo

COVID-19 has created enormous stress on families, staff, and communities, and exposed existing and new challenges that families face when it comes to accessing and benefitting from supportive services. In response to these new challenges, we conducted our strategic learning process with the COVID Resilience Plan through which we learned that we could better meet the needs of our clients if we increased the voice of lived experience in our program design, implementation and improvement efforts.  “…Lived experience brings value, particularly in contexts with rich histories, cultural nuances, and generations of communal knowledge. These are the things we can’t bottle up in a diagram or find best practices for in a textbook” (Ali, 2019).

When we elevate the voice of lived experience and create authentic engagement and accountability between our program staff and clients, we “prioritize relationships, increase trust across all stakeholders, and use participatory approaches to ensure the work is guided by those most affected” (Hayden et al). So, how might we bring the voice of lived experience to our programs’ training, use of evidence-based models, and “content expertise” to ultimately deliver more positive outcomes for the children and families that we serve?

Many programs already include the voice of lived experience in their program design and improvement efforts in the form of:

  • Program completion/ satisfaction surveys
  • Focus groups
  • Family Advisory Councils
  • Parent Advocates

Through the use of these approaches, programs can better understand our clients’ needs, barriers, priorities, and strengths. Empowered with this knowledge, we are better positioned to design, implement, and adapt programs that more effectively meet our clients where they are, build trust, and lead to better engagement. Additionally, these approaches can provide feedback on what works and what doesn’t work for our clients, so that we may make program improvements that demonstrate authentic engagement and accountability to those we serve.

Children’s Child Well-being Programs’ Voice of Lived Experience Journey

Prior to COVID-19, Children’s Child Well-being leadership was polled on its priorities, and the overwhelming majority chose “client voice” in program activities and improvement as its top priority. In 2020, through the COVID Resilience Plan we conducted 19 After Action Reviews, in which it became clear that there were three core areas that we needed to prioritize:

  • Client Voice/Community Engagement in Program Design and Improvement
  • Virtual Practice/Service Delivery and Training
  • Remote/Work from Home Transitions

Consequently, we developed a Community Engagement in Program Design and Improvement Community of Practice, which met over four months and developed three core recommendations, which were then presented as the primary design objectives of the Champions team that represented each program area of the Child Well-being department.

Framing the Challenge

Upon recruiting Champions from each program area across the Child Well-being department, we focused our design project on the following question, so that we could effectively design program and department-wide policy and practice recommendations.

As our service environment has changed due to families’ complex situations and needs – COVID-19, access and technology issues, cultural needs, etc. – how might we increase and/or center family/client voice in our program design, implementation, and improvement processes?

Our Translational Design Process

Over the course of 8 working 90-minute meetings, we centered the Champions team activities on the three COVID Resilience Plan Community Engagement recommendations.

  • Develop a Parent Advisory Council
  • Improve Client Satisfaction Survey process
  • Develop a client readiness/access assessment process
Source: Center on the Developing Child at Harvard University.

Our Translational Design process centers the principle that the lived experience of the professional and client should be present in all activities while also elevating the best available evidence from our fields. As a result, each phase of the process incorporated reflective practices, client and colleague feedback, and tools that centered the client’s experience, relationships and needs.

  1. Frame the Challenge. Define accountability.
  2. Create sub-committees for each core recommendation based on Champions’ experience and interests.
  3. Storyboard.
  4. Prototype Workflow.
  5. Theory of Change.
  6. Best practice readings.
  7. Office Hours.

As the Champions completed their Storyboards, Prototype Workflows, and Theories of Change, they worked closely with their sub-committee partners to review and reflect on their ideas before sharing them with their colleagues and clients for further feedback. They then reworked their ideas and updated the tools to reflect what they had learned. Lastly, they shared their tools on our Basecamp page where all Champions could review them and share their lessons learned. Additionally, throughout the process, the Champions could attend Office Hours with me to work individually on their tools, reflect on what they had learned, and make final updates before submitting to Basecamp.

In our final phase of the design process, we reviewed best practices and evidence by reading literature from national and local partners that have been strong examples of incorporating lived experience into their organizational practices and culture. We then made final additions to our design projects or cited those ideas that we had already developed that are supported by evidence.

In the coming weeks, we will present our final policy and practice recommendations along with a number of the design projects to the Child Well-being leadership team to determine how we might implement them.

References:

Ali, Kareeshma. (2019, February 8) There is an imbalance between lived and learned experience. Retrieved from: https://medium.com/@kareeshma/there-is-an-imbalance-between-lived-and-learned-experience-975d7f35d1bc

Hayden, Justin, Kalra, Surbhi, Rudd, Christopher, Walker, Justin. How can organizations assess their readiness to co-design? Casey Family Programs, Questions from the Field. Retrieved from: https://www.casey.org/codesign-lived-experience/

Learn More:

Translational Design Workshops – If you are interested in learning more about our Translational Design workshops, contact Luke Waldo at lwaldo@chw.org.

Storyboarding – IDEO

Theory of Change – Center on the Developing Child at Harvard University


Trauma and Recovery Project Training

By Meghan Christian

As the final year of Trauma and Recovery Project 5-year SAMHSA grant comes to a close, the final cohort of 21 Trauma-Focused Cognitive Behavioral Therapy trainees from around the state of Wisconsin completed their last synchronous training days. Already this cohort has begun treating 55 child and families affected by post-traumatic stress. During these training days, topics included developing and processing a trauma narrative, identifying supportive caregivers to serve as a witness to the narrative, in-vivo exposure, developing future resilience and safety and creating resilience and longevity in clinicians using the Components for Effecting Clinician Experience and Reducing Trauma (CE-CERT) model by Dr. Brian Miller. Cohort trainees will continue to develop their practice through literature review and consultation with the trainer, Jennifer Wilgocki, LCSW and ICFW team member, Meghan Christian.

If you would like to refer a family to a Children’s provider for trauma therapy, please call 414-266-3339. You can also search for certified clinicians by visiting https://tfcbt.org/ or check out our website’s map of Wisconsin TF-CBT therapists here.

Learn More

More information on Trauma-Focused Cognitive Behavioral Therapy can be found at https://www.nctsn.org/.

If you would like to learn more about Components for Effecting Clinician Experience and Reducing Trauma click here: http://oklahomatfcbt.org/wp-content/uploads/2019/05/CE-CERT-Overview-Handout.pdf


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

Presentations, Trainings and Workshops:

January 2022

PCIT Within Agency Trainer (WATer) Training

February 2022

Frontiers of Innovation and Children’s Home Society of America Webinar

Roundtable on Overloaded Families with Children’s Wisconsin’s Community Services Programs

  • If you are interested in attending an upcoming Roundtable, please provide your contact information in the link above.

 

 

 

 

 

 

2021 Year in Review

This past year marked the fifth anniversary of the Institute for Child and Family Well-being. As we reflect on the past five years, we are humbled by the opportunities we have had to join many others who are dedicated to strengthening families and nurturing children. Our community-university partnership emerged from a shared commitment to promoting the well-being of all children and families and to addressing barriers that result in unequal access to the best available care. We do so by translating the science of what works into prevention and intervention strategies that are effective in the real world. Central to this process is the relationships that are present in communities, organizations, and systems with whom we work to integrate effective, culturally responsive, and sustainable solutions. The list of agencies and stakeholders who deserve our gratitude is too long to acknowledge here, but we invite you to check out our project pages where you will find many of our key partners.

As we look to the future, our aim is to strengthen these alliances and forge new community connections that are necessary to disseminate effective strategies and produce lasting systems change. So take a moment to review what we learned and accomplished in 2021, and keep an eye on our newsletter, social media, and webpage that will celebrate our five years of partnership as the Institute for Child and Family Well-being.


Meet the 2021 ICFW Affiliates

As Community Engagement and Systems Change are a core service area of the ICFW, collaboration with our community and systems partners is critical to fulfilling our mission. In recognition of those that value collaboration and whose mission seeks to improve child and family well-being, we have invited those partners to join us as ICFW Affiliates. We were honored to introduce eight ICFW Affiliates in 2021, and are looking forward to expanding our affiliates in 2022.

Jennifer Jones, Dr. John Meurer, & Carmen Pitre

Dr. Julian Ford, Clarence Johnson, & Dr. Christy Warner-Metzger

Leah Jepson & Jennifer Winkler


ICFW Honored with Key Innovator Award

We are excited to announce that Children’s Wisconsin was presented with the Key Innovator award from Economic Mobility Pathways (EMPath). Over the past few years, our ICFW team has worked closely with Jen Winkler, an ICFW Affiliate, to adapt and implement Mobility Mentoring® into Children’s Wisconsin’s child welfare program in Milwaukee. We are honored to be recognized for the collaboration and innovation that have contributed to the implementation of this promising model. Please read the award statement from the EMPath Annual Report below.

 

 

 

 


ICFW Dissemination in 2021: New Journal Articles, Report and Webinar


New Projects and Partnerships

ICFW Newsletter, Fall 2021

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.


In This Issue


Meet the ICFW

We are excited to announce that Children’s Wisconsin was presented with the Key Innovator award from Economic Mobility Pathways (EMPath). Over the past few years, our ICFW team has worked closely with Jen Winkler, an ICFW Affiliate, to adapt and implement Mobility Mentoring® into Children’s Wisconsin’s child welfare program in Milwaukee. We are honored to be recognized for the collaboration and innovation that have contributed to the implementation of this promising model. Please read the award statement from the EMPath Annual Report below.

 

 

 


Program Design & Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.


Mobility Mentoring® in Family Support and Preservation Programs

By Gabe McGaughey

Children thrive when they have regular interactions with responsive, caring adults. Families experiencing significant stressors related to financial insecurity, housing instability, or the impact of systemic and interpersonal trauma can be overwhelmed with stress, interrupting those interactions. To better support families overloaded by stress, Children’s Wisconsin is proud to announce a partnership through Children’s Home Society of America (CHSA) to bring EMPath’s Mobility Mentoring intervention into our Family Preservation and Support programs around the state for implementation starting in January 2022. Mobility Mentoring® focuses on using a science-based approach to support family-led goal attainment with a primary goal of economic mobility out of poverty. Children’s ICFW team members will be supporting this implementation, evaluation, and shared learning moving forward.

Learn More:

ICFW Practice Brief: Mobility Mentoring


Executive Function and Mobility Mentoring®: Using Brain Science to Promote Mobility Out of Poverty 

By Meghan Majors

Early adversity can derail the development and use of the core capabilities for success in adulthood. Childhood stress and trauma can have a negative impact on the developing brain. The prefrontal cortex, which controls executive functioning, and the limbic system, which controls the assessment of threats, are the most affected. When exposed to enough stress, this leads to brains that lack skills in planning and impulse control and are hypervigilant of threats. Chronic stress can also lead to a dysfunctional stress response over the lifespan. When experiencing a threat, the brain activates the “fight-or-flight” response to deal with the threat, limiting one’s ability to utilize self-regulation skills. Therefore, living in an environment of frequent fear and anxiety leads to brains that are continuously in “fight-or-flight”, affecting one’s ability to both develop and use executive function skills.

Executive function refers to the capacity to plan ahead and meet goals, control impulses, prioritize tasks, and stay focused despite distractions. These skills are developed through practice. Early childhood is an important period for developing executive function. Children who do not have the opportunity to use and strengthen these skills are less proficient and may have a difficult time managing routine tasks of life. In adulthood, executive functioning and self-regulation are the key skills necessary to get and keep a job, develop healthy relationships, and manage finances.

Growing up in poverty, even without the addition of trauma, can have a negative impact on the developing brain and executive function. Poverty is associated with chronic stress and fewer opportunities to practice executive functioning skills. Chronic scarcity, such as that experienced when living in poverty, can be viewed as a series of frequent, stressful events that can result in an overloaded brain. Constantly needing to direct attention to crises takes a toll and requires an incredible amount of energy and time. This bandwidth tax leads to poor decision making and difficulty setting realistic goals. Additionally, it can be difficult for people experiencing chronic scarcity to plan and set goals for the future because needing to frequently handle short-term crises can consume a lot of bandwidth. Executive functions, like impulse control, working memory, and mental flexibility, are important for success in work and school. This contributes to the cycle of poverty, as living in poverty itself limits one’s ability to have mobility out of poverty.

Poverty itself can impact executive functioning but considering the large overlap between living in poverty and experiencing early trauma, the cumulative impact on executive functioning is greater. This intersection of trauma and poverty is frequently seen in the populations involved in home visiting and the child welfare system. The impact can span across the life course. Childhood poverty and adversity can lead to increased parenting stress as an adult and reduce the ability to provide effective care to children. This can be associated with poor emotional regulation in children and neglect, contributing to intergenerational effects. Therefore, to implement programs that will improve the lives of child and families in this population, it is necessary to consider the impact of trauma, stress, and poverty on executive functioning.

Mobility Mentoring® is an executive functioning and trauma informed intervention that focuses on partnering with clients to build the skills, resources, and behavior to achieve financial independence. Mobility Mentoring®  engages clients through a coaching model to develop decision-making and goal-setting skills in five key pillars: family stability, health and well-being, financial management, education and training, and employment and career. The intervention includes the use of external incentives to build intrinsic motivation in participants. Children’s Wisconsin is expanding the Mobility Mentoring® program to five programs in six regions in Wisconsin: Family Support (Black River Falls, Northwoods), Home Visiting (Black River Falls, Northwoods, Stevens Point, Milwaukee, Rock County), Early Head Start (Northwoods), and Education and Employment (Madison).


T-SBIRT Training and Development

By Dimitri Topitzes

T-SBIRT, or trauma screening, brief intervention and referral to treatment, is a one-session interview protocol that has been integrated into health and human service programs across Wisconsin. Implementing T-SBIRT in such settings recognizes two interrelated truths: a) most people experience significant adversity and trauma across the life course, an assertion that is all-the-more salient during this time of pandemic and collective trauma, and b) cumulative trauma exposure undermines functioning across many domains and limits engagement in various service systems.

Derived from screening, brief intervention, and referral to treatment for substance use, T-SBIRT has several distinct goals for participants. Namely, it was designed to:

  1. help participants generate insight into the extent and effects of trauma exposure,
  2. deepen participants’ awareness of and commitment to positive coping skills,
  3. enhance participants’ motivation to seek formal or informal supports, and
  4. strengthen participants’ engagement in current service episodes.

Thus far, T-SBIRT has been delivered by direct service providers from a variety of settings, including community-based primary care clinics, nurse home visiting programs, and employment service programs. Typically, providers conduct T-SBIRT sessions early in the course of services to strengthen rapport with service recipients, generate insight into root causes of presenting problems, and develop well-informed service and referral plans. T-SBIRT sessions extend over approximately 10 to 45 minutes, dependent on context, and evaluators have published three studies to date indicating that it is feasible to implement T-SBIRT across these diverse settings.

The primary author of T-SBIRT, Dimitri Topitzes, has led multiple T-SBIRT training initiatives in southeastern Wisconsin and other parts of the state. Typically, trainings involve one or two day intensive workshops followed by ongoing technical assistance. The workshops cover topics such as the rate and consequences of trauma exposure. He also presents the trauma service frameworks on which T-SBIRT is based, such as trauma-informed care and trauma-responsive practices. Subsequently, training participants observe T-SBIRT demonstration role-plays and complete T-SBIRT practice role-plays.

The gatherings generally end with discussions about implementation drivers and barriers along with agency-specific plans for integrating T-SBIRT within service workflows. Dr. Topitzes provides monthly T-SBIRT technical assistance or consultation during initial phases of integration to support ongoing practice. During these consultation sessions, usually held remotely, participants present T-SBIRT case examples, discuss T-SBIRT practice themes, and raise T-SBIRT-related questions.

In September of 2021, Dr. Topitzes delivered a two-day T-SBIRT training workshop to health and human service prevention specialists in Dayton, Ohio. Thirty-five direct service or administrative professionals from six area agencies attended the event, sponsored by Montgomery County Alcohol, Drug Addiction, and Mental Health Services (ADAMHS). All agencies represented at the training received grant funding from ADAMHS, and many were planning to combine T-SBIRT with SBIRT services, a relatively common practice. According to evaluations completed by participants at the conclusion of the training workshop, participants found T-SBIRT to be very useful for their practice and were very satisfied with the training event. The participating agencies are currently completing the initial stages of implementation with the help of monthly consultation. If interested in learning more about T-SBIRT, please see the T-SBIRT Issue Brief or contact the Institute for Child and Family Well-Being.

Learn More:  

ICFW Webinar – T-SBIRT: An Introduction

ICFW T-SBIRT Demonstration Video


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Recent ICFW Publications

Mersky, J. P., Choi, C., Lee, C. P., & Janczewski, C. E. (2021). Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample. Child Abuse & Neglect, 117, 105066.

Mersky, J. P., Topitzes, J., Langlieb, J., & Dodge, K. A. (2021). Increasing mental health treatment access and equity through trauma-responsive care. American Journal of Orthopsychiatry.

Romain Dagenhardt, D., Mersky, J.P., Topitzes, J., Schubert, E., & Krushas, A. (2021). Assessing polyvictimization in a family justice center: Lessons learned from a demonstration project. Journal of Interpersonal Violence.


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


Evaluating Systems Change at the Organizational Level

By Kelah Hatcher and Luke Waldo

“Real and equitable progress requires exceptional attention to the detailed and often mundane work of noticing what is invisible to many.” – The Water of Systems Change.

Introduction

As demand for mental and behavioral health services has grown over the past decade and is projected to outpace growth of most sectors in the coming decade, mental and behavioral health organizations face complex challenges as to how to meet the needs of children and families. At Children’s Wisconsin, we have been implementing evidence-based therapies as one potential strategy and evaluating their impact over the past four years as part of a five-year Substance Abuse and Mental Health Services Administration (SAMHSA) grant.

The Trauma and Recovery Project (TARP) is a 5-year SAMHSA-funded initiative that aims to increase the availability and accessibility of trauma-responsive treatments for children and families in southeastern Wisconsin. Children’s Wisconsin’s Child and Family Counseling programs in southeastern Wisconsin form part of the project’s Center of Excellence (CoE), which consists of clinicians who have been trained in trauma-informed and evidence-based therapies and deliver these models to children and families. In order to demonstrate the impacts of the CoE to SAMHSA, clinicians must complete a National Outcomes Measures (NOMs) assessment at baseline, every six months, and discharge.

Presenting Challenge

During the third year of TARP, NOMs completion rates fell below 10% and the project was notified by SAMHSA that completion rates needed to improve to a benchmark of 80% or better. Clinicians face increasing and, at times, conflicting demands on their time and ability to focus on the care of their clients. By adding new assessments to their workflow, there may be a perception that their limited time with their client is being infringed upon even further. Consequently, an intense effort was made by leadership and CoE clinicians to increase completion rates. After a variety of systemic interventions, NOMs completion rates eventually reached a high of 82.1% in year four of the grant.

In order to learn how we addressed this challenge and improved our outcomes, we conducted interviews and surveys with grant managers, administrative staff, clinical supervisors, and CoE clinicians. We explored the six drivers of systems change to evaluate the factors involved in this process.

Six Drivers of System Change

Policies ♦ Resource Flow Relationships & Connections

According to Kania et al, policies include the “rules, regulations, and priorities that guide actions”. Resource flow is “how money, people, knowledge, information, and other assets such as infrastructure are allocated and distributed.” Relationships and connections are the “quality of connections and communication occurring among actors in the system, especially among those with differing histories and viewpoints.” Based on these conditions and feedback from clinicians, supervisors, and administrative support staff, the most significant impact on NOMs compliance was the addition of an administrative support staff member to manage the NOMs process across offices. Having an administrative staff member assigned to track compliance and offer support to clinicians centralized the process. The administrative support staff emailed the clinicians and their supervisors each month with upcoming NOMs due dates so they knew in advance what their NOMs workload would be. Each week, emails were sent to the clinicians individually reminding them what they needed to complete. The information including specific clinician, child, caregiver, and due dates made next steps very clear. The administrative support staff also entered all the NOMs into the SAMHSA database within one week of them being completed further reducing clinician burden. The policies, resource flow, and relationships and connections impacted by this change helped to improve NOMs completion by guiding actions, distributing information, centralizing core responsibilities, and ensuring quality communication.

Policies   Practices

A second area that contributed to improved NOMs completion was the adaptation of tools to increase accessibility and use. This involved the organizational policies that guide actions, and practice or the “activities targeted to improving social and environmental progress; and the procedures, guidelines, or informal shared habits that comprise their work.” NOMs was initially a long, printed assessment that was filled out by hand. When COVID-19 hit, SAMHSA converted it into a six-page word document that could be completed electronically. The electronic format caused issues with clinicians not being able to type in responses and check boxes, which created another barrier to timely completion. Consequently, our team modified the assessment to make it more user friendly. This included dividing the assessment into three separate measures to use at baseline, reassessment, and discharge. Finally, clinicians were not required to enter NOMs into a database and instead were able to email them directly to the administrative support staff upon completion. These tools and increased accessibility worked to simplify processes for all staff.

Relationships & Connections Power Dynamics

Another contribution to improved NOMs completion was increasing the accountability between clinicians and their supervisors. The relationships and connections involved in this process, and the power dynamics or “the distribution of decision-making power, authority, and both formal and informal influence among individuals and organizations” were central to creating change. Regular meetings were set up with supervisors to discuss NOMs completion. These meetings were designed to support the sites with their individual issues, empower supervisors to enhance their clinicians’ NOMs completion rates, and build a community of practice to meet SAMHSA requirements.

Mental Models

Mental models are deeply held beliefs that influence our behavior and are instrumental in making transformational change. In this case study, we asked the CoE clinicians about their attitude towards assessment-based interventions to learn more about barriers to completing NOMs. All thirteen clinicians who completed the survey reported that assessment-based interventions were important in their clinical practice. Working with clinicians who value assessment-based interventions likely contributed in a positive way to the increase in NOMs completion because the clinicians understood and valued the importance of the measure.

Conclusion

Organizational and system change can be tremendously complex. We believe that we must strive for ongoing improvement, but improvement without understanding what, how and why we improved is simply not enough. Through the evaluation of our small internal system change, we were able to engage clinicians, supervisors, and administrative support staff to determine that the most influential drivers of change were new policies, resource flows, and relationships and connections. By using the six conditions of systems change, we are able to identify the many factors that impact our ability to accomplish our objectives and, ideally, replicate similar efforts in the future for sustained improvements and success.

References

Kania, J., Kramer, M., & Senge, P. (2018). The Water of Systems Change. FSG, pp. 1-18.

Learn More:

National Outcomes Measure (for children)


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.


Presentations, Trainings and Workshops:

August 2021

PCIT National Biennial Convention – ICFW presented the following panels, symposia, papers and posters:

September 2021

September 15th: Brain Science and Self-Esteem Workshop for Foster Parents

December 2021

December 1st:  Mindfulness for the Family – Workshop for UWM’s Children’s Learning Center

ICFW Newsletter, Summer 2021

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.


In This Issue


Meet the ICFW Affiliates

As Community Engagement and Systems Change are a core pillar of the ICFW, collaboration with our community and systems partners is critical to fulfilling our mission. In recognition of those that value collaboration and whose mission seeks to improve child and family well-being, we have invited those partners to join us as ICFW Affiliates. We are honored to introduce our three newest ICFW Affiliates with whom we look forward to partnering with now and into the future.


Leah Jepson

Leah Jepson is the Project Director of the Milwaukee Coalition for Children’s Mental Health (CCMH) at Mental Health America of Wisconsin, an initiative to improve the mental health of children 0 – 8 in the City of Milwaukee through systems change and authentic engagement of people with lived experience. She is also the co-founder and Executive Co-Director at the Next Step Clinic, a community-based collaboration to address disparities in Autism Spectrum Disorder and children’s mental health identification and treatment. Leah has nearly 25 years’ experience as a social worker that includes home visitation, research, community-based program development and implementation, advocacy, and coalition-building. Her current focus is on young children’s mental health and social-emotional development, authentic engagement of those with lived experience, social justice and health equity.

Leah holds a Master’s of Science degree in Social Work and a Bachelor of Arts degree in Psychology, both from the University of Wisconsin-Milwaukee.

Leah has collaborated with ICFW through the Milwaukee Coalition for Children’s Mental Health to align action and values around children’s mental health, bringing in ICFW staff to provide presentations for coalition members. Leah served on an expert panel for the ICFW webinar, Authentic Community Engagement: Made in Milwaukee. Most recently, we collaborated with ICFW through the Next Step Clinic. When the clinic was first opening, Dr. Topitzes joined the team to advise clinic leadership on the manifestations of childhood trauma in the children that are served by the clinic. The ICFW team has also trained Next Step Clinic clinicians in Parent-Child Interaction Therapy through the Trauma and Recovery Project.


Jennifer Winkler

Jennifer Winkler is currently the Family Case Management Well-Being & Family Support Manager at Children’s Wisconsin, where she has worked for the last 12 years in various direct practice and leadership positions within the agency. Throughout her career, Jennifer has demonstrated passion around staff and program development, continuous quality improvement efforts, and building an organizational culture that is rich in innovation.

Jennifer received a Bachelor of Arts degree from Carthage College in 2006, with a major in Social Work, and a Master’s of Social Work from the University of Wisconsin-Madison in 2007, with a specialization in child and family welfare.

The ICFW team has worked collaboratively with Jen to conduct a human-centered design process that led to the adaptation and implementation of Mobility Mentoring® (MM) into Milwaukee’s Family Support Program. Jen has continued to collaborate with the ICFW to engage and interview her staff and the families that they serve to evaluate the effectiveness of and opportunities to improve MM. Additionally, Jen has co-presented with ICFW at regional and national conferences, and advocated for MM and strategic adaptation which has inspired other Children’s programs to begin implementation of the model.


Program Design & Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.

Minecraft® to Build Our Children’s Social Skills

By Meghan Christian

A virtual game-based, social skills group recently completed its first prototype iteration. The group planned to improve social and emotional skills such as social communication, cooperation, problem solving, and self-control. For 6 weeks, children ranging from 6.5 to 13 years old gathered on Zoom with a Mental Health Consultant for a brief didactic lesson on a specific social skill, and then the group played the video game Minecraft® to practice and develop the skill.

There was initially a group of 9, with 8 finishing the group. A few participants missed 2 groups meetings in the middle weeks. Although technical problems were frustrating to the facilitator and the participants in the beginning, the participants did not note this as a barrier on a post-group survey. Weekly email touch points with caregivers were provided by the facilitator and the use of the Manatee app was expected, however, low enrollment in the app and lack of engagement with this app by parents and staff found this not to be a useful tool in tracking progress. Of those who responded to a feedback request, all (children and parents alike) agreed the group was a useful way to spend their time and felt the group helped them improve their social skills. One child respondent and the facilitator shared they hope the group can run longer each week in the future. In fact, as the weeks went by, the children often preferred to continue interacting with each other in the game world after group time had ended. Some lessons learned garnered through the use of an After Action Review completed by staff suggested that a mixed level of familiarity with Minecraft® actually facilitated more opportunities to practice adaptive social skills and strongly indicated the need for a facilitator workflow to be documented so another facilitator could recreate or step in, if necessary. Also suggested by staff was splitting the age groups up, although the children respondents did not mention this.

In future iterations, ICFW will continue to work on supply chain issues brought on by COVID-19 to make a standardized pre and post assessment a part of the intake and discharge process in order to gather data on efficacy, likely implement a 90 minute group instead of 60 minutes, have a written workflow for the facilitator, and expand the referral opportunity to all children in the state.

For more context, see the original briefing in the Spring 2021 newsletter. If you are interested in referring a child to a future group, please email mchristian@chw.org.

Learn More:

ICFW Practice Brief – After Action Review
ICFW Practice Brief – Strategic Learning
Raelene Dundon


Utilizing Technology for Continued Evidence-Based Clinical Training
By Kate C. Bennett, LCSW

With support from the Trauma & Recovery Project, a 5-year SAMHSA-funded initiative that aims to increase the availability and accessibility of trauma-responsive treatments in southeastern Wisconsin, the ICFW has continued to collaborating with partner agencies to disseminate Parent-Child Interaction Therapy (PCIT) to families Milwaukee, Racine, and surrounding southeastern Wisconsin counties.

This summer, PCIT International certified trainers from Children’s Wisconsin/ICFW and Washington County Health and Human Services facilitated the second annual virtual Wisconsin Regional PCIT Initial Therapist Training for 9 newly trained clinicians. Each clinician participated in 40 total hours of didactic evidence-based workshops over Zoom videoconferencing during learning sessions held in May and July 2021. All trained clinicians will be providing the evidence-based intervention to families under consultation with our trainers through May 2022.

Please help us in welcoming each clinician to our Wisconsin Regional PCIT community!

Beth Strickland, LCSW – PSG (Washington County)
Stacey Davison, LCSW – PSG (Washington County)
Amber Stroud, LPC – Pediatric Psychology Associates (Milwaukee County)
Cathy Brown, LPC – Children’s Wisconsin (Milwaukee County)
Lauren Miller, LPC – Children’s Wisconsin (Milwaukee County)
Leann Vice-Reshel, PsyD, LPC – Children’s Wisconsin (Milwaukee County)
McKenzie Rehm, LPC – Children’s Wisconsin (Milwaukee County)
Michelle Jerard, LPC – Children’s Wisconsin (Milwaukee County)
Kelah Hatcher, MSW Student – University of Wisconsin Milwaukee / Children’s Wisconsin (Milwaukee County)

Learn More

Children’s Wisconsin Telehealth: Video Visits
PCIT at ICFW


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.

A Brief Measure of Work Environment for Human Service Organizations

By Colleen Janczewski

The Measure of Work Environment (MWE) is a new, brief instrument developed to assess work environment in human service agencies. The MWE demonstrated good internal consistency when tested with staff from child welfare and home visiting agencies. With an administration time of less than five minutes, the MWE offers applied researchers and evaluators an efficient method to assess and compare organizational functioning. It may also provide program administrators insight into specific areas of improvement.

 

Learn More:

Publication – Human Service Organizations: Management, Leadership & Governance.
Tool – Measure of Work Environment


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

Presentations, Trainings and Workshops:

May and July 2021:

PCIT Therapist Training

August 2021:

PCIT National Biennial Convention

Jennifer Winkler

ICFW Affiliate
Children’s Wisconsin

Jennifer Winkler is currently the Family Case Management Well-Being & Family Support Manager at Children’s Wisconsin, where she has worked for the last 12 years in various direct practice and leadership positions within the agency. Throughout her career, Jennifer has demonstrated passion around staff and program development, continuous quality improvement efforts, and building an organizational culture that is rich in innovation.

Jennifer received a Bachelor of Arts degree from Carthage College in 2006, with a major in Social Work, and a Master’s of Social Work from the University of Wisconsin-Madison in 2007, with a specialization in child and family welfare.

Leah Jepson

ICFW Affiliate
Mental Health America
Milwaukee Coalition for Children’s Mental Health

Leah Jepson is the Project Director of the Milwaukee Coalition for Children’s Mental Health (CCMH) at Mental Health America of Wisconsin, an initiative to improve the mental health of children 0 – 8 in the City of Milwaukee through systems change and authentic engagement of people with lived experience. She is also the co-founder and Executive Co-Director at the Next Step Clinic, a community-based collaboration to address disparities in Autism Spectrum Disorder and children’s mental health identification and treatment. Leah has nearly 25 years’ experience as a social worker that includes home visitation, research, community-based program development and implementation, advocacy, and coalition-building. Her current focus is on young children’s mental health and social-emotional development, authentic engagement of those with lived experience, social justice and health equity.

Leah holds a Master’s of Science degree in Social Work and a Bachelor of Arts degree in Psychology, both from the University of Wisconsin-Milwaukee.

ICFW Newsletter, Spring 2021

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.


In This Issue


Reflections on Our 5th Anniversary

A Message from Our Co-Directors, Gabe McGaughey and Josh Mersky

This newsletter marks the fifth anniversary of the Institute for Child and Family Well-being. As we reflect on the past five years, we are humbled by the opportunities we have had to join many others who are dedicated to strengthening families and nurturing children. Our community-university partnership emerged from a shared commitment to promoting the well-being of all children and families and to addressing barriers that result in unequal access to the best available care. We do so by translating the science of what works into prevention and intervention strategies that are effective in the real world. Central to this process is the relationships that are present in communities, organizations, and systems with whom we work with to integrate effective, culturally responsive, and sustainable solutions. The list of agencies and stakeholders who deserve our gratitude is too long to acknowledge here, but we invite you to check out our project pages where you will find many of our key partners.

As we look to the future, our aim is to strengthen these alliances and forge new community connections that are necessary to disseminate effective strategies and produce lasting systems change. In that spirit, we will be organizing a series of events over the next year to support the exchanging of information, building relationships, and translating knowledge into action. We hosted our first event in April to highlight our Program Design and Implementation efforts with group-based, telehealth therapy. To learn more about upcoming events, follow us on social media, visit our website, and subscribe to our newsletter.

We hope that you will join us!


Meet the ICFW Affiliates

As Community Engagement and Systems Change are a core pillar of the ICFW, collaboration with our community and systems partners is critical to fulfilling our mission. In recognition of those that value collaboration and whose mission seeks to improve child and family well-being, we have invited those partners to join us as ICFW Affiliates. We are honored to introduce our three newest ICFW Affiliates with whom we look forward to partnering with now and into the future.


Dr. Julian Ford, Ph.D., A.B.P.P.

Dr. Ford is a board certified clinical psychologist and Professor of Psychiatry and Law at the University of Connecticut where he directs two Treatment and Services Adaptation Centers in the National Child Traumatic Stress Network: the Center for Trauma Recovery and Juvenile Justice and the Center for the Treatment of Developmental Trauma Disorders. Dr. Ford is past President of the International Society for Traumatic Stress Studies, and a Fellow of the American Psychological Association. He has published more than 250 articles and book chapters and is the author or editor of 10 books, including Posttraumatic Stress Disorder, 2nd Edition, Treating Complex Trauma: A Sequenced, Relationship-Based Approach, 2nd Edition, Treating Complex Traumatic Stress Disorders in Children and Adolescents: Scientific Foundations and Therapeutic Models, and Critical Moments: Transforming Crises into Turning Points in Psychotherapy.  Dr. Ford is the Principal Investigator for the national Developmental Trauma Disorder Field trial research study, and  developed and has conducted randomized clinical trial and effectiveness studies with the Trauma Affect Regulation: Guide for Education and Therapy (TARGET©) model for youths and adults with developmental trauma histories and complex PTSD.

ICFW leaders have collaborated with Dr. Julian Ford, an international leader in traumatic stress studies, on several occasions. First, Dr. Ford served as an expert consultant during initial implementation of the trauma screening, brief intervention, and referral to treatment (T-SBIRT) protocol. Subsequently, he co-authored the initial T-SBIRT feasibility study that Dr. Topitzes published in 2017 along with Dr. Mersky (Topitzes et al., 2017).  Second, Dr. Ford presented his trauma counseling model for youth, TARGET, in a symposium led by Dr. Mersky at the Society for Social Work and Research 2018 annual conference. Dedicated to exploring new frontiers in trauma research, the symposium included presentations delivered by Drs. Mersky and Topitzes.  Future collaborations might center on the continued development of the T-SBIRT and TARGET models.


Clarence Johnson

Mr. Clarence Johnson is currently serving as the Executive Director of Wisconsin Community Services. The mission of WCS is to advocate for justice and community safety, providing innovative opportunities for individuals to overcome adversity. Mr. Johnson was instrumental in leading the effort that resulted in the WCS Center for Driver’s License Recovery being named as one of Mutual of America’s three national 2019 Community Partnership Award winners. Clarence also brought Community Building Milwaukee to WCS, which involves numerous agencies, institutions and organizations across the Milwaukee community serving, youth and adults.

Mr. Johnson believes the key ingredients to effective and successful leadership include holding yourself accountable to the highest standards of performance and empowering and supporting others to reach for their highest level of effectiveness. As one of the most experienced African American nonprofit leaders in the Milwaukee area, he has helped shape the future of several nonprofit organizations in the Milwaukee Community and is held in high regard in many circles. During his long and distinguished career, Mr. Johnson has served on over 20 nonprofit boards and remains an active member of the Milwaukee area community. He was recently elected to the board of directors of the Wisconsin Association of Family and Children’s agencies and also serves as a board member for NAMI Southeast Wisconsin.

Mr. Johnson is a lifelong resident of city of Milwaukee and earned both his undergraduate and graduate degree from the University of Wisconsin-Milwaukee. He has worked on several research projects during his career and began a program to reduce the incidence of obesity and chronic disease among central youth. Working for over 35 years in Social Services, Mr. Johnson has served as Executive Director of Neighborhood House of Milwaukee, Chief Operating Officer for YW Works, and as a high level manager for Milwaukee County Department of Health and Social Services.

ICFW leaders have worked directly with Mr. Johnson in several capacities. Dr. Topitzes, for instance, serves on the WCS board of directors and on several project-based work groups overseen by WCS and Mr. Johnson, including the Community Building Milwaukee Steering Committee.


Dr. Christy Warner-Metzger

Christina Warner-Metzger, Ph.D., hails from Oklahoma State University with a doctorate in Clinical Psychology. True to her organization’s motto of Doing good and doing it wellTM, Dr. Warner-Metzger founded Evidence-based Practices and International Consulting (EPIC), LLC, to promote increased accessibility and excellence in professional training, consultation, and program development within the mental health and wellness sector. With a focus on training culturally humble and socially responsible professionals, she also directs the Parent-Child Interaction Therapy (PCIT) Program and Early Assessment and Recommendations for Learning in Young Children (EARLY) Clinic at DePaul University’s Family and Community Services. She is 1 of 21 PCIT International Certified Global Trainers worldwide and a Child-Adult Relationship Enhancement (CARE) co-developer, which provides her with clinical expertise in PCIT and CARE training and dissemination. Dr. Warner-Metzger is also the co-developer of a project piloting Trauma-Directed Interaction (TDI) with young children. She has served as a trainer and consultant for dissemination efforts across the United States, as well as Indonesia and Australia. Her contributions as an expert trainer and consultant on institutional, regional, federal, and international grant-funded projects has spanned the greater part of the past decade.

She is also experienced using the National Child Traumatic Stress Network (NCTSN) Learning Collaborative model. Dr. Warner-Metzger’s clinical and research interests include Autism Spectrum Disorders (ASD), developmental disabilities, disruptive behavior disorders, trauma-informed systems, underserved populations, barriers to treatment participation, and dissemination efforts. She has contributed to these topics through numerous peer-reviewed and invited presentations at national and international conferences, as well as authored peer-reviewed journal articles, government publications, and edited book chapters. Her previous clinical work in Memphis and current work in Chicago has focused on serving urban populations experiencing economic and racial marginalization.

ICFW leaders and clinicians, Dimitri Topitzes, Kate Bennett, and Leah Cerwin have worked closely with Dr. Warner-Metzger in their continuing development as certified PCIT International Within-Agency and Regional Trainers as part of the Trauma & Recovery Project. Dr. Warner-Metzger has also co-facilitated PCIT Therapist Trainings with our team in Milwaukee and as part of a statewide dissemination project in Utah.


ICFW Recognition

 

 

Congratulations to Ross Gilbert on matching for his residency in Internal Medicine and Pediatrics at Johns Hopkins Medicine-Pediatrics Urban Health Residency Program in Baltimore, Maryland. Ross has worked with the ICFW as a fellow through the TRIUMPH program while completing medical school at UW-Madison.

 

 


 

 

Congratulations to Mary Kusch on her acceptance to the Wisconsin Population Health Service Fellowship Program. She will be placed with the Wisconsin Division of Public Health, Bureau of Environmental and Occupational Health. Mary has worked with the ICFW as a research assistant while completing her master’s degree at the UWM Zilber School of Public Health.

 

 


Program Design & Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.

Minecraft® to Build Our Children’s Social Skills

By Meghan Christian

The Institute for Child and Family Well-Being consulted with Children’s Wisconsin professionals across the state to develop Community Services’ COVID Resilience Plan. During this process, a collaboration between Black River Falls Family Support Prevention Program and the ICFW resulted in a virtual, game-based social skill building group opening up to children statewide. This program is designed to help youth acquire social and communication skills to help them interact with others more successfully.

Minecraft® and the work of Australian psychologist Raelene Dundon are used by a Family Support Specialist in secure video teleconferencing software currently in a 1:1 format. This will be the first iteration of using groups and inviting children from all over Wisconsin. The program will target the improvement of social and emotional skills such as social communication, cooperation, problem solving, and self-control. Weekly touch points with caregivers and the use of the Manatee app will help monitor goals and foster communication between the provider and caregivers. Our Before Action Review was used to help create workflows, determine how to collect data and set goals. An After Action Review will be used to log design learning, propose improvements and assess for possible scalability. In future iterations, data will be gathered on executive functioning pre and post completion to examine possible correlations between participation in group and improved functioning.

If you would like more information on referring a child, please email mchristian@chw.org.

Learn More:

ICFW Practice Brief – After Action Reviews
ICFW Practice Brief – Strategic Learning
Raelene Dundon


Parenting with P.R.I.D.E. and Web-based Assessments

By Kate Bennett

As the ICFW clinical team continues to work toward improved iterations of group-based intervention modifications, we are reminded that successful program design and implementation relies on collecting and analyzing quality data. While data is critical for program analysis, it is also one of the cornerstones of Parent-Child Interaction Therapy (PCIT) treatment and the multifamily Parenting with P.R.I.D.E. intervention.

The screening and assessment tools typically applied in PCIT are accessible for use at Children’s Wisconsin and include the following:

  • Eyberg Child Behavior Inventory (ECBI; Eyberg & Pincus, 1999)
  • Child Behavior Checklist for ages 1.5-5 and ages 6-18 (CBCL; Achenbach & Rescorla, 2001)
  • Dyadic Parent–Child Interaction Coding System, Fourth Edition (DPICS‑IV; Eyberg et al., 2013)
  • Parenting Stress Index, Fourth Edition: Short Form (PSI‑4: SF; Abidin, 2012).

Because the ongoing administration and analysis of each of these assessments results are critical to individual patient/family treatment and the overall program evaluation, our clinicians have been piloting the use of web-based assessment forms. Our purpose in moving to electronic administration and scoring is to enhance convenience for both clinicians and families as we continue forward with telehealth delivery of Parenting with P.R.I.D.E. and other trauma-based treatment groups. For example, web-based administration of the ECBI through Psychological Assessment Resources allows a parent/caregiver to report on child behavioral observations on a weekly basis from their phone or laptop throughout the duration of treatment. Form completion takes approximately 5 minutes for a respondent and is entered within 24 hours prior to the family checking into a therapy session. The assigned clinician receives the assessment results in real-time. This allows for more focused time in treatment, and additionally contributes to the fidelity of goal-directed services for families.

Our intention is to continue to pilot the use of web-based screening and assessment tools for ease of caregiver completion, immediate scoring, and automatic skill progress tracking throughout treatment for PCIT and other evidence-based treatments. We look forward to sharing our findings and feedback from families in coming newsletters and reports.

References:
Abidin, R. R. (2012). Parenting stress index–fourth edition (PSI-4). Lutz, FL: Psychological Assessment Resources.
Achenbach, T.M., & Rescorla, L.A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Eyberg, S., & Pincus, D. (1999). Eyberg child behavior inventory & Sutter-Eyberg student behavior inventory-revised: Professional manual. Psychological Assessment Resources.
Eyberg, S. M., Nelson, M. M., Ginn, N. C., Bhuiyan, N., & Boggs, S. R. (2013). Dyadic parent–child interaction coding system, 4th edition (DPICS-IV) comprehensive manual for research and training. Gainesville, FL: PCIT International.

Learn More:
Psychological Assessment Resources
Achenbach System of Empirically Based Assessment
PCIT International


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Milwaukee Equity Action Plan

By Dimitri Topitzes

Leaders at the Institute for Child and Family Well-Being at UWM are collaborating with the Wisconsin Department of Workforce Development, Division of Vocational Rehabilitation (DVR) to develop, implement and test a consumer quality improvement plan at the Milwaukee central city location. This initiative builds on an extensive consumer service review that DVR conducted in 2019. Stakeholder interviews revealed that Milwaukee-area DVR consumers, the majority of whom are Black Americans, face multiple barriers to effective service engagement and completion. These include extreme poverty resulting from structural racism, significant distress due to current and historical trauma, and poor service access owing to organizational policies and procedures. Titled the Milwaukee Equity Action Plan, the consumer quality improvement plan aims to enhance the culturally responsive and trauma-informed nature of DVR consumer services.

Members of the Institute’s team for the Milwaukee Equity Action Plan project will help translate insights from the field and results from DVR’s consumer service review into a viable quality improvement plan. The Institute team will also develop and execute an evaluation plan to help DVR gauge progress toward consumer service goals and adjust the quality improvement plan as needed. In addition, the team will help DVR develop a sustainable, high quality consumer service model that reflects its values.

Learn More:

Milwaukee Equity Action Plan


Recent ICFW Publications

Practice Brief: COVID Resilience Plan for Nonprofits

Gilbert, R., Mersky, J. P., & Plummer Lee, C. (2021). Prevalence and correlates of vaccine hesitancy in a sample of low-income mothers. Preventive Medicine Reports, 21, 101292

Mueller, D., Bacalso, E., Ortega-Williams, A., Pate, D. J., & Topitzes, J. (in press). A mutual process of healing self and healing the community: A qualitative study of coping with and healing from stress, adversity and trauma among diverse residents of a midwestern city. Journal of Community Psychology.

The Impact of the COVID-19 Pandemic on Maternal Mental Health –  Meghan Majors from the 2021 (virtual) UWM Health Research Symposium. 


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


Seeking Solutions for Youth Aging Out of Foster Care

By Luke Waldo

In November 2020, Children’s Wisconsin’s and collaborating partners, Wisconsin Department of Children and Families and Bay Area Workforce Development Board, began working on a planning grant to facilitate a community assessment to determine the causes of poor outcomes for youth between the ages of 18-24 who are aging out of foster care and to propose targeted solutions. The assessment surveyed the region’s strengths, resources, needs and gaps as they relate to the population of youth transitioning to adulthood in Northeastern Wisconsin.

Through these collective efforts, the long-term goal is to provide a pathway to independence by strengthening youths’ resiliency and equipping them with the knowledge and skills necessary to become self-sufficient, build a strong support network, achieve educational and/or job training goals to earn a living wage, and maintain safe and stable housing.

Over four months, insights were gathered from leaders, staff and administrators working within the region’s Independent Living systems, as well as from youth and young adults who have received services through those systems. We used a human-centered design approach in the development of the assessment. A core planning team consisting of representatives from the following organizations and groups developed the assessment:

  • Wisconsin Department of Children and Families – Independent Living Program
  • Bay Area Workforce Development Board – Region II Independent Living Service Providers
  • Youth Advisory Council – Youth who have been involved with child welfare systems

Data were collected through surveys, focus groups and literature review.

Surveys

Between the youth/young adult and provider surveys, there were areas of strong consensus and divergence in the responses noted in Table 1. Consensus occurred when youth and provider responses had strong consensus within and across groups. Divergence occurred when strong consensus was present in one of the surveyed groups but not the other.

Table 1:


Focus Groups

Focus Groups were conducted over 90 minutes on Zoom due to COVID-19 safety and health requirements. Participants were asked a series of questions and were provided between 1-3 minutes to individually reply in the Chat box. Upon completing individual brainstorming, the facilitators identified themes and asked participants to elaborate on those themes and ideas. Between the youth/young adult and provider focus groups, there were areas of strong consensus and divergence noted in Table 2.

Table 2:

Lessons Learned: The Importance of Mental Health and Supportive Relationships

During our assessment, we came back to a number of key questions for youth and providers in response to the prioritization of mental health. Do youth today have more mental health needs, or are we just more aware of those needs? Are housing and financial stability less important to youth today, or do youth prioritize them lower than mental health in recognition that they are much more difficult to obtain and maintain when they are struggling with mental health issues?

While elaborating on why mental health is a bigger concern than it may have been in the past, one of our youth team members said that managing overwhelming feelings and stress is harder to manage than the initial cause of the stress (i.e. relationship or financial issues). She expressed that there might be a generation gap as it was not previously “acceptable” to talk about mental health.

Throughout this assessment, we have heard how having a trusted, supportive person to talk to, even if they aren’t a mental health professional, can be beneficial in strengthening youth’s executive functioning (i.e. enhancing coping and organizational skills). Ultimately, we see potential for meaningful impact by training service providers in trauma, mental health and strengths-based engagement so that they may support youth’s mental well-being and executive functioning, while not expecting them to serve as mental health professionals for youth.

During the final phase of this planning grant, we will develop and identify solutions that align with the lessons learned from the regional assessment. Our final analysis and proposed solutions will be delivered to the regional funder, Oshkosh Area Community Foundation, and the grant partners for future funding and implementation consideration.


Children’s Mental Health in Times of COVID: Interviews with ICFW Clinicians

By ICFW Interns – Paige Bintz, Kelah Hatcher, and Johanna Nelson (photos in order)

While the ICFW clinicians were adapting their therapy to virtual platforms in response to the COVID crisis, the need for Parent-Child Interaction Therapy (PCIT) was growing. From the end of in-person visits until the start of virtual therapy in May, a significant waitlist had developed. The stress related to COVID-19 seemed to have created and exacerbated mental health issues for children and their families.

Early on in virtual therapy, clinicians noticed an increase in externalizing behaviors for both caregivers and children. Irritability, animosity, and jealousy towards siblings were some of the commonly reported behaviors that clinicians saw in response to children adjusting to COVID-19. Family relationships also were impacted due to increased time spent together while kids were doing school virtually and caregivers worked from home or had lost their jobs. Consequently, caregivers reported more conflicts with their children and between siblings.

Several months into the pandemic, the clinicians began hearing caregivers attributing their children’s challenges directly to the impact of COVID-19. Our clinicians noted an increase in internalizing behavior such as fatigue, anxiety, and depression in children. Symptoms of social anxiety or anxiety around getting sick were also reported more often than previously.

The effect of the pandemic on children’s school experience has varied based on numerous factors. Younger children have struggled more with remaining attentive during virtual learning, while older children have suffered from the lack of social interaction with their peers. For families with multiple children, a lack of consistency between virtual and in-person learning for different age groups has also presented a challenge. However, children are more resilient than we often realize, and the support provided by their families and teachers can make a big difference.

Children of all ages had to adjust to virtual learning and then back to hybrid or fully in-person learning. Virtual learning is unfortunately less cooperative, and older students have shared that they have been stressed by an increase in assignments. More students than usual are “behind”, and while eager to see their friends and teachers, they may not want to return to in-person school if it’s not the same as before. It’s difficult to predict if there will be a long-term impact on social skills, especially for younger children, but so far there is no indication of that. Conversely, a lack of closure for older students, especially seniors, has been disappointing, but again their experience was often dependent on how their school supported them.

The clinicians are noticing that the grief process has been intense for children and families who have experienced loss (i.e. death of a family member, employment, normalcy with school, social life, etc.). They are having to identify loss and know what it looks like, which can be difficult without social interaction. Without social situations due to the pandemic, children are having a harder time developing empathy and different point of views which is strengthened through interaction. Children are being siloed into basic emotional words but grief is a continuous cycle that is more complex than “sad” or “mad”. Caregivers can have difficulty with this too. With a noticeable increase in parental stress, there may be “shorter fuses”. Caregivers are going into survival mode, trying to keep their children safe from disease as well as maintain the mental and economic well-being of their family. Clinicians are noticing that parental response to children’s grief along with their own is key to process the past year and build emotional awareness.

All of this stress and grief seems to have reached an equilibrium due to telehealth, according to the clinicians. Mental health services have become more accessible with the push to virtual formats. Clients do not need to worry about childcare, transportation, or other barriers when seeing their care provider from the comfort of their own home. Families are more willing to reach out for help online. Because of this, clinicians push for more agency leaders, insurance companies, and other services to keep telehealth options and increase accessibility for families in need post pandemic. This way caregivers can focus on the relationships they build with their children, managing emotions and behaviors, responding to uncertainty, and building resilience.

The ICFW Clinicians’ Tips to Building Resilience:

  1. Acknowledge the gravity and complexity of this past year

Encouraging emotional labeling with children is key to helping them understand what the pandemic is and how it has impacted them. Then focus on validation. Let the children know that this has an impact on everyone and they are not alone.

  1. Set up a conversation on boundaries and needs

Come together as a family and determine what boundaries need to be implemented in order to maintain emotional and physical well-being. Saying “no” can be difficult, but caregivers should emphasize self-care and what is best for the family. An example of a boundary could include electronic use because of the increased need for virtual access during the pandemic. Now may be a good time to develop a plan to return to basics or having conversations about healthy electronic use with children.

  1. Be mindful in reintroducing social situations

At this point of the pandemic, people are exhausted and social interaction can be overwhelming. To minimize the stress of this, set up a hierarchy of social stimulation and work your way upwards with the child. For example, this means starting with a walk around the block and working your way up to sitting in a classroom surrounded by other children. Overall, be proactive about creating a safe place and work in short bursts to make the transition smoother.

  1. Build a sense of routine

Caregivers should be mindful of preparing children for possible unknowns, but having a daily routine is key to dealing with tough situations like a pandemic. Caregivers could plan out the day and create visual charts, that way the children can tangibly see and check off accomplishments during the day. Make sure to praise for any adaptation that the child is going through and say that you are proud they are dealing with difficulty. Also, building the routine may be a great opportunity to set new and healthier habits that get back to family time.


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

ICFW 5th Anniversary – May 2021

Schedule of events to celebrate our anniversary year and highlight our efforts to achieve our mission will be announced soon on our website and social media.

ICFW Webinars:

April:

ICFW Webinar: Parenting with PRIDE – Designing Group-based, Telehealth Solutions with PCIT in Times of COVID

Presentations, Trainings and Workshops:

April:

Together for Children Conference: Vicarious Trauma: Honoring the Weight of our Work – Meghan Christian and Luke Waldo

Together for Children Conference: Asking Sensitive Questions: Effectively Assessing for Exposure to Trauma and Adversity – Kate Bennett and Dimitri Topitzes

May and July 2021:

PCIT Therapist Training

Christy Warner-Metzger, Ph.D

ICFW Affiliate
PCIT International Certified Global Trainer
Child-Adult Relationship Enhancement (CARE), Co-Developer
Evidence-based Practices & International Consulting (EPIC), LLC

Christina Warner-Metzger, Ph.D., hails from Oklahoma State University with a doctorate in Clinical Psychology. True to her organization’s motto of Doing good and doing it wellTM, Dr. Warner-Metzger founded Evidence-based Practices and International Consulting (EPIC), LLC, to promote increased accessibility and excellence in professional training, consultation, and program development within the mental health and wellness sector. With a focus on training culturally humble and socially responsible professionals, she also directs the Parent-Child Interaction Therapy (PCIT) Program and Early Assessment and Recommendations for Learning in Young Children (EARLY) Clinic at DePaul University’s Family and Community Services. She is 1 of 21 PCIT International Certified Global Trainers worldwide and a Child-Adult Relationship Enhancement (CARE) co-developer, which provides her with clinical expertise in PCIT and CARE training and dissemination. Dr. Warner-Metzger is also the co-developer of a project piloting Trauma-Directed Interaction (TDI) with young children. She has served as a trainer and consultant for dissemination efforts across the United States, as well as Indonesia and Australia. Her contributions as an expert trainer and consultant on institutional, regional, federal, and international grant-funded projects has spanned the greater part of the past decade.

She is also experienced using the National Child Traumatic Stress Network (NCTSN) Learning Collaborative model. Dr. Warner-Metzger’s clinical and research interests include Autism Spectrum Disorders (ASD), developmental disabilities, disruptive behavior disorders, trauma-informed systems, underserved populations, barriers to treatment participation, and dissemination efforts. She has contributed to these topics through numerous peer-reviewed and invited presentations at national and international conferences, as well as authored peer-reviewed journal articles, government publications, and edited book chapters. Her previous clinical work in Memphis and current work in Chicago has focused on serving urban populations experiencing economic and racial marginalization.

Julian D. Ford, Ph.D

ICFW Affiliate
Professor of Psychiatry and Law, University of Connecticut

Julian D. Ford, Ph.D., A.B.P.P. is a board certified clinical psychologist and Professor of Psychiatry and Law at the University of Connecticut where he directs two Treatment and Services Adaptation Centers in the National Child Traumatic Stress Network: the Center for Trauma Recovery and Juvenile Justice and the Center for the Treatment of Developmental Trauma Disorders. Dr. Ford is past President of the International Society for Traumatic Stress Studies, and a Fellow of the American Psychological Association. He has published more than 250 articles and book chapters and is the author or editor of 10 books, including Posttraumatic Stress Disorder, 2nd Edition, Treating Complex Trauma: A Sequenced, Relationship-Based Approach, 2nd Edition, Treating Complex Traumatic Stress Disorders in Children and Adolescents: Scientific Foundations and Therapeutic Models, and Critical Moments: Transforming Crises into Turning Points in Psychotherapy.  Dr. Ford is the Principal Investigator for the national Developmental Trauma Disorder Field trial research study, and  developed and has conducted randomized clinical trial and effectiveness studies with the Trauma Affect Regulation: Guide for Education and Therapy (TARGET©) model for youths and adults with developmental trauma histories and complex PTSD.

Clarence Johnson

ICFW Affiliate
Executive Director, Wisconsin Community Services

Fueled by a lifelong commitment to leadership excellence in Human Services, Clarence Johnson has held many high-level positions since beginning his career decades ago. Clarence believes the key ingredients to effective and successful leadership include holding yourself accountable to the highest standards of performance and empowering and supporting others to reach for their highest level of effectiveness. As one of the most experienced African American nonprofit leaders in the Milwaukee area, Clarence has helped to shape the future of several nonprofit organizations in the Milwaukee Community and is held in high regard in many circles. During his long and distinguished career, Clarence has also served on over 20 nonprofit boards and remains an active member of the Milwaukee area community. Clarence was recently elected to the board of directors of the Wisconsin Association of Family and Children’s agencies and is also serving as a board member for NAMI Southeast Wisconsin.

Mr. Clarence Johnson is currently serving as the Executive Director of Wisconsin Community Services, a position he has held since January of 2017. Established in 1912, Wisconsin Community Services, Inc. (WCS) is a non-profit organization respected throughout the Milwaukee region and state of Wisconsin for its steadfast commitment to bettering the lives of individuals involved in, or at risk of becoming involved in, the criminal justice system. WCS provides services to more than 15,000 individuals each year through 40+ programs in southeastern Wisconsin. The mission of WCS is to advocate for justice and community safety, providing innovative opportunities for individuals to overcome adversity. Since assuming top leadership role at WCS, Clarence has led the organization to a 62% increase in revenue (from 24 million to 40 million dollars), and significantly expanded the number of programs offered by the agency. Johnson was also instrumental in leading the effort that which resulted in the WCS Center for Driver’s License Recovery being named as one of Mutual of America’s three national 2019 Community Partnership Award winners. A national award that honors the outstanding contributions that nonprofit organizations, in partnership with public, private, and other social sector organizations, make to society.

Johnson joined Wisconsin Community Services in 2010 as the Associate Executive Director. In addition to providing high-level leadership, Johnson was then responsible for various programs and divisions, which helped to expand the work of WCS, and cultivate partnerships with community organizations and stakeholders. Clarence also brought Community Building Milwaukee to WCS, which involves numerous agencies, institutions and organizations across the Milwaukee community serving, youth and adults. Johnson is a lifelong resident of city of Milwaukee and earned both his undergraduate and graduate degree from the University of Wisconsin-Milwaukee. Has worked on several research projects during his career and began a program to reduce the incidence of obesity and chronic disease among central youth. A program that is now offered city-wide. Working for over 35 years in Social Services, Johnson has extensive experience working in and leading nonprofit, government, and human/social services agencies in the Milwaukee area. Prior to his time at WCS, he served as  Executive Director of Neighborhood House of Milwaukee, Chief Operating Officer for YW Works (then subsidiary of the YWCA), and spent several years as a high level manager for Milwaukee County Department of Health and Social Services.

Parenting with PRIDE – Designing Group-based, Telehealth Solutions with PCIT in Times of COVID

The Institute for Child and Family Well-Being was proud to host the webinar “Parenting with PRIDE – Designing Group-based, Telehealth Solutions with PCIT in Times of COVID” with Haley Challoner Miller, Child and Family Therapist II, and Kate Bennett, Well-Being Lead Clinician, on April 14, 2021 from 12:30-1:30PM CST.

One of the most profound and noticeable effects of the COVID-19 pandemic, aside from the toll on the physical health of individuals and families, is the impact on the mental health of individuals, specifically in children. Inconsistency in school models, pressures put upon caregivers due to loss of or changes in employment, illness or death of family members, and the stress of family isolation and lack of support led to a rush of referrals and a building waitlist of families looking for mental health treatment for their children at Children’s Wisconsin.

Parent Child Interaction Therapy (PCIT) has been referred to by experts as the “gold standard” treatment for children with disruptive behaviors, and is a well-known, well-researched evidence-based treatment for children with behavioral difficulties and adjustment disorders. In order to meet the growing need for PCIT services, Institute for Child and Family Well-being clinicians at Children’s Wisconsin designed and implemented a program that administers core components of PCIT in a group setting by way of telehealth, to reach larger numbers of families in a safe and effective way.

In this webinar, Leah Cerwin discussed the following with Ms. Bennett and Ms. Miller:

  • The challenges and opportunities that led to the design of a program to provide PCIT in a group setting, by way of telehealth;
  • The Program Design and Implementation process by which the program was created, and how it was administered to families;
  • How Parenting with PRIDE is a change maker for families, and what effects are seen after completion of the program.

Listen to the recorded webinar here.

Related Resources from the ICFW

ICFW Newsletter – Winter 2021: Parenting with PRIDE

Practice Brief: Internet-based PCIT: Beyond the Pandemic

Wisconsin Regional PCIT Therapist Training

PCIT & Child Welfare Webinar

Integrating PCIT into Child Welfare Programs

Webinar PowerPoint Presentation

Related Resources from PCIT International

PCIT International – Wisconsin Certified Therapists

Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status

Mersky, J. P., Choi, C., Plummer Lee, C, & Janczewski, C. E. (2021). Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample. Child Abuse & Neglect.

Abstract

Background
Adverse childhood experiences (ACEs) are disturbingly common and consequential. Priority should be given to identifying populations that bear a disproportionate share of the burden of ACEs, but such disparities have received limited attention to date.

Objective
This study analyzes data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample in the U.S., to explore variation in ACEs by race/ethnicity, economic status, and gender.

Methods
In addition to using conventional statistical methods to generate unadjusted and adjusted estimates, we conduct an intercategorical intersectional analysis of variation in ACEs using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).

Results
Descriptively, we find that ACEs are more prevalent overall among the poor than the non-poor, among most racial/ethnic minority groups than non-Hispanic Whites, and among females than males. However, multivariate regression results indicate that gender is not a robust correlate of cumulative adversity and that economic status moderates racial/ethnic differences. MAIHDA models further expose heterogeneity in aggregate ACE scores between intersectional strata representing unique combinations of gender, race/ethnicity, and economic status.

Conclusions
The MAIHDA results confirm that conclusions based on unadjusted group differences may be spurious. While most variance in ACE scores is explained by additive main effects, accounting for intersections among social categories generates a more complex portrait of inequality. We compare our work to prior studies and discuss potential explanations for and implications of these findings for research on disparities.

Link to publication

A mutual process of healing self and healing the community

Mueller, D., Bacalso, E., Ortega-Williams, A., Pate, D. J., & Topitzes, J. (in press). A mutual process of healing self and healing the community: A qualitative study of coping with and healing from stress, adversity and trauma among diverse residents of a midwestern city.” Journal of Community Psychology.

Abstract

Residents of urban American neighborhoods facing economic hardship often experience individual and collective adversities at high levels. This study explores how racially diverse adults experience stress, adversity, and trauma, and how they cope and heal in the context of their environment. Following a critical realist grounded theory methodology, four focus groups were conducted with African American, White and Latinx participants (N = 21) within an employment service program. Participants identified key stressors ranging from financial and job challenges, violence, and trauma. To cope with and heal from adversity, they practiced positivity, named trauma and its effects, sought social connection, envisioned community‐based resources, and addressed structural and systemic barriers. The data generated a theory of “a mutual process of healing self and healing the community” through intrapersonal, interpersonal, and structural change. The results of this study indicate a need for peer‐led, community‐engaged initiatives and holistic, trauma‐informed, healing‐centered practices.

Link to publication

ICFW Newsletter, Winter 2021

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.


In This Issue


Meet the ICFW Affiliates

As Community Engagement and Systems Change are a core pillar of the ICFW, collaboration with our community and systems partners is critical to fulfilling our mission. In recognition of those that value collaboration and whose mission seeks to improve child and family well-being, we have invited those partners to join us as ICFW Affiliates. We are honored to introduce our three newest ICFW Affiliates with whom we look forward to partnering with now and into the future.


Jennifer A. Jones, MSW
Chief Strategy Officer, Prevent Child Abuse America

Jennifer Jones currently serves as the Chief Strategy Officer at Prevent Child Abuse America (PCAA) where she develops, implements and advocates for an integrated strategic framework to help grow PCAA’s leadership role consistent with national prevention priorities, and serves as the lead on regional and national strategic partnerships. Prior to her role with PCAA, Jones was the Director of the Change in Mind Institute and the Co-Director of the Safety and Resilience Impact Area at the Alliance for Strong Families and Communities. As the Director of the Change in Mind Institute, she worked closely with ICFW Co-Director Gabe McGaughey as Children’s Wisconsin was one of the organizations that participated in the inaugural Change in Mind class. Since then, Jennifer has partnered with Gabe and Luke Waldo to present the impact of and findings from the Change in Mind experience at conferences across the country.

Jones led all aspects of the Institute, including raising $1.7 million for the Texas Change in Mind Learning Collaborative and National Impact Study. Jones also served as the Project Director of the Child Safety Forward Initiative, a three-year Department of Justice cooperative agreement working with 5 jurisdictions to develop community-led, systematic solutions to reduce child fatalities caused by child maltreatment. Jones worked closely with the Alliance policy team, other national organizations and congressional representatives to advance brain science infused policy and trauma-informed care legislation.

Preceding her role at the Alliance, Jones served as the Associate Director of the Wisconsin Children’s Trust Fund (CTF). In her last two years at the agency, Jones served as Interim Executive Director, at the Board’s request, and coordinated all activities related to the Governor-appointed Child Abuse and Neglect Prevention Board, including managing all operations, and overseeing the agency’s budget and grantmaking functions. Before her positions with the Children’s Trust Fund, Jennifer served as the communications specialist in the Secretary’s Office at the Wisconsin Department of Children and Families and as a child welfare policy advisor in the Wisconsin Division of Children and Family Services. Jones is also a member of the National HOPE (Healthy Outcomes from Positive Experiences) Advisory Board and serves on the Board of Directors of the Hunger Task Force.

Jennifer received her master’s in social work from the University of Wisconsin-Madison and bachelor’s in social work from Marquette University.


Dr. John Meurer
Professor and Institute for Health & Equity Director, Medical College of Wisconsin

John Meurer, MD, MBA is Professor and Director of the Medical College of Wisconsin Institute for Health & Equity. The mission of the Institute is to improve health and advance equity through research, education, and shared expertise by working collaboratively with local, national and global communities.

Dr. Meurer is a general pediatric clinician-educator and is academically recognized for his achievements in community-engaged research. He has a national reputation for research to improve childhood asthma and advance early childhood development and community-engaged health systems research. He has been a collaborative and transformative steward and leader of 25 Advancing a Healthier Wisconsin projects including 5 recently focused on improving early childhood developmental care systems.

Dr. Meurer worked closely with ICFW Co-Directors Gabe McGaughey and Josh Mersky on his Parent Education and Support Network that aimed to improve early childhood developmental screening and assessment along with improved practices in data monitoring and integration. More recently, he co-led the Scaling Wellness in Milwaukee (SWIM) Policy Action Team with Gabe.

He holds a medical degree from the University of Wisconsin-Madison, completed his residency at Baylor College of Medicine, Houston, Texas, attained a master of business degree from Northwestern University, and was a fellow with the David Winston Program, Washington DC.


Carmen Pitre
President & CEO, Sojourner

Carmen Pitre is the President and Chief Executive Officer of Sojourner, Wisconsin’s largest service provider for families dealing with domestic violence. Under Pitre’s leadership, Sojourner provides crisis housing, system advocacy and individual support to thousands of women, children and families.

Carmen and her team at Sojourner worked closely with ICFW Co-Director Josh Mersky and Clinical Director Dimitri Topitzes to develop and administer a polyvictimization screening tool with clients that receive services from the Sojourner Family Peace Center. Subsequently, Carmen and her team have remained strong partners with the ICFW in the pursuit of collaborative community efforts through initiatives like Scaling Wellness in Milwaukee.

Pitre draws on decades of work and personal experience to improve the way the community supports families impacted by domestic violence. Pitre believes – and data proves – a holistic approach of co-locating services and coordinating resources is effective, efficient and yields better outcomes for families. In 2016, Pitre rallied key community leaders to create the Sojourner Family Peace Center where people impacted by domestic violence can access emergency shelter, domestic violence services, physical and mental health services, law enforcement and legal assistance, counseling, employment services, financial literacy, community education and professional training – all under one roof.

Pitre was integral in the 2009 merger of Sojourner Truth House and the Task Force on Family Violence when she became Co-Executive Director of the new agency, Sojourner Family Peace Center. Before the merger, Pitre was the Executive Director of the Task Force on Family Violence from 2002 to 2009. Pitre served as the Director of the First Judicial District Judicial Oversight Demonstration Initiative and the Coordinator of the Milwaukee Commission on Domestic Violence and Sexual Assault from 1997 to 2000.

Pitre graduated from the University of Southwestern Louisiana – Bachelor of Arts program in 1984.


Program Design & Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.

Parenting with P.R.I.D.E. – Group-based, Virtual Parent-Child Interaction Therapy

By Kate Bennett and Haley Challoner Miller

Due to the COVID-19 pandemic, we recognize that it is imperative to meet the mental and behavioral health needs of families through safe, convenient and swift approaches. Providing telehealth services in the context of Parent-Child Interaction Therapy (PCIT) allows for evidence-based treatments to reach more families in a shorter period of time. As a result, waitlist times decrease for families seeking treatment. As many children and families are socially isolated during these times, virtual group-based therapy offers a sense of connection and community that otherwise would not be available right now.

As a result of earlier prototype designs and testing conducted by the Institute for Child and Family Well-being (ICFW), Children’s Wisconsin is currently providing an 8-week virtual therapy group for parents/caregivers and a child in their care: Parenting with P.R.I.D.E. This group is being facilitated by licensed mental and behavioral health clinicians and masters-level student interns, and includes components from the evidence-based intervention PCIT. Providing this group-based service through telehealth offers caregivers and children the opportunity to learn with and from one another in a supportive online environment from the comfort and safety of their own homes.

Parenting with P.R.I.D.E. helps caregivers of young children manage challenging behaviors including not listening, difficulty with transitions, acting out, and handling big emotions. Each family is able to learn tangible strategies that promote positive behaviors, enhance the caregiver-child relationship, and decrease undesired behaviors through engaging activities and live coaching with a PCIT-trained therapist. Additionally, this group benefits parents who may identify as overwhelmed, depressed, stressed, feeling guilty, or are confused about how to best meet the needs of their children who might be struggling with focus on tasks or changes in daily life. Parents who have previously participated in the ICFW’s PCIT-based groups have provided feedback that they feel less isolated and have experienced a reduction in parenting stress.

Specifically, the group format of the Parenting with P.R.I.D.E. program allows for virtual service delivery to a maximum of six caregiver/child dyads (families) through telehealth. Dyads include children between the ages of 2.5-5 years who were screened for inclusion criteria prior to intake. Caregivers access weekly therapy appointments through Zoom on Children’s Wisconsin MyChart, the web-based portal for their child’s electronic medical record. Services are provided in the following format:

  • 60-90 minute intake appointment including baseline dyadic observation of caregiver and child.
  • One hour group session per week for 6 weeks.
  • One hour individual graduation session including post-treatment dyadic observation of caregiver and child.

Children’s Wisconsin plans to continue to utilize group-based therapy approaches for children and families beyond the pandemic and will begin to share new offerings in coming weeks.


Seeking Solutions for Youth Aging Out of Foster Care

By Luke Waldo

Youth aging out of foster care do not fare as well as their same-aged peers. Frequent exposure to trauma and adversity stresses executive functioning skills most needed to perform essential life skills that set the foundation for self-sufficiency and independence. According to the National Center for Children in Poverty, youth who are aging out of care are at increased risk for a variety of adverse outcomes, including homelessness/unstable housing, unemployment, low educational attainment, higher prevalence of poor health status, sexual and physical victimization, and incarceration.

Children’s Wisconsin’s Institute for Child and Family Well-being (ICFW) and its collaborative partners were awarded a planning grant from the Oshkosh Area Community Fund to facilitate a community assessment to delineate the causes of poor outcomes for youth 18-24 years of age who are aging out of foster care and to identify solutions. The assessment will help us gain a greater understanding of the risk factors and future difficulties that young adults in the region face when leaving the foster care system. These youth are often left on their own to navigate the transition to adulthood, and in the absence of strong, stable connections with parents or extended family members, there is no safety net to support them.

The ICFW will convene key stakeholders, including but not limited to the Wisconsin Department of Children and Families, Bay Area Workforce Development Board and the region’s Youth Advisory Council to collect and assess information about the extent of the challenges facing this population. The assessment will include surveying the region’s strengths, resources, needs, and gaps as they relate to the population of youth transitioning to adulthood. The assessment findings will provide a foundational framework that we will use for exploring existing service delivery models, such as Youth Villages LifeSet and/or developing a tailored intervention(s) to meet the unique needs of the target population. Through these collective efforts, our long-term goal is to provide a pathway to independence by strengthening youths’ resiliency and equipping them with the knowledge and skills necessary to become self-sufficient, build a strong support network, achieve educational and/or job training goals to earn a living wage, and maintain safe and stable housing.

Learn More:

Wisconsin Department of Children and Families Independent Living
Bay Area Workforce Development Board
LifeSet – Youth Villages


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.


Birth to Three Social-Emotional Innovation Grants

By Allison Amphlett

We are pleased to announce a new partnership with the Wisconsin Department of Health Services (DHS) to support the evaluation of  innovation grants awarded to 15 Birth to 3 programs across the state to pilot new and innovative efforts to improve social-emotional outcomes for participating children.

The ICFW team is conducting a cross-site evaluation of the 15 projects with 3 central aims:

  • To describe trends in Birth to 3 program services delivered and outcomes of children and families served, observing changes that occur in the overall client population and specific demographic subgroups after the adoption of the proposed program enhancements.
  • To identify common and unique approaches across the sites, and draw associations between observed trends, reported successes, and specified programmatic changes.
  • To support recommendations about whether and which program elements should be sustained and incorporated in Wisconsin’s Birth to 3 programs.

Learn More:

Birth to Three Social-Emotional Innovation Project


Recent ICFW Publications

Gilbert, R., Mersky, J. P., & Plummer Lee, C. (2021). Prevalence and correlates of vaccine hesitancy in a sample of low-income mothers. Preventive Medicine Reports, 21, 101292

Mueller, D., Bacalso, E., Ortega-Williams, A., Pate, D. J., & Topitzes, J. (in press). A mutual process of healing self and healing the community: A qualitative study of coping with and healing from stress, adversity and trauma among diverse residents of a midwestern city.” Journal of Community Psychology.

More ICFW publications


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.


COVID Resilience Plan

By Gabe McGaughey

COVID-19 placed unique and unprecedented stress on families, staff, and communities while also exacerbating already existing health and economic disparities. On March 18, 2020, Wisconsin’s governor issued a ‘Safer-at-Home’ order to mitigate the impact of COVID-19 that dramatically impacted nonprofit service delivery, a $14.6 billion sector in Wisconsin, accounting for 1 in 12 employees in the state. In one survey, 27.6% of nonprofits reported widespread conversion to virtual programming.

System disruption can lead to one of three types of outcomes for families and service providers to navigate; a return to the old equilibrium, finding a new equilibrium, or managing a new disequilibrium. The scale of the innovation required to adapt to the challenges associated with COVID-19 have been staggering, from rapid expansion of virtual therapy to radical shifts in group-based parent support programs. At no time in our profession’s history has innovation occurred on this scale so rapidly. How might organizations move quickly, but also identify what has value that will be useful to carry into the ‘new normal’ of a post-COVID social service delivery system?

COVID-19 has forced nonprofit human services providers to rapidly adapt to new restrictions on how they might engage families made more vulnerable because of either disparities or the inability of systems to support their well-being. Coming out of this unprecedented level of disruption, nonprofits have an opportunity to reflect on what of their innovative responses can support their objectives moving forward. Children’s Wisconsin’s Well-Being programs developed a COVID Resilience Plan to identify and elevate innovative practices that have surfaced since the start of the COVID-19 crisis that supports the well-being of families, are adaptable to our current limitations, and may enhance future practice. This process leveraged strategic learning to highlight lessons learned to carry forward in the future state, including:

  • Support for enhancing staff comfort and skill in providing virtual group-based, home visiting, child welfare, and other supportive services. 42% of parents surveyed by the ICFW indicated that they preferred virtual services to traditional in-person services. While connectivity challenges and disparities likely left some families with a reduced amount of support, home visiting and other services still saw new families that hadn’t sought out services previously. Segments of a nonprofit’s target demographic may be more open to, or even prefer, having virtual options continue.
  • Virtual training for staff, stakeholders, and foster parents, when done in an engaging manner, addresses some challenges around travel and childcare while also providing flexibility of how and when to deliver content. The COVID Resilience Plan will continue to explore the balance between convenience of virtual services and the quality of engagement and service delivery through these methods.
  • Community engagement, providing authentic role and voice of people with lived experience in program development and feedback, continues to be essential. Families are stressed because of a lack of capacity of systems to meet their needs. Eliciting their voice and insight is fundamental to advocacy and systems change. Virtual connection options provide new, more widely accepted, methods for program participants to have input into program direction.

The ongoing work of the COVID Resilience Plan is now focused on facilitating Communities of Practice focused on these three prioritized findings to deliver recommendations on concrete next steps for activities that will carry forward beyond the restriction associated with social distancing. While these findings reflect a specific set of experiences, the role of virtual service provision in what was almost exclusively in-person supportive services is inescapable. Different organizations may be able to yield relevant insights for their own work from these lessons, or adapt the strategic learning process to identify their own specific lessons learned to carry into the ‘new normal’ of a post-COVID world.

Learn More:

Practice Brief: Strategic Learning
Practice Brief: After Action Reviews


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

ICFW 5th Anniversary – May 2021

Schedule of events to celebrate our anniversary year and highlight our efforts to achieve our mission will be announced soon on our website and social media.

ICFW Webinars:

April 14th:

Parenting with PRIDE – Designing Group-based, Telehealth Solutions with PCIT in Times of COVID

Presentations, Trainings and Workshops:

January 21st-22nd:

Mersky, Joshua (2021) Interrupting the Intergenerational Transmission of Trauma, Society for Social Work Research, January 21. Virtual Event

Janczewski, C.E., Nitkowski, J. (2021). Parental Mental Health and Substance-Related Services Among CPS-Involved Families, Society for Social Work Research, January 22. Virtual Event

February 22nd:

Topitzes, J. (2021). Secondary trauma: What is it and how can we overcome it? Wisconsin Head Start Association Conference, February 22nd, 2021, Virtual Event.

April 15th:

Together for Children Conference: Vicarious Trauma: Honoring the Weight of our Work – Meghan Christian and Luke Waldo

May and July 2021:

PCIT Therapist Training

John Meurer, MD, MBA

ICFW Affiliate
Professor and Institute for Health & Equity Director, Medical College of Wisconsin

John Meurer, MD, MBA is Professor and Director of the Medical College of Wisconsin Institute for Health & Equity. The mission of the Institute is to improve health and advance equity through research, education, and shared expertise by working collaboratively with local, national and global communities.

Dr. Meurer is a general pediatric clinician-educator and is academically recognized for his achievements in community-engaged research. He has a national reputation for research to improve childhood asthma and advance early childhood development and community-engaged health systems research. He has been a collaborative and transformative steward and leader of 25 Advancing a Healthier Wisconsin projects including 5 recently focused on improving early childhood developmental care systems.

He holds a medical degree from the University of Wisconsin-Madison, completed his residency at Baylor College of Medicine, Houston Texas, attained a master of business degree from Northwestern University, and was a fellow with the David Winston Program, Washington DC.

Lixia Zhang, PHD, MSW

ICFW Affiliate
Assistant Professor, University of Northern Iowa

Lixia Zhang’s research interests focus on child maltreatment and other negative circumstances that undermine individuals’ health and well-being across the life span. She is also interested in prevention and intervention strategies to avert childhood trauma or mitigate its effects, especially among disadvantaged children and families. Zhang has been involved in a variety of international, national and state research projects.As an ICFW affiliated scholar, she is currently collaborating with Dr. Joshua Mersky on two adverse childhood experiences (ACEs) studies. The first study is a cross-cultural ACEs Study. Dr. Zhang and Dr. Mersky collected original data from more than 1,200 recent high school graduates in China to test the effects of ACEs on psychosocial well-being in emerging adulthood. The second study is an intergenerational ACEs study. Dr. Zhang and Dr. Mersky are working with families and schools to determine how parents’ exposure to ACEs can affect the emotional and behavioral development of their school children.

Lixia holds a master’s and PhD in social work from the University of Wisconsin-Milwaukee.

Penelope Dixon

ICFW Affiliate
Shelter Manager, Milwaukee Women’s Center

Penelope is the Shelter Manger at the Milwaukee Women’s Center, a division of Community Advocates. In her role as the shelter manager, she oversees the 68 bed shelter for families experiencing homelessness and domestic violence. She is committed to providing a trauma-informed approach to enhance housing stability for the families served.

Prior to her role as a shelter manager, Penelope spent eight years with Children’s Wisconsin and the Institute for Child and Family Well-Being as a Child and Family Therapist and Foster Parent Educator. In both roles she worked directly with families involved in child welfare. Earlier in her career, she worked in special education in Milwaukee Public Schools.

Penelope is a licensed professional counselor. She earned her bachelor’s degree in educational policy and community studies from the University of Wisconsin-Milwaukee, and later a master’s degree in professional counseling from Grand Canyon University. She is a Milwaukee native with a passion for caring for Milwaukee’s most vulnerable populations.

Laura A. Voith, MSW, PHD

ICFW Affiliate
Assistant Professor, Case Western University

Stemming from her macro and direct practice work with domestic violence and sexual assault services, Dr. Voith focuses on violence prevention and intervention, particularly violence against women and children, and implementation science on the delivery of violence prevention programs. Her research on social inequalities contributing to the risk of violence exposure, subsequent health disparities resulting from violence exposure, and the prevention of such violence is carried out through two lines of research. (1) Dr. Voith examines the effects of individual- and neighborhood-level cumulative risk and protective factors on the relation between violence exposure and risky outcomes with children and adolescents. (2) Dr. Voith examines how men’s exposure to trauma, violence, and adversities contribute to violent perpetration and victimization, and how individual factors, such as men’s social networks, interact with neighborhood-level characteristics to enhance or diminish the risk of men’s use of violence in intimate relationships. These two lines of research will inform the development and evaluation of violence prevention programs with at-risk children and adolescents, and the improvement of batterer intervention programming with men.

Jennifer Jones

ICFW Affiliate
Chief Strategy Officer, Prevent Child Abuse America

Jennifer Jones currently serves as the Chief Strategy Officer at Prevent Child Abuse America (PCAA) where she develops, implements and advocates for an integrated strategic framework to help grow PCAA’s leadership role consistent with national prevention priorities, and serves as the lead on regional and national strategic partnerships.

Prior to her role with PCAA, Jones was the Director of the Change in Mind Institute and the Co-Director of the Safety and Resilience Impact Area at the Alliance for Strong Families and Communities. Jones led all aspects of the Institute, including raising $1.7 million for the Texas Change in Mind Learning Collaborative and National Impact Study. Jones also served as the Project Director of the Child Safety Forward Initiative, a three-year Department of Justice cooperative agreement working with 5 jurisdictions to develop community-led, systematic solutions to reduce child fatalities caused by child maltreatment. Jones worked closely with the Alliance policy team, other national organizations and congressional representatives to advance brain science infused policy and trauma-informed care legislation.

Preceding her role at the Alliance, Jones served as the Associate Director of the Wisconsin Children’s Trust Fund (CTF). In her last two years at the agency, Jones served as Interim Executive Director, at the Board’s request, and coordinated all activities related to the Governor-appointed Child Abuse and Neglect Prevention Board, including managing all operations, and overseeing the agency’s budget and grantmaking functions. Before her positions with the Children’s Trust Fund, Jennifer served as the communications specialist in the Secretary’s Office at the Wisconsin Department of Children and Families and as a child welfare policy advisor in the Wisconsin Division of Children and Family Services.

Jones is an affiliate of the Institute for Child and Family Well-Being, a joint project of Children’s Wisconsin and the University of Wisconsin-Milwaukee.  Jones is also a member of the National HOPE (Healthy Outcomes from Positive Experiences) Advisory Board and serves on the Board of Directors of the Hunger Task Force.  Jennifer received her master’s in social work from the University of Wisconsin-Madison and bachelor’s in social work from Marquette University.

Katelyn Blair PHD, MSW

ICFW Affiliate
Senior Researcher, JBS International, Inc.

Katelyn Blair, MSW, Ph.D., is a Senior Researcher in Child Welfare at JBS International, Inc. She is responsible for the analysis of Child and Family Services Review data on child and family outcomes, yielding results on national and State performance and best practices in child welfare. Dr. Blair also contributes to the analysis of calculating Statewide Data Indicator Profiles for the Children’s Bureau. She provides support in the analysis of estimates of improper payments and state and national error rates for the IV-E Foster Care Program.Previously, Dr. Blair worked at the University of Wisconsin-Milwaukee and Children’s Wisconsin as a research assistant and clinician where she designed and implemented studies that aided in the translation of evidence-based interventions into child welfare. She led efforts to examine distal system-level intervention outcomes, developed and validated a measure of early childhood resilience, and evaluated child welfare practice. She also delivered evidence-based interventions (Parent-Child Interaction Therapy and Trauma-Focused Cognitive Behavioral Therapy) to children and families within the context of child welfare services to improve well-being and facilitate resilience. As a researcher-practitioner, Dr. Blair married her clinical work with data collection, analysis and management to help develop an applied, translational research and evaluation agenda that contributed to the implementation and dissemination of trauma-informed services to underserved families.

As an ICFW affiliate, Dr. Blair continues to collaborate with team members to promote the use of evidence-based interventions and resilience in child welfare research and practice.

Dr. Blair holds a master’s degree in social work and a doctoral degree in social work from the University of Wisconsin-Milwaukee.

Reggie Moore

ICFW Affiliate
Medical College of Wisconsin Comprehensive Injury Center

Reggie Moore serves as the Injury and Violence Prevention Director of the Office of Violence Prevention (OVP) located within the City of Milwaukee’s Health Department. Appointed in 2016, Reggie leads the city’s efforts to assess, prevent, and decrease incidents of structural and community violence. OVP’s mission is to prevent and reduce violence through partnerships that strengthen youth, families, and neighborhoods. On November 11, 2017, the Office of Violence Prevention released Milwaukee’s first comprehensive plan to address violence from a public health perspective.

Prior to joining the city, Reggie has led local and national organizations including the Center for Youth Engagement, Urban Underground, and the national Youth Activism programs for the Truth Initiative in Washington, DC. He has volunteered his time with several local and national organizations including the Milwaukee Public Schools Foundation, the Funders Collaborative on Youth Organizing, and Scaling Wellness In Milwaukee. An organizer at his core, Reggie has dedicated his life to being a catalyst for social change.

Tim Grove

ICFW Affiliate
Senior Consultant, SaintA

Tim Grove is a senior consultant at SaintA, a human services agency whose mission is to facilitate equity, learning, healing and wellness for all. He has 25 years of professional experience in a variety of direct care and administrative positions including, in-home services, foster care, treatment foster care, residential treatment, child welfare, community based services, quality improvement and staff development.

Grove’s work at SaintA includes being the senior leader of trauma informed care (TIC) initiatives across all agency programs and as such was responsible for implementing SaintA’s TIC philosophy and practices, including Dr. Bruce Perry’s Neurosequential Model of Therapeutics (NMT). He also created a TIC training curriculum centered around the Seven Essential Ingredients, or 7ei, of understanding and practicing TIC. Grove and the training team at SaintA have used the 7ei framework to train more than 50,000 people across the country over the past 12 years. Groups that are currently using the 7ei curriculum include judges, law enforcement/first responders, schools, child welfare agencies, social service agencies, health centers, community agencies, post secondary academic institutions and many others.

He is a Mentor with the ChildTrauma Academy and a Master Trainer in Dr. Rob Anda and Laura Porter’s ACE Interface curriculum. Grove and the SaintA team’s work has been highlighted in various radio and television projects, including a 2018 60 Minutes segment with special correspondant Oprah Winfrey. Their work has also been showcased in a number of magazines, journals and newspapers, including a three-year research study on the effectiveness of 7ei in child welfare published by the Journal of Child Custody in 2019.

Carmen Pitre

ICFW Affiliate
President & CEO, Sojourner

Carmen Pitre is the President and Chief Executive Officer of Sojourner, Wisconsin’s largest service provider for families dealing with domestic violence. Under Pitre’s leadership, Sojourner provides crisis housing, system advocacy and individual support to thousands of women, children and families.

Pitre draws on decades of work and personal experience to improve the way the community supports families impacted by domestic violence. Pitre believes – and data proves – a holistic approach of co-locating services and coordinating resources is effective, efficient and yields better outcomes for families. In 2016, Pitre rallied key community leaders to create the Sojourner Family Peace Center where people impacted by domestic violence can access emergency shelter, domestic violence services, physical and mental health services, law enforcement and legal assistance, counseling, employment services, financial literacy, community education and professional training – all under one roof.

Pitre was integral in the 2009 merger of Sojourner Truth House and the Task Force on Family Violence when she became Co-Executive Director of the new agency, Sojourner Family Peace Center. Before the merger, Pitre was the Executive Director of the Task Force on Family Violence from 2002 to 2009. Pitre served as the Director of the First Judicial District Judicial Oversight Demonstration Initiative and the Coordinator of the Milwaukee Commission on Domestic Violence and Sexual Assault from 1997 to 2000.

Pitre graduated from the University of Southwestern Louisiana – Bachelor of Arts program in 1984.

2020 Year in Review

At the Institute for Child and Family Well-being, we recognize that COVID-19 has created challenges during this past year that require innovative practices and policies that draw on established evidence to provide the best possible care to our community, and opportunities to learn from those practices and policies that may lead to more resilient and supportive communities in the future. As we reflect on this past year, we have deepened our commitment to strong community and systems partnerships, research and evaluation, and adaptation and innovation to meet the needs of our clients and community, so that we may ultimately improve child and family well-being.

We are excited to remain steadfast in these commitments and to continue this journey as we celebrate our 5th anniversary later this year. So take a moment to review what we learned and accomplished in 2020, and keep an eye out for upcoming announcements for our events that will celebrate our five years of partnership as the Institute for Child and Family Well-being.


Meet the 2020 ICFW Affiliates

As Community Engagement and Systems Change are a core service area of the ICFW, collaboration with our community and systems partners is critical to fulfilling our mission. In recognition of those that value collaboration and whose mission seeks to improve child and family well-being, we have invited those partners to join us as ICFW Affiliates. We were honored to introduce three ICFW Affiliates in 2020 and are looking forward to expanding our affiliates in 2021.

Penny Dixon is the Shelter Manager at the Milwaukee Women’s Center, a division of Community Advocates
Tim Grove is a senior consultant at SaintA
Reggie Moore serves as the Injury and Violence Prevention Director of the Office of Violence Prevention (OVP)


Confronting COVID-19

COVID-19 placed unique and unprecedented stress on families, staff, and communities while also exacerbating already existing health and economic disparities. Read some of our articles that illustrate how we responded to COVID-19 and its challenges this past year.


New Webinars in 2020

From Trauma Screening to Authentic Community Engagement, Housing as a Pathway to Prevent Maltreatment and Executive Functioning for Child and Family Well-being, check out our conversations with the ICFW team and community and national experts on these important issues.

To learn more, explore the webinars here. 


ICFW Publications in 2020: New Journal Articles, Reports and Practice Briefs


New Projects and Partnerships

Executive Functioning for Child and Family Well-being

The Institute for Child and Family Well-Being was proud to host the webinar “Executive Functioning for Child and Family Well-being” with John Till, Senior Vice President of Strategy and Innovation at The Family Partnership, and Jennifer Winkler, Family Case Management Well-Being and Family Support Manager at Children’s Wisconsin, on December 7th from 11:00-12:00 CST.

Executive function skills are like an air traffic control system in the brain that helps us manage information, make decisions, and plan ahead. Stress and the lingering impact of Adverse Childhood Experiences (ACEs) can negatively impact executive functioning, making it difficult to effectively navigate challenging and uncertain circumstances.

This webinar explored how executive functioning is impacted by Adverse Childhood Experiences (ACEs) and toxic stress, why it is critical to our child and family well-being systems, and how our presenters’ organizations have developed and implemented executive functioning programming into their core service delivery through robust conversation with an experienced panel through their work with the Executive Functioning Across Generations and Mobility Mentoring models.

Listen to the recorded webinar here.


Related Resources from the ICFW

Related Resources from Jennifer Winkler

Related Resources from John Till

Related Resources from the Center on the Developing Child at Harvard

ICFW Newsletter, Fall 2020

The mission of the Institute for Child and Family Well-Being is to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

The Institute for Child and Family Well-Being is a collaboration between Children’s Wisconsin and the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee. The shared values and strengths of this academic-community partnership are reflected in the Institute’s three core service areas: Program Design and Implementation, Research and Evaluation, and Community Engagement and Systems Change.


In This Issue


Meet the ICFW

Meghan Christian is a Child and Family Therapist with the Institute for Child and Family Well-Being and a Licensed Clinical Social Worker.

Meghan has spent most of her career in the nonprofit sector, working with people who have experienced acute or ongoing trauma including abused children and adults, refugees and families living in poverty. Meghan’s interests lie in translating research on the effects of trauma on the developing brain into practical ways of using evidence-based interventions with her clients. She’s particularly interested in the role resilience plays in protecting against and transforming negative neurophysiological changes.

Along with her direct practice, Meghan enjoys exchanging perspectives and knowledge with fellow helping professionals by way of communities of practice, case consultation and facilitating workshops relating to neurodevelopment, responsive relationships and resilience.

Meghan received her master’s degree in social work in 2009 from the University of Wisconsin-Milwaukee. She earned her bachelor’s degree in social work from the same institution in 2006.


Dr. Colleen Janczewski is a policy and practice analyst at ICFW and an assistant professor at the University of Wisconsin-Milwaukee’s Helen Bader School of Social Welfare. Her research interests include child maltreatment and improving public systems that serve children and families. She has expertise in applying advanced statistical techniques to inform policy decisions and practice innovations in social service systems.

In terms of ICFW projects, Dr. Janczewski is currently the lead evaluator of the Alternative Response in Wisconsin evaluation, for the Wisconsin Department of Children and Families. She is also on the evaluation team for the FACT Study, the Healthy Families Study, Family Foundations Home Visiting Program, and the Trauma and Recovery Project. Dr. Janczewski holds a Ph.D. in social welfare from the University of Wisconsin-Milwaukee and a master’s degree in social work from Virginia Commonwealth University.


Program Design & Implementation

The Institute develops, implements and disseminates validated prevention and intervention strategies that are accessible in real-world settings.

Innovation and Executive Functioning: A new feasibility study

By Gabriel McGaughey and Paige Bintz

Executive function (EF) skills are like an air traffic control system in the brain that helps us manage information, set and work towards goals, and make decisions that help us reach those goals. EF Skills, which can be developed throughout the life-course, are central to navigating distractions, unexpected challenges, and stressful situations while making decisions that contribute to long-term goal attainment.

Executive Functioning Skills support intentional self-regulation that is central to success in school, work, and parenting. Source: Center on the Developing Child at Harvard University

Childhood experiences are the foundation for healthy development into adulthood. Adverse Childhood Experiences (ACEs) can cause cracks in that foundation, potentially impairing EF Skills and contributing to less intentional self-regulation. ICFW team members Drs. Mersky and Janczewski co-authored a study finding that parents in home visiting programs reported the same level of ACEs as parents with children involved in the child welfare system.

Resilience, or the ability to overcome serious hardship, is a central concept operationalized, in part, through EF Skills. Building resilience helps children and adults navigate stressful situations and the lingering impact of trauma.

Parents participating in Children’s Wisconsin Wausau home visiting program face a myriad of complex challenges beyond the legacy of ACEs. 77% of caregivers in that program have reported an alcohol or other drug abuse, mental health, or domestic violence issue. 48% of caregivers screened positive for postnatal depression. Through those challenges, 56% of parents are receiving services and 90% demonstrate positive parent-child interactions, a core component to child health, well-being, and resilience.

How might programs that already reach families further address enhancing executive functioning of parents and children in their programs to promote long-term stability and success?

Children’s Wisconsin, along with two other Children’s Home Society of America partner organizations, is participating in a collaborative feasibility study of the “Executive Functioning Across Generations™” program, funded by Frontiers of Innovations, the R&D platform of the Center on the Developing Child at Harvard University. Developed in 2017 by The Family Partnership (TFP) in Minneapolis, Minnesota, the organizations are working together to adapt the intervention for virtual use in a Healthy Families America home visiting program.

Source: https://www.researchgate.net/figure/Examples-of-mothers-internal-state-language-during-mother-ehild-interaction_tbl1_313631209

Over the course of 10 virtual sessions, parents learn about brain science and familiarize themselves with the types of activities that help foster brain development and self-regulation in their children through a language-based curriculum. Specifically, there will be an increase in knowledge of brain science, internal state words, theory of mind, serve and return, and personal narratives (BITSN’s). These are all key functions of brain development in children. Parents will learn how to recognize, model and respond to Internal State Words (ISWs) as part of a supportive relationship with their child. ISWs are important because they are used by children in order to express themselves by describing thoughts, feelings and perceptions. This helps them to tell stories about events that have affected them emotionally (see chart).

Home visitors coach families, encourage further learning, and provide teaching tools, like storybooks that use ISW-based language. There will also be activities and handouts for the parents to practice skills with their children in between the sessions. This project has a greater impact with the implementation of a two-generation approach because it allows for more alignment with the goals and more stability in the family unit. The skills learned and the impacts made can continue to affect more generations and create a “domino effect” of positive development.

In order to measure the impact of the curriculum, Minnesota Executive Functioning Scale (MEFS), developed at the University of Minnesota by Dr. Stephanie M. Carlson and Dr. Philip Zelazo, will be used. The app is a quick, “game-like” measure of executive functioning for anyone over the age of 2 that features audio and picture-based prompts. This administration should only take 15 minutes to complete virtually. Overall, the MEFS provides a direct behavioral measure of executive functioning skills which are vital for the development of a child’s social and emotional wellbeing.

By increasing the use of internal state words and a personal narrative, Executive Functioning Across Generations™ helps to foster better parent/child relationships, which is central to child resiliency and being able to adapt to challenges. The ICFW is looking forward to collaborating with The Family Partnership, Nebraska Children’s Home Society, Children and Families First of Delaware, and the Frontiers of Innovation at the Center on the Developing Child at Harvard University to share our lessons learned as we go through this process.

Learn More:

Frontiers of Innovation: An R&D platform designed to accelerate the development and adoption of science-based innovations that achieve breakthrough impact at scale.

Adverse Childhood Experiences in home visiting: Validity of expanded assessment of adverse childhood experiences: A replication study (Choi, et al., 2020)

Executive Functioning Across Generations

Leveraging A Two-Generation Approach To Improve Executive Function in Families


Research and Evaluation

The Institute accelerates the process of translating knowledge into direct practices, programs and policies that promote health and well-being, and provides analytic, data management and grant-writing support.

Promoting Dignity through Work

By Josh Mersky and Dimitri Topitzes

We are pleased to announce a new partnership with Goodwill Industries of Southeast Wisconsin on their Boys and Men of Color Initiative, which aims to support career advancement, self-sufficiency, and leadership development among youth and young men in Milwaukee.  An Institute team headed by James “Dimitri” Topitzes, Josh Mersky, and Allison Amphlett are working with Goodwill to design and evaluate an innovative workforce development program to address barriers to economic prosperity, including generational poverty and trauma, incarceration, and health disparities. The program’s immediate goal is to help participants establish a foothold in the labor force. In the long run, the program aims to help young men of color forge a path toward career success and community leadership.

The Boys and Men of Color Initiative builds on the Institute’s ongoing commitment to workforce development efforts that promote the dignity of work. We continue to collaborate with the Public Policy Institute at Community Advocates on the Healthy Workers, Healthy Wisconsin project.  This job enhancement project aims to strengthen employment services for low-income job seekers by increasing client access to trauma-responsive health and mental health care. The Institute also is partnering with Higher Expectations for Racine County on its Rise Up initiative, which is supporting  underemployed mothers with young children by increasing access to an enhanced workforce training program. Taken together, these workforce development projects draw on the Institute’s academic expertise and reflects our mission to improve the lives of children and families with complex challenges by implementing effective programs, conducting cutting-edge research, engaging communities, and promoting systems change.

Recent ICFW Publications

Choi, C., Mersky, J. P., Janczewski, C. E., Plummer Lee, C., Davies, W. H., & Lang, A. C. (in press). The Childhood Experiences Survey: Replication study of an expanded assessment of adverse childhood experiences. Children and Youth Services Review.  

Mersky, J. P., Janczewski, C. E., & Plummer Lee, C., Gilbert, R. M., McAtee, C., & Yasin, T. (in press). Effects of home visiting on breastfeeding and bedsharing in a low-income urban sample. Journal of Health Education and Behavior.

Plummer Lee, C., Mersky, J. P., Marsee, I., & Fuemmeler, B. (in press). Child maltreatment and marijuana use trajectories. Development and Psychopathology.

Zhang, L., & Mersky, J. P. Bidirectional relations between adverse childhood experiences and children’s behavioral problems. (in press). Child and Adolescent Social Work Journal.

Zhang, L., Mersky, J. P., & Topitzes, J. (in press). Adverse childhood experiences and psychological well-being in a rural sample of Chinese young adults. Child Abuse & Neglect.

More ICFW Publications


Community Engagement & Systems Change

The Institute develops community-university partnerships to promote systems change that increases the accessibility of evidence-based and evidence-informed practices.

Trauma and Recovery Project (TARP) 2020: Implications of COVID-19 on Training, Service Delivery, and Trauma Screening

By Leah Cerwin

Virtual Training

ICFW PCIT Trainers Dimitri Topitzes, Kate Bennett and Leah Cerwin training with PCIT Global Trainer Dr. Christy Warner-Metzger earlier this year.

As the ICFW set out to adapt to the unprecedented changes brought about by COVID-19, many services provided by the Trauma and Recovery Project moved to virtual delivery. This year, our trainers were abruptly asked to shift all training of evidence-based interventions to a virtual setting. This necessitated hand delivery of printed materials to trainees’ homes, the need to learn and use novel tools and apps to complete activities virtually, and changes to  training structure and processes due to both the trainees’ and trainers’ new realities; often including lack of their own home office space, supplies, and even childcare. During our third year of the Trauma and Recovery Project, even with this enormous shift, there were a total of 43 new clinicians in Milwaukee & Racine Counties trained in the target interventions (Parent Child Interaction Therapy, and Trauma-Focused Cognitive Behavioral Therapy).  Hitting this number during such an unprecedented time required enormous adaptability from our trainers and was an enormous success for the project.

Evidence-Based Treatments as Virtual Services

Similar to our trainers, Center of Excellence (CoE) clinicians at Children’s Wisconsin quickly and effectively shifted their services to virtual therapy. This was most evidenced by the number of children provided services during the months when COVID-19 hit.  During this time, even as clinicians made the immediate move to telehealth services from their homes, only six fewer children were provided services by CoE clinicians, as compared to the previous quarter (136 => 130).

In addition to finding ways to successfully serve their kiddos, clinicians reported high levels of success in adapting PCIT to virtual visits with clients. This, in part, is attributed to the model of PCIT, where clinicians conceal themselves behind a one-way mirror and the parent wears an earpiece to hear the clinician’s instructions. When using PCIT in a virtual format, clinicians could turn off their cameras, simulating the “behind the scenes” nature of in-person PCIT. This also speaks to the skill, passion, and dedication of the clinicians in administering PCIT to clients—without their knowledge and energy, PCIT would fall flat in a virtual setting. Clinicians could maintain the most fidelity to the PCIT model when meeting virtually with families, especially families they had previously seen in-person.

Of course, there is always a learning curve to new things: the new reality of virtual meetings created the most change for clinicians administering PCIT. Logistically, no access to a printer, variability of internet connections, an increased demand in time required to do simple tasks, and limitations of a webcam were some of the challenges brought on by administering PCIT virtually. Additionally, in a virtual visit, clinicians are now responsible for filling out paperwork that would normally be completed by the parent, creating additional work for the clinician, and delaying the amount of time spent in PCIT.

With the clinician experience aside, parents and children overall have adapted well to the changes and liked the changes to service delivery. Many parents like the video sessions, noting how easy and convenient the virtual format was for them and their family; additionally, when only one parent was previously able to participate in PCIT, now both could, due to the convenience of virtual service delivery. And, many children were more likely to engage in play during the virtual visits. This can be attributed to children feeling more comfortable in their own environment, feeling more familiar in their home versus the office setting.

Trauma Screening and Assessment

In addition to maintaining our service delivery throughout COVID-19, the number of children screened for trauma during this time was actually higher than its preceding quarter (186 => 296).

As clinicians moved to providing assessments from home via telehealth, they experienced the same challenges mentioned above in regards to service delivery. However, our clinicians were able to screen and assess 1,134 children, exceeding our goal of 750 by adapting to web-based screening and assessments to children receiving virtual care.

Overall, our third year of this grant has been unprecedented: a world ravaged by the COVID-19 pandemic and a nation swept by a social movement against racial injustice have changed us. In an effort to maintain normalcy, life moved online: work was largely conducted from home, social gatherings were moved to virtual happy hours, school shifted to virtual classrooms, and so many other changes were made to hold on to life as we knew it. In order to adapt to the rapid changes of reality, clinicians worked tirelessly to continue service delivery for their clients in virtual spaces while finding a new urgency and purpose to increase humility towards race and culture within service delivery.

Learn More:

Children’s Wisconsin Telehealth: Video Visits

PCIT at ICFW

2021 PCIT Initial Therapist Training


Parent-Child Interaction Therapy During Times of COVID-19

By Kate Bennett, Meghan Christian and Haley Miller

Parent-Child Interaction Therapy (PCIT) is an internationally-recognized, evidence-based parent management program for families who have young children with internalizing and/or externalizing behavior problems. PCIT was developed in the early 1970s by Dr. Sheila Eyberg, and involves live coaching of parents and caregivers as they interact with their child. Historically, PCIT and the training of new clinicians in this treatment modality have been done in person, however, internet-based PCIT (iPCIT) has been utilized within certain clinics prior to the COVID-19 pandemic. Comer, et al. (2017) showed increased parent-reports of improvement in child behaviors with the provision of iPCIT. With approval from PCIT International and support from the Trauma and Recovery Project, ICFW clinicians Kate Bennett, Leah Cerwin and Dr. Dimitri Topitzes were some of the first in the nation to train new PCIT clinicians and new Level 1 PCIT trainers through virtual platforms.

Traditionally delivered in a clinic setting, PCIT uses a one-way mirror and an earpiece listening device while the clinician is in another room coaching the caregiver during dyadic sessions on how to manage certain behaviors (PCIT International, 2018). In order to establish similar observation and communication capabilities for iPCIT, a webcam on laptop, tablet or phone is set up by the parent with the help of the clinician allowing for sessions to occur in the home. Several benefits have been identified through qualitative and quantitative data. Comer, et al. (2017) have found that families are more likely to stay engaged in treatment and attend services if they do not have to travel to a provider. Some contributing factors to this may be flexibility in scheduling, especially when children have appointments with several specialists, parents who work 1st shift jobs and/or have limited access to childcare, and the ability to physically distance. ICFW works with many families with complex circumstances that made attending appointments regularly difficult. Because of this, ICFW clinicians were some of the first within Children’s Wisconsin to begin completing virtual PCIT sessions.

The ICFW team of clinicians receives frequent feedback from caregivers about the benefits of iPCIT, which is in line with their findings on doing in-home PCIT years before. Clinicians are now able to be in the home environment while being invisible to the child, which results in clinicians being able to see behaviors that caregivers report only occur at home. At the start of one coaching session, a parent asked if the clinician “could be here all the time” after successfully navigating a particularly lengthy instance of defiance using PCIT skills. Within two sessions, the same parent said they have “started to see [them] transform into a new child” and the clinician noticed significantly improved concentration, self-regulation, social skills, and joy in the child.

Training new PCIT clinicians and trainers using the internet to maintain safe distances is new to PCIT International, but is likely not going anywhere due to the successes that have been seen thus far. Facilitating sessions with a trainer can now also be done with ease and safety through the use of iPCIT. This keeps clinicians growing in their expertise of the model, and families receiving the best possible service to address treatment goals. Our experience in providing web-based training, consultation, and mentorship for clinicians in 2020 has shown us that PCIT is well-served to fidelity in this context. Clinicians trained in PCIT under the ICFW have reported that they are confident in use of the evidence-based protocol and have learned effective ways to manage telehealth sessions.

To help support trained PCIT clinicians, ICFW has long used virtual case consultations and a Community of Practice through Zoom for live discussions and Basecamp, a project management website, for ongoing shared learning. In Basecamp, digital materials and discussion between clinicians are shared in order to provide clinicians quick access to materials and answers needed, ultimately optimizing family experience with the model. The ability to quickly connect with other clinicians has been helpful in minimizing the isolation felt by clinicians working from home during the pandemic.

PCIT is not a widely practiced modality but has demonstrated high success rates for families. We are excited to be able to work with families who may not have otherwise had access to PCIT due to transportation and scheduling barriers or lack of access to PCIT practitioners around the state. Parity of access from insurance companies now must be matched with clinician availability so all families in Wisconsin have access to iPCIT. ICFW is dedicated to expanding access through training new clinicians, implementing new web-based strategies and sharing information about PCIT throughout the state and nation.

Learn More:

ICFW Internet-Based PCIT Practice Brief

Internet-Based PCIT (I-PCIT): Recommendations for Service Delivery

Prepared in Response to COVID-19

Internet Delivered PCIT: So Far It Gets a Labeled Praise (Kurtz Psychology Webinar)


Recent and Upcoming Events

The Institute provides training, consultation and technical assistance to help human service agencies implement and replicate best practices. If you are interested in training or technical assistance, please complete our speaker request form.

ICFW Webinars

November 16th:

Executive Functioning for Child and Family Well-being

Presentations

October 26th:

T-SBIRT – National Association of Social Workers National Virtual Conference 2020

October 28th:

Engaging Youth in Evidence-Based Interventions in the Community – National Association of Social Workers National Virtual Conference 2020

Trainings and Workshops:

August

Home Visiting T-SBIRT Training (Northwest Region) – La Courte Oreilles (HFA); Indianhead Community Action Agency (HFA); Burnett County (HFA)

September

Brain Architecture and Relational Skills Workshops – Children’s Wisconsin Family Support and Preservation Program

October

Child Adult Relationship Enhancement (CARE) Workshops – UWM’s Children’s Learning Center

October 8th and 9th:

TF-CBT Training (Learning Session II)

October 15th:

Home Visiting T-SBIRT Training (Northeast Region) – Howe Community Center (PAT); Children’s Wisconsin Northwoods (HFA)

November 5th and 6th:

PCIT Training (Learning Session III) – State of Utah

November 6th:

Home Visiting T-SBIRT Training (Southcentral Region) – Children’s Wisconsin Black River Falls (HFA); Sauk NFP (PAT); SWCAP Early Head Start

November 24th:

PCIT Recalibration Workshop Kickoff

December 2nd:

Mindfulness for Parents and Children – UWM’s Children’s Learning Center and Life Impact Program