Family Safety Center, St. Barnabas Hospital
Bronx, NY

St. Barnabas Hospital
Family Safety Center

260 East 188 Street, 5th floor
Bronx, NY 10468

Focus:

Children exposed to community and family violence

Age range:

0–6

Sharon doesn't understand why her daughter Krisiti's health is worsening.

When she was 3, her doctor diagnosed her with asthma.

A year later, she began experiencing sporadic seizures.

Kristi's symptoms have always been controllable, but in her first 2 weeks of kindergarten, she suffers three asthma attacks and a seizure.

But Kristi's pediatrician, Dr. Edwards, suspects a likely cause: exposure to violence.

He knows that Sharon survived ongoing domestic violence while Kristi was only a toddler, and he thinks Kristi's symptoms may be related to the emotional stress of witnessing that violence—even though it was several years ago.

Like the many other children exposed to violence who experience physical symptoms, Kristi needs help soon. The earlier the root cause of her health problems is addressed, the better off she will be. Dr. Edwards immediately refers the family to the St. Barnabas Hospital Safe Start program.

After learning more about Sharon and Kristi's family history through a multidisciplinary assessment, the Safe Start "medical home" team at St. Barnabas concludes that some of Kristi's recent symptoms may stem from the fact that, having just started school, she feels insecure, scared, and cut off from her mother. The team educates Sharon about the possible connections between the emotional triggers of Kristi's current physical symptoms and the long-term emotional effects of the domestic violence she witnessed as a baby. Safe Start staff also accompanies Sharon to meetings with Kristi's teacher and guidance counselor, and mother and daughter participate in weekly parentchild psychotherapy sessions. Together, Kristi and Sharon begin the process of restoring a sense of safety and rebuilding the foundation of a healthy family that will allow Kristi to develop to her maximum potential.

Interventions

Medical Home: The Family Safety Center at St. Barnabas Hospital (the Center) provides needed medical and nonmedical services for the child and family. An interdisciplinary team comprising a general pediatrician, a developmental pediatrician, a child psychologist, and social workers provide medical and pediatric care, parenting education, counseling, advocacy with schools, and referrals to other services. The team also conducts medical, developmental, and psychosocial evaluations.

The medical home maintains a centralized, comprehensive record of services to facilitate continuity and coordination of care, thereby expanding access and making possible more family-centered, culturally competent, and compassionate service delivery.

Child Parent Psychotherapy (CPP): The program provides an hour of weekly dyadic psychotherapy over 12 months. The goal of the CPP model is to restore the child-parent relationship as well as the child's mental health and developmental progression, which may have been damaged by the experience of violence. Child-parent interactions are the focus of six intervention modalities aimed at restoring a sense of mastery, security, and growth as well as promoting congruence among bodily sensations, feelings, and thinking on the part of both child and parent in their relationship with each other.