Chelsea HealthCare Center, Massachusetts General Hospital
Chelsea, MA

Massachusetts General Hospital
Chelsea HealthCare Center

151 Everett Avenue
Chelsea, MA 02150

Focus:

Children exposed to community and family violence

Age range:

0–17

Julia picks up her 9-year-old son, Eric, from his afterschool program. As they approach their housing complex, three teenagers are fighting, including Eric's cousin, George, who has a knife. Another has blood on his leg.

When the police arrive, the three young men are thrown to the ground and searched, handcuffed and taken away. When Eric asks Julia about the incident, she is too upset to respond. Eric later finds out that his cousin was selling drugs.

The following month, Julia gets called to school because Eric is not doing his homework and seems to be mentally absent. The teachers wonder why a child with so much potential is slipping out of reach.

Like many other elementary-school-aged children exposed to violence, Eric is old enough to express what he is going through, but he needs someone who can understand what he is feeling. The school counselor finds the right outlet for him at the Safe Start program at Massachusetts General Hospital's Chelsea HealthCare Center.

Eric enters the Cool Youth program, a group therapy program for children, ages 7 to 11, who have been exposed to violence. Meeting once a week with specially trained therapists, Eric and the other children share how the violence they've witnessed makes them feel and discuss how to understand and deal with those feelings.

At the same time, Julia joins a group for mothers with children in the Cool Youth program. The mothers exchange personal stories and learn how to help their children overcome the effects of witnessing violence.

By giving Julia and Eric safe spaces and separate forums in which to air their feelings, the Cool Youth program has helped them understand each other better.

Interventions

Comprehensive assessment: A multidisciplinary team conducts comprehensive assessments of mental and physical health as well as an in-home safety assessment. The team then connects the family with community services and supports.

Attachment, Self-Regulation, and Competence: Based on the results of the comprehensive assessment, a multi-disciplinary team determines which model of care each family and child receives. Treatment focuses on attachment, regulation, and competence and is grounded in trauma-informed interventions strategies.

Clinicians from the mental health unit provide individual, group, and family therapy. Based on the child's or adolescent's needs and strengths, the practitioner chooses an appropriate intervention from a menu. Therapeutic procedures include psycho-education, relationship strengthening, social skills, and parent-education training as well as psychodynamic, cognitive, behavioral, relaxation, art/expressive, and movement techniques.

Institutional change: Various hospital units (mental health, social services, pediatric, Ob/Gyn, and school-based health programs), police action counseling teams, the school system, the Department of Social Services, and family violence advocates work together to create policies and procedures that expand access to psychiatric intervention and ensure quality services for children and families.