County of San Diego, Health and Human Services Agency
San Diego, California

County of San Diego – Health and Human Services Agency

6950 Levant Street
San Diego CA 92101

Focus:

Children exposed to violence and their families

Age range:

3–8

Carlos and Lucia Menendez have been arguing a lot lately. Fueled by unemployment and subsequent drinking, Carlos has begun to turn his rage on Lucia, shouting that it's all her fault and hitting her. Their 5-yearold son, Jorge, is terrified of his father. He's not sleeping or eating well, and he cries frequently.

Everything comes to a boil one night when a screaming match between Carlos and Lucia leads to a physical fight. Carlos repeatedly hits Lucia and then hits Jorge, who jumps in to try to protect his mother. A concerned neighbor calls 911. When the police arrive, the investigating officer finds Jorge hiding beneath his bed.

Concerned about the young boy's situation, the officer calls the San Diego Child Welfare office. Carlos and Lucia reluctantly agree to voluntary services. As a "family maintenance case," the family voluntarily separates until they are considered stable enough for reunification. Carlos moves in with a cousin, and Lucia and Jorge receive a referral to the Safe Start San Diego program. Safe Start helps Carlos, Lucia, and Jorge begin to heal—both as a family and as individuals in relationship to one another.

A Safe Start child advocate connects Lucia and Jorge with nonprofit and faith-based organizations that provide a wide range of services, including language classes and job training. After putting in place all of the safety precautions, a community-based clinician begins meeting with the Menendez family in his office.

While his parents work to resolve the issues underlying their domestic problems, Jorge works with a therapist to learn to cope with his exposure to violence. He makes a storybook about his experiences in a violent home and shares it with his parents. Finally, they can see the true impact their actions have had on their son.

By the time they are reunited, the family members have improved their ability to cope with life's stressors, to listen to one another, and to treat one another with love and respect.

Interventions

Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway: This model is an assessment framework for understanding traumatized children and making informed clinical decisions that enable clinicians to gain an in-depth understanding of children, their developmental levels, their traumatic experiences, and the family, community, and cultural systems in which they live. This information assists the clinician in making effective decisions throughout the treatment process.

Trauma-Focused Cognitive Behavioral Therapy Treatment Model: This model is a therapeutic approach for children who have had one or more traumas and are demonstrating symptoms of post-traumatic stress. The therapist meets with the child each week before meeting with the parent/caregiver to teach methods for helping the child at home. The therapy includes education about trauma and common reactions to it, help with parenting and behavior problems, information about relaxation and stress management, and other strategies.

Case management: A child protection worker coordinates case planning and management services that include family assessment, safety planning, family advocacy, parenting classes, and referrals to community-based and other services. In addition, a child advocate for case planning helps the family with child-focused safety planning, provides linkages to support services for the child, assists with problem solving, and supports the primary caregiver.Monthly clinical case consultation meetings are used to review progress and plan follow-up.

Capacity building: To institutionalize an improved response to children exposed to violence and their families, the project builds the capacity of agencies, systems, and professionals interacting with children through a countywide community conference, regional interagency and community training, and specialized training focused on identifying, treating, and preventing/reducing children's exposure to violence.