By Dr. Amanda M. Stylianou
June 5, 2018

When there is domestic violence in the home, children may witness or experience the violence. This can make them feel unsafe and more vulnerable to developing mental health issues such as post-traumatic stress disorder. To help these children, Safe Horizon and our partners have created a groundbreaking pilot program called the Child Trauma Response Team (CTRT). Our Research and Evaluation team has analyzed the effectiveness of the pilot program, and with support from Rutgers University, is sharing our findings with this blog post.

What is CTRT?

CTRT is a collaborative model designed to reduce the negative impact of children’s exposure to domestic violence. From March 2016 to April 2017, a pilot program was implemented in the East Harlem section of Manhattan for families in the 23rd precinct. The pilot program was a partnership with:

• New York City Police Department (NYPD)
• New York County District Attorney’s Office (DANY)
• Safe Horizon, Inc.

What Does the CTRT Program Do?

• Identify children who have witnessed serious incidents of domestic violence and provide an immediate, coordinated, trauma-focused and interdisciplinary response to children under the age of 18 and their impacted family members.
• Provide coordinated home-based outreach by the NYPD and Safe Horizon, case management services, and evidence-based, mental health interventions.

What Was the Goal of Pilot Program?

• Determine the impact of the CTRT on children exposed to severe domestic violence and their impacted family members
• Identify key factors that facilitate successful collaborations between law enforcement and domestic violence/child trauma specialists
• Provide a roadmap for expanding and adapting the CTRT program throughout New York City

Who Participated in the Study?

Eligible families were identified by reviewing the NYPD Domestic Incident Reports as well as receiving referrals for the program from a partner domestic violence organization and the Manhattan District Attorney’s Office.

• 105 families were eligible for the CTRT intervention and 90 families elected to receive services
• The majority of caregivers were females between the ages of 24 and 39, identifying as Hispanic/Latina or Black/African-American and caring for one or two children primarily between the ages of 0 and 6.
• 82% of families who elected to receive services had at least one child that screened positive for post-traumatic stress disorder

Following a severe incident of domestic violence, the Child Trauma Response Team:

• Provides a therapeutic acute response to the family within 72 hours of the traumatic event consisting of either a joint home visit by the DV Police Officer and a Safe Horizon Child Trauma Specialist or a phone call by the SH child trauma specialist
• Completes a child trauma screening and/or assessment
• Educates the caregiver about common trauma reactions and how his/her child’s behavior may be linked to the child’s exposure to domestic violence
• Provides safety assessment and risk management to the family
• Links the child and impacted family members to evidence-based mental health treatment services, which may include interventions focused on the peri-traumatic phase such as Child and Family Traumatic Stress Intervention (CFTSI)

Practice Recommendations

The following practice recommendations are from Safe Horizon’s Research and Evaluation team. They are based on the evaluation of the pilot program.

• Enhance the identification of eligible families by focusing on increasing police documentation on the Domestic Violence Incident Report when a child is present in the home during an incident
• Collaborate to increase the speed of home visits to families experiencing severe domestic violence within 72-hours post-incident
• Shift the model to address needs across diverse communities
• Explore expanding capacity to offer mental health intervention services to young children
• Discuss the sensitivity and specificity of assessment tools used
• Develop and implement CTRT model guidelines for case review meetings, home visits, and steering committee meetings
• Define and clarify roles of each partner and enhance communication between CTRT team

Policy Recommendations

• Consider expanding the CTRT model to other NYC precincts to increase impact of the program
• Consider expanding the CTRT model to focus on all incidents of domestic violence, rather than just severe incidents
• Consider expanding the CTRT model to other forms of trauma and violence experienced and witnessed by children

Research Recommendations

• Secure additional funding for a longitudinal program evaluation
• Understand the impact of the CTRT model among a diverse array of communities
• Explore the potential impact of the CTRT model in responding to all domestic violence incidents and/or all traumatic incidents children may witness
• Examine the impact of the CTRT on families’ safety, level of post-traumatic stress disorder, access to community services, ability to utilize emotional coping skills, trust in the criminal justice system, and engagement in the criminal justice system
• Understand the impact of CTRT from the perspective of families utilizing the program’s services

We are committed to consistently evaluating the impact of our programs and are proud to report on the pilot’s success. This insightful and actionable analysis brings us one step closer to our vision of a society free from violence. The CTRT pilot program analysis is just one of the projects that our Research and Evaluation team spearheads. To learn more about our programs, visit our policy and research page. To download a PDF version of this study, click here. To learn more about CTRT, click here.