Traumatic Stress Safety Treatment:

This evidence-based intervention, derived from widely used positive psychiatry practices, consists of behavioral modules focused on self-compassion, treatment engagement, increased ability to manage trauma reminders, distress tolerance, and safety planning skills. This EBP is associated with reducing PTSD symptoms and enhanced coping skills during trauma reminders, contracting safety skills, rapid stabilization of acute crisis of PTSD with suicidality, and adherence to post ER visits and treatment. This practice is well accepted and adopted in African American and Hispanic communities with favorable outcomes.

Vascular function Biomarker (VFB):

VFB is used to monitor response to PTSD interventions. It is a dynamic reversible biomarker associated with the severity of reactivity to trauma reminders and increased major adverse cardiovascular events. Further, an increase in vascular function is directly related to reducing reactivity to trauma reminders, core PTSD symptoms, and improvement of inflammation. VFB is well-accepted and adopted in adolescents with PTSD with favorable outcomes, especially in African American and Hispanic communities.

Evidence-based Trauma and Grief Assessment:

Trauma-informed screening and assessment practices help providers identify children and families’ needs early in the process and tailor services to meet those needs. The UCLA PTSD Reaction Index for DSM-5, UCLA Trauma Reminder Inventory, and UCLA Persistent Complex Bereavement Disorder (PCBD) Checklist will be used in adolescents. These are all well-validated measures.

NCTSN Core Curriculum on Child Trauma:

The Core Curriculum is comprised of modules on basic concepts of traumatic stress and the application of those concepts to clinical cases. The basic structure of modules on the Core Curriculum involves a skilled facilitator who carries out three tasks:

(1) Determining the essential learning objectives for the audience receiving supervisory consultations at a specific site.

(2) Selecting case vignettes that apply best to the learners and choosing those Core Concepts that are most relevant to the consultation’s needs.

(3) Using problem-based learning (PBL), which is a collaborative learning experience that presents learners with complex problems as those encountered in practice. These complex problems contain multiple decision-making points that require learners to repeatedly sort through, integrate, and develop solutions for case information as it unfolds. Applying the Core Concepts during hypotheses generation is designed to strengthen critical reasoning and case conceptualization skills.

The focus of RFPP is on enhancing contextual discrimination and emotional regulation and promoting the use of adaptive coping strategies in response to trauma reminders, including recognizing reminders, shifting attention from intrusive memories during exposure to reminders to a focus on positive feelings, thoughts, goals, and choices. RFPP also includes exercises to deal with avoidance and psychological and physiological reactivity associated with trauma reminders. RFPP is an evidence-based, trauma reminder-focused group treatment for both children and adolescents with PTSD and their families. RFPP includes two components:

A) Child/Adolescent (Component 1):

1. Trauma Reminders:

This component consists of exercises to reduce reactivity to trauma reminders.

2. Avoidance and Negative Cognitions:

This component consists of activities to promote flexible thinking less influenced by traumatic expectations; Antecedent-Behavior-Consequence skill-building exercises to promote increased self-understanding and enhanced coping strategies; exercises to enhance verbal, emotional labeling and verbal expression of physical reactions; teaching of strategies to deal with setbacks and risky behavior; and strategies to promote posttraumatic constructive action, and developmental progression.

B) Parent (Component 2):

This component includes psychological education, positive psychiatry module skills, role-play, gratitude journaling, and dealing with setbacks.

The Stress Resilience Clinic – an integrated pediatrics and psychiatry initiative – has been providing reminder-focused positive psychiatry (RFPP) to both families and children with PTSD. RFPP is associated with improved core PTSD symptoms, decreased severity of reactivity to PTSD trauma reminders, and increased vascular function. Positive parenting education is known to enhance child-parent interactions, improve emotional regulation, increase school attendance and performance, encourage better citizenship of society, and is associated with no recurrence of symptoms or psychiatric hospitalization, especially in African American and Hispanic youth and their families. Our clinical practice initiative revealed that vascular function is a dynamic reversible psychiatric medicine biomarker, which its impairment is directly associated with the severity of reactivity to PTSD trauma reminders and lifelong health consequences, and its improvement in response to prevention and early interventions (PEIs) is linked with reduction of reactivity to trauma reminders, core PTSD symptoms, and major adverse events, thus facilitating early identification and monitoring response to youth with PTSD. There is an enormous need in North LAC to widen the scope of trauma-informed screening and treatment for adolescents with PTSD and families by building on feasible and effective culturally/linguistically well-documented current approaches for adolescents with PTSD in OVMC-LAC, and adapting trauma-informed screening tools and reminder focused PEI with the collaboration of NCTSN and SAMHSA to improve access to such care on a large scale in North LAC.