Improving Service Delivery for Children Affected by Trauma
An Implementation Study of Children’s Institute, Inc.
The Children’s Institute, Inc. (CII), is a multiservice organization in Los Angeles, California, that combines clinical mental health and other supportive services to meet the needs of children and their families who have been affected by trauma, such as physical or sexual abuse, domestic violence, or violence in the community. Through its Integrated Service Model, CII provides holistic and coordinated support to children and families by potentially engaging them in multiple services: clinical services to address children’s mental health needs, programs for parents and guardians to help them better support their children, and youth activities to develop protective factors. The comprehensive nature of this model sets it apart from the often fragmented and uncoordinated child welfare system. A central aspect of CII’s model is using evidence-based practices — highly specified treatment models that research has shown to be effective in treating a targeted population — in its clinical services.
The CII evaluation had two main components: an implementation study of CII’s service model and a study of CII’s delivery of evidence-based practices, including an in-depth fidelity study of its Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) services.
CII is achieving its goal of engaging clients in multiple services to holistically meet their needs. A majority of clients receiving clinical services from CII also participated in another service at the organization.
Analysis of management information system data indicates that nearly a third of the children engaged in clinical services received an evidence-based practice. While little is known about national norms for the use of evidence-based practices, the study’s findings suggest that CII is a leader in providing them.
Analysis also indicates that the dosage levels of Functional Family Therapy and TF-CBT — two prominent evidence-based practices at CII — were both in line with model expectations.
The in-depth fidelity study of TF-CBT indicated that CII’s implementation of the treatment model was aligned with that of other community-based organizations in similar fidelity studies. The average client had at least a 50 percent chance of receiving half of the model’s core components.
A Technical Resource for this report presents the complete set of findings from the in-depth fidelity study of CII’s delivery of TF-CBT and is available on the MDRC website.
CII is also involved in MDRC’s Building Bridges and Bonds study of fatherhood programs, funded by the U.S. Department of Health and Human Services.