Format for Writing a Best Practice - DOC

							                                                 National Child Traumatic Stress Network
                                                  Minutes – Systems Integration Group
                                                              March 13, 2003
   Members Present: Charles Wilson, Connie Carnes, Judy Holland, Joel Rosch, Miriam Birkman, Mary Laska, Lisa Amaya-Jackson, Chris Siegfried



           ITEM                                         DISCUSSION                                                              ACTION
Introductions                   Group members introduced themselves.

                                Chris Siegfried and others reiterated preliminary conversations with
Discussion of System of          Ken Curl at SAMHSA about potentially doing some activity relating the
Care                             trauma Network and its principles and practices to the System of Care
                                 initiative. Joel Rosch thought it was important to pay attention to the
                                 system of care issues because the President’s New Freedom
                                 Commission, the reauthorization bill for IDEA, and other federal
                                 initiatives all mentioned System of Care. A discussion ensued about
                                 the political debate surrounding systems of care and about getting
                                 beyond the label of system of care to its principles. Members agreed
                                 that many of the systems of care principles are shared by our trauma
                                 network, although perhaps not all. Evidence of clinical effectiveness
                                 has been missing according to some evaluations of systems of care.
                                 Chris shared copies of a concept paper on systems of care from Joe
                                 Benamati. Lisa Amaya-Jackson and Connie discussed the need for
                                 clinicians to be trained and to use evidence-based practices.

Recap of literature review      Charles Wilson reiterated the intent of the group to see what research    The group agreed to send out Charles’s format
                                 literature exists about the various systems that interact with            for the literature review along with another copy of
                                 traumatized children. The group wants to know what the literature         the table of who is doing the various literature
                                 identifies as “best practice” in these various systems. Charles           reviews.
                                 circulated a format for writing up the literature review.


Review of systems               Group members reviewed a modified version of the systems diagram
diagram                          developed by Charles Wilson. Joel asked about the presence of the
         ITEM                                       DISCUSSION                                                              ACTION
                          Red Cross. Judy Holland asked about the role of culture in a child’s
                          healing. Miriam Berkman mentioned that Steven Marans at Yale is
                          putting together a work group to look at principles and practices of first
                          responders. She emphasized the need not to duplicate this effort.

Discussion of payer      Judy asked about the role of various payers. Group members
systems                   discussed VOCA and VOWA funds. Charles mentioned that the
                          National Center needs to make contact with the National Association
                          of Victims of Crime Boards. It should also sit down with the Office of
                          Victims Compensation to promote reimbursement for use of evidence-
                          based practices. Charles and Joel discussed the national cap on
                          VOCA funds and the possibility of designating part of new VOCA
                          money for children. Joel mentioned that the Network Policy Core is
                          doing some surveying of payer sources and how sites pay for trauma
                          services.

                         Joel asked if we knew how many children encounter each of the
Further discussion        various systems. He also inquired about the “therapeutic court
                          movement” of which Joy Osofsky is a part. Chris shared an email
                          message from Mark Rains with the group where he discussed the
                          intention at the Maine Center to interview children about their
                          experience with the child protective/foster care system. Group
                          members wondered if Mark could have a control group. Group
                          members liked the idea of having clinicians interview children about
                          the extent to which the systems themselves produce trauma. Charles
                          said that when children in therapy start talking about the system
                          they’re experiencing, they may be talking about new trauma. Several
                          group members discussed how systems can interfere with clinicians
                          doing therapy, especially if the systems are re-locating the children.
                          Perhaps the goal should be “harm reduction.” Joel mentioned that
                          there is a group of former foster children in California who is very
                          active.

Next steps                                                                                              Chris will type up the minutes of this meeting
                                                                                                       and send them to the group members together
ITEM   DISCUSSION                        ACTION
                    with the minutes of the last meeting, the concept
                    paper on systems of care, a committee roster,
                    revised copies of the mission, goals and systems
                    diagram, and a notice about the next conference
                    call.