Turning to the Evidence
Both Jan and Healthy Families Durham had become well known in the area, and Tomeika Watson, who was finishing a position in school violence prevention at UNC School of Social Work, knew that CCFH was where she wanted to be next. A Smart Start grant expanded HFD’s capacity to serve families, opening up a new position for a family support worker in 2003, and Tomeika came on board. Eighteen years later, she leads Healthy Families Durham as its Program Manager.
“Over the course of the first couple months that I was here, even though people were from all different backgrounds – psychologists, psychiatrists, the medical team – everyone made you feel welcome,” Tomeika says, reflecting on her first impressions of CCFH. “Those relationships with people are part of why I continue today.”
Relationships within the center and across the field of child traumatic stress strengthened, as did CCFH’s drive to bring evidence-based treatment to children. The close connections to experts who were developing evidence-based treatments increased the understanding and motivation of the CCFH staff to put these treatments into practice here in Durham. That, in turn, strengthened the application for CCFH’s first grant from the National Child Traumatic Stress Network (NCTSN) in 2001. As Lisa Amaya-Jackson notes, this was the time when treatments were coalescing into manuals and being disseminated across the country.
“Getting an NCTSN grant meant that what was starting to happen nationally was coming to our own backyard,” she says. “The people that we were reading in the textbooks were now people we were talking to and thinking through what was the best [course for treatment].” For instance, Esther Deblinger, another co-developer of Trauma-Focused Cognitive Behavioral Therapy, was the first guest speaker in CCFH’s didactic lecture series.
The shift to following evidence-based trauma treatment models with fidelity would be a major turning point for the health of the children who came to CCFH, and later, for children throughout North Carolina. At the time, it was normal for children who had experienced trauma to stay in therapy for their entire childhood, but leaders in the field of child traumatic stress were beginning to demonstrate that evidence-based treatments, provided with fidelity to the model, resulted in a reduction of trauma symptoms that lasted. Children could get better and stay better.
This approach met some resistance from clinicians accustomed to weaving different treatment strategies together in their own way, but leaders at CCFH and in the field more broadly saw that using evidence-based treatment models with fidelity was the way to sustain healing in children. When CCFH was awarded NCTSN funding to become a Community Treatment and Services Center in 2003, its commitment to evidence-based treatment became official.
A Vision to Teach
That same year, George “Tripp” Ake joined the center staff on its first grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), working with Ernestine Briggs-King on research data and providing clinical services. He remembers how exciting a place it was to be, where professionals were constantly engaging with kids and there was so much to learn.
“I was so struck by this really difficult topic and how passionate and positive people were about being there and doing this work,” he says. “It introduced me to talking with families right after they learned about a disclosure [of abuse] and gave me a lot of skill in what it’s like being in the room with families that are struggling with something really difficult right then.”
In 2004, the center welcomed Robert Murphy as its new Executive Director. Coming from the Yale Child Study Center, he was drawn to the role because of how the community and university intersected at CCFH.
“That kind of mixture can be messy, but it’s creative and it’s fun – a never finished, never boring sort of place,” he reflects. He also recognized that, even eight years after its launch, there still was not anywhere else quite like CCFH.
Robert’s vision for CCFH’s growth centered on the expansion of training and disseminating evidence-based, trauma-informed practices. At the time, the center was primarily focused on providing direct services to the community through mental health treatment and family support programs, but Robert could see how the number of children receiving effective care could be exponentially increased by training other clinicians to use the evidence-based models the center was practicing and gaining real world experience in implementing. Tripp Ake remembers Robert applying for ten or more grants in his first year at CCFH in pursuit of this expansion.
“CCFH was doing amazing clinical work, amazing treatment,” Robert says. “It became pretty obvious that we had this tremendous opportunity to grow the workforce [and] the quality of the system serving kids. I thought that was the leading edge of where we could grow and expand our expertise.”
There was great energy throughout the center around this idea of training other clinicians to provide effective trauma treatment within their own communities, and in 2005, a group of CCFH staff embarked on their first project: teaching Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) to clinicians in the Department of Behavioral Health for Washington, DC.
“I remember us all being incredibly excited about the opportunity,” says Robert, “both because we could put what we knew into action, but also because of how much it challenged us to recognize what we didn’t know.”
And so, the enthusiastic young CCFH staff piled together in a van and traveled to Washington every few months over the next year to transform how mental healthcare was provided to traumatized children. This first project was the beginning of today’s Training Services department at CCFH as well as the North Carolina Child Treatment Program (NC CTP), which Lisa Amaya-Jackson, Dana Hagele, and Rebecca Socolar would co-found in 2006.
With new grants making room for programs to launch or expand, CCFH moved in 2006 from its first home on Westgate Drive to a new location inside the NC Mutual Building in downtown Durham. The Clinic welcomed families on the ninth floor, with the rest of the staff on the floor above.
For Donna Newberne, who came on in 2005 with the Durham Family Initiative and now serves as the Mental Health Clinic Director and Clinical Faculty, the new space mirrored the high quality of the mental health treatment available at CCFH.
“Our clinical spaces [at the Mutual building] were more conducive to doing the work,” she says. “We had better facilities to deliver really good services, making our services that much more enhanced. I think it was more welcoming, too. It felt more like a clinic, which helped amplify what we were doing.”
Pictured below; Jan Williams in her NC Mutual Building office. Tomeika Watson (right) and a colleague meet among boxes of home visiting supplies making the move from Westgate Drive to downtown Durham. Donna Newberne from her office in the NC Mutual Building, where CCFH moved in 2006 as programs and staff grew.