A New Program in Philadelphia Aims to Identify and Treat Childhood Traumatic Stress

African American teenager wearing a face mask

August 28, 2020 - COVID-19 New Jersey, New York and PA

This 2019 Ready Challenge recipient is focused on serving underserved families

The stress of trauma during childhood can last a lifetime if left untreated.

It happens when a child's fears linger following a terrifying event or scary situation, even if they have only witnessed what happened. Over time, this can lead to depression and nightmares, or even drug abuse and relationship problems if left untreated.

That's why it's important to figure out if a child has a history of traumatic stress and treat it as soon as possible.

In underserved communities, this can be very difficult. It can be hard just to get to an appointment when you rely on buses and subways that often take hours. Even getting time off from work is hard when you have multiple jobs and can't afford to lose pay.

The staff at Children's Hospital of Philadelphia (CHOP) saw how much this affects children and are looking at new and better ways to identify children who have childhood traumatic stress and treat them.

CHOP developed the Growing Resilience in Teens (GRIT) project, to actively screen for trauma and help children receive early treatment. The program will be based at Karabots in West Philadelphia and focuses on those affected ages of 8-17.

"We've seen so many children who are anxious in recent years, that's why this program is so important to make sure that children get the right treatment early," said Dr. Kari Draper, Medical Director of CHOP's Karabots Pediatric Care.

GRIT received a 2019 TD Ready Challenge grant of $750,000 for this new and innovative program that starts in October. TD Ready Challenge grants were given in 2019 for Better Health by supporting programs that focus on preventative care and help increase equal access to health care, no matter a person's zip code or economic status.

These grants are a key part of the bank’s corporate citizenship program, the TD Ready Commitment. This program enables the bank to play an active role in improving society in areas where it can have the greatest impact.

"GRIT provides help to children who have experienced a traumatic event, which gives them the chance to recover and heal," said Mike Carbone, Metro PA Regional President and Chair, TD Charitable Foundation. "The TD Ready Challenge is about making the world more inclusive and sustainable. By supporting the GRIT program, it does just that, one child at a time."

Living with violence and poverty can be too much, especially for children

Gun violence is a major problem in West Philadelphia. In the entire city, shootings have increased 30% in 2020 from the previous year through July, according to data from the City of Philadelphia. Adding to the stress is more than 35% of people living in West Philadelphia live below the federal poverty line.

Living in poverty and unhealthy conditions can make it very hard for a child to deal with stress, according to Alonzo South, CHOP's Senior Director of Community Engagement.

Programs such as GRIT are even more important amid the COVID-19 pandemic. The pandemic has shown that children in underserved communities are exponentially hurt during this time, along with their families, friends and neighbors.

How GRIT Works

The program is made up of three parts.

  • Eligible children will be identified during their annual checkups. There will also be outreach based on information in their electronic medical records. CHOP medical professionals will follow-up with patients who exhibit trauma exposure and/or symptoms.
  • Some families will be referred to start treatment for trauma at Karabots based on their responses and the follow-up meeting. GRIT is adding new services at Karabots to make sure patients can get the right services. There will also be groups to help the whole family.
  • CHOP will also arrange for community health workers to be assigned to some families to help them work through any problems they have with getting treatment.

"Mental health-related treatment has high no-show rates," Alonzo said. "The first appointment can have no-show rates up to 50%. Community health workers will help improve this by meeting with families. They will explain the services and follow up with them. We will also work with families to encourage them to come to appointments."

The GRIT team is hopeful that with successful results, there will be a potential for the program model to be used by other medical centers throughout the nation.

"GRIT is helping to build new tools to help kids who are facing complex challenges on a regular basis," said Steve Wilmot, Senior Director of Practice Management Services at CHOP. "Thanks to the TD Ready Challenge, we can help these children and improve their ability to cope.”

The impact of COVID-19 on GRIT

There have been some adjustments to the program with COVID-19 restrictions. GRIT will move many of the in-person appointments to virtual meetings.

But Alonzo noted that there are also new opportunities with virtual meetings. By meeting at home, you don't have to worry about how to get to an appointment. Being able to see a patient in a home environment can help give more information about the child and family life.

"The digital divide -- which includes devices, broadband, and training – is a contributor to health inequity," Alonzo said. "At CHOP, we both direct people to, and create, resources to lessen this divide."

The efforts include connecting patients and families with resources provided by the City of Philadelphia. CHOP has also launched its own initiatives including:

  • A dedicated website which aggregates social needs information – such as internet access -- for families across the Delaware Valley.
  • CHOP has used grant funding to provide devices and/or broadband access to high-need families.

While there are many challenges ahead, both GRIT team members and TD Bank are excited for the program to start this fall. "We are honored to partner with the GRIT program at CHOP to help children and parents recover from traumatic events, enhance their resiliency and create a better future," said TD's Mike Carbone


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