The Child Witness to Violence Project (CWVP) provides free, specialized counseling, advocacy, and outreach services to support young children and their caregivers. CWVP works with children, ages birth to 8 years old, who have been exposed to domestic violence, community violence, or other potentially traumatic events. From within Boston Medical Center's Division of Developmental and Behavioral Pediatrics, CWVP has provided therapy to thousands of children and their families since its inception in 1992.
CWVP is staffed by a multi-cultural team of social workers, educational and clinical psychologists, mental health clinicians, early childhood specialists, and a consulting pediatrician. The Child Witness to Violence Project facilitates local, state-wide, and national trainings for mental health clinicians, health care professionals, police, educators, and many other social services professionals who support children who have been exposed to violence.
- Developmentally sensitive, trauma-focused therapy for young child that includes their primary caregiver.
- Caregiver guidance and family therapy, as needed.
- Advocacy and support to stabilize the environment of the child.
- Case-related consultation to schools, early childcare agencies, and development centers.
- Clinical consultation to clinicians and/or agencies working with young children impacted by trauma. And
- Training to professionals and caregivers on a variety of topics related to early childhood trauma, the impact of domestic and community violence, and clinical intervention with very young children
Referrals to CWVP come from a variety of sources, including the police, health and mental health providers, Head Start and other early childhood programs, schools, attorneys, domestic violence shelters, court-sponsored victim programs and families themselves. CWVP specializes in working with very young children who have been exposed to significantly difficult events. This includes, but is not limited to, exposure to domestic violence, exposure to community violence, the experience of immigration-related trauma, and the experience of significant disruptions in the child’s relationship with a primary caregiver.
Referral criteria include:
- The child must be 8 years old or younger
- The child must have witnessed or been affected by an act of significant violence
If the child’s primary reason for referral does not meet the criteria for our program, we will help to refer the child to other programs.
- Initial Phone Screening. This is a brief yet thorough phone discussion with a member of the CWVP team. The phone screening is completed with the parent/caregiver as well as with any referring providers. This screening helps to ensure that clinical services are a good fit for the child and family. It also provides an opportunity for a CWVP staff member to provide an overview of therapy services.
- Intake Clinic. This meeting is an opportunity for a member of our clinical team to meet with child's caregiver to further discuss their interest in services. Usually caregivers attend this appointment independently (without their child/children). During the intake clinic, the therapist will gather more information about the family and their needs. The CWVP clinical team, with input from the child’s caregiver, then make a determination about moving forward with therapy.
- Therapy. Therapeutic services are initiated when the caregiver and the clinical team feel it is appropriate to move forward with services. Services are tailored to best suit the individual needs of each family. Caregivers work closely with their assigned therapist to develop goals to guide the course of treatment.
The services Child Witness to Violence Project are supported by the Massachusetts Office for Victim Assistance through a Victims of Crime Act of 1984 (VOCA) grant from the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. Due to this generous support all services are free. No health insurance necessary.
For general information about our services or to make a referral, please call 617.414.7425. If you need information in Spanish or to make a referral for a Spanish-speaking family, please call 617.414.4522.
Question: What does therapy at CWVP look like?
Answer: CWVP therapeutic services are individualized to meet the unique needs of each family. To begin therapy, a caregiver will work closely with their child’s assigned therapist to complete a comprehensive assessment. This usually occurs over the course of 3-5 one-on-one sessions with the caregiver and the therapist. The goal of this assessment is to gather information about the child, like their strengths, coping skills, and important relationships. Caregivers are also able to discuss their concerns for the child. The child’s assigned therapist collaborates with the caregiver to create customized treatment goals that will then guide the child’s treatment.
Question: What happens next?
Answer: Once the caregiver and therapist complete the assessment phase, therapy for the child will begin. Sometimes, the therapy may be “dyadic,” which means that the child and caregiver participate in the sessions together. Although the therapy is still for the child, the caregiver’s participation is extremely helpful. Caregivers help the therapists build trusting relationships with child clients. Caregivers also provide helpful information that helps the therapist understand each unique child.
Question: Do therapists ever meet with children one on one?
Answer: There are times, particularly when the child is older, that therapy may be one-on-one. This means that the child meets individually their assigned therapist. Although caregivers do not participate in these sessions, it is still an expectation that the caregivers will be actively involved in their child’s treatment. This engagement often takes the form of regular communication with the child’s assigned therapist either in person or by phone.
Question: Once the child starts therapy, what happens?
Answer: At CWVP, therapy usually begins with an acknowledgement of what brings the child in for therapy services (e.g., “You saw something scary happen in your neighborhood.”), although this will be informed through the assessment process with the caregiver. The therapist will use a variety of clinical techniques to build a relationship with the child and work toward their identified treatment goals. Because Child Witness specializes in working with very young children (0-8 years old), most therapy session predominantly utilize play. Play is often considered the “language” of very young children and is a very helpful form of expression for children to “talk” about their experiences.
Question: How long does therapy last?
Answer: The length of time a child receives therapy depends on many factors such as the nature of the event(s) bringing the child in for therapy, their past experiences, their age, and the response of their caregivers. For some children, therapy may be brief, lasting only a few sessions. Other children may be in therapy for a longer period of time. CWVP therapists will be in regular communication with caregivers about their child’s progress.
Question: What are the benefits of participating in therapy?
Answer: Families have reported several different gains from participating in therapy including:
- Decreases in their child’s concerning or challenging behaviors,
- Increases in caregiver’s ability to respond to their child in times of need,
- Increased child and caregiver understanding about the difficult events that happened,
- Increased understanding about the child’s thoughts and feelings associated with the experience, and
- Increased caregiver understanding of child development.
These gains happen as the caregiver, child, and therapist work together to build the family’s support system, identify strengths, and galvanize the child and family’s resiliency. Most of all, therapy is geared to help the child and family recover and heal from the challenging experiences they have been through.
Question: How much does therapy at CWVP cost?
Answer: CWVP’s therapy services are entirely free. These services are funded through the Victims of Crime Act (VOCA). A family’s insurance is not billed for therapy services.
Training and Consultation
CWVP offers many training opportunities for agencies and providers who work with children affected by violence. Some examples of our trainings/consultations include:
- Clinical Intervention with Children Affected by Domestic Violence and other Sources of Trauma: A one-day training that provides an introduction, overview, and intensive skills training on working with young children exposed to trauma. This training includes a specialized focus on the dynamics of domestic violence and its impact on children. Participations will learn about complex trauma, trauma symptom manifestation, assessment techniques for working with children exposed to trauma, and considerations for clinical treatment.
- Clinical Intervention with Caregivers Affected by Intergenerational Trauma: This is a one-day training that seeks to expand providers’ clinical knowledge and skills in working with caregivers who are affected by intergenerational trauma. This training explores the psychological impact of trauma that can be transmitted across generations and provides strategies for therapeutic intervention for families impacted by intergenerational trauma.
- Introduction to Child-Parent Psychotherapy: Clinical Intervention with Young Children Affected by Trauma and Domestic Violence: This two-day seminar provides an introduction to Child-Parent Psychotherapy, a dyadic, attachment-based intervention for young children exposed to interpersonal violence and other trauma, which has been empirically validated for use with children under age six. Across this seminar, participants will be exposed to the theoretical foundation of Child-Parent Psychotherapy. An overview of assessment protocols and the core clinical skills that guide clinical intervention will be provided.
- The Intersection of Trauma, Culture and Immigration: This one-day workshop provides an overview and analysis of the role of culture, language and immigration as risk and protective factors. This training reviews strategies for intervention with immigrant children and their families, with a particular emphasis on working with Latino families. Participants will consider the challenges in working cross culturally, including working with client whose first language in not English and working with an interpreter.
- Child-Parent Psychotherapy (CPP): Full-Implementation Training: This is an 18-month intensive learning collaborative offered to clinical groups (clinicians, supervisors, and senior administrative leaders) from mental health agencies. Across this rigorous training program, participants gain core knowledge about the implementation of Child-Parent Psychotherapy and practice the clinical competencies of the CPP model in their clinical work with families. Participating agencies will increase their capacity to provide evidence-based trauma treatment for children in the birth-to-six age range.
Interested individuals or agencies should contact CWVP for information on our training opportunities by calling 617-414-4244.
Looking for a training that was not listed above? Please contact our program by calling 617-414-4244 to discuss further. CWVP will work closely with interested individuals and agencies to develop a training opportunity that meets your needs.
- The Early Trauma Treatment Network (ETTN)/National Child Traumatic Stress Network (NCTSN) (www.nctsn.org)
- In October, 2001, The Substance Abuse and Mental Health Services Administration funded a national network of centers to improve the quality and availability of services for traumatized children, their families and communities throughout the United States by establishing the National Child Traumatic Stress Network (NCTSN). CWVP has received funding since that time as a member of the Early Trauma Treatment Network (ETTN), a unique collaboration between the University of California, San Francisco, Louisiana State University Health Sciences Center, Tulane University Medical Center, and Boston Medical Center. The ETTN is focused on providing Child-Parent Psychotherapy, a manualized, multimodal, relationship-based treatment for infants, toddlers, and preschoolers exposed to domestic violence, child abuse, or traumatic loss. CWVP has implemented this innovative treatment approach with children aged 0–5, and their caregivers who have experienced violence and traumatic loss. Staff from the program are credentialed trainers in the model, and have disseminated a number of products related to early childhood trauma and Child-Parent Psychotherapy.
The ETTN Boston Site Associate Director:
Carmen Rosa Noroña, LICSW, Ms.Ed, CEIS