Promoting Resilience

Dr. Laura Schwab-Reese, Assistant Professor of Public Health at Purdue University, joins host Dr. Kate Cerulli, professor of Psychiatry at the University of Rochester, and Veronica Leva, Assistant Director of Community Engagement for the TRANSFORM Research Center, to discuss the National Child Abuse Hotline, Child Help, and provide updates on her work since joining us in Season One of the podcast. Laura shares information about the services that the National Child Abuse Hotline offers, which includes text, chat, and phone call options for everyone from mandatory reporters unsure of how to handle a situation, to the children who are experiencing abuse and neglect themselves. She discusses how meeting kids where they are through the use of technology is so important in addressing challenging topics such as child abuse and neglect. Additionally, Laura explores what the barriers and facilitators are in creating a transdisciplinary team, as well as how she addresses the vicarious trauma that impacts teams who are doing this important work.

Host, Dr. Catherine Cerulli (Kate), a professor of Psychiatry at the University of Rochester, is joined by her guest, Chad Frymire, the Director of Public Policy at Court Appointed Special Advocates (CASA) in Dallas, Texas, and the Board President of the North Texas Coalition Against Human Trafficking. In this episode, Chad and Kate discuss Chad's work within the foster care and child welfare systems, child abuse and neglect, and how human trafficking crosses into these areas. CASA works closely with foster care systems throughout the United States to advocate for the best interests of children who experience child abuse and neglect, maltreatment within the child welfare system or from their domestic families. Chad details the important and impactful work he and volunteers have done for children throughout the state of Texas. They explore volunteer recruitment, retainment, and diversity in this space. Chad explores how he became involved with human trafficking work through a personal anecdote that connects him to the work. Chad's unique experience led him to meaningful work in the foster care system and in turn, the human trafficking arena. Traffickers often prey on vulnerable populations to manipulate and take advantage of them; children in the foster care system are at high risk of being trafficked due to their past experiences with child abuse and neglect, maltreatment, and wary relationships with adults and others. Through his work, Chad and his team have created trainings in human trafficking prevention to educate others as human trafficking is a large domestic problem and can happen to anyone, anywhere. It is critical for advocates to have the knowledge and resources to continue serving children who are at risk. Chad shares information and key warning signs of trafficking in children, mechanisms that traffickers use to persuade and manipulate children, and how youth with an online presence can become dangerous for their safety. The episode also covers vicarious trauma and ways that Chad and Kate care for themselves while working with traumatized populations so that they can mitigate burnout and continue to serve children in need. Keep up with upcoming projects from Chad and Dallas CASA at: https://www.dallascasa.org/

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guests, Ash B. Alpert, MD, MFA, a Hematologist and Medical Oncologist and an AHRQ T32 Post-Doctoral Fellow in Health Services Research at the Brown University School of Public Health and Sabrina Jamileh Sayegh, a queer and nonbinary third-year medical student at the University of Rochester School of Medicine and Dentistry. Dr. Alpert and Sabrina share insights regarding their research to understand and address cancer risk factors as a result of violence for multiply marginalized populations. They explore the mechanisms by which violence plays a role in social determinants of health and how violence can contribute to cancer and/or cancer risk factors. Dr. Alpert explains that there are 4 major ways violence can lead to cancer and/or cancer risk factors including: 1) increased stress, otherwise known as allostatic load, which can lead to a higher risk of cancer through inflammatory pathways, 2) increased exposure to viruses including HPV, HIV and hepatitis for those exposed to sexual violence, 3) increased distress which can lead to increased substance use which can increase the risk of certain cancers including lung and liver cancer, and 4) increased mental distress and illness, which is linked to increased mortality for people living with cancer. To address this, Dr. Alpert and Sabrina discuss exploring strategies such as ensuring adequate training is provided to clinicians caring for transgender people, implementing screening questions related to violence to be asked to all patients, and on a structural level, considering the ways that legislation might facilitate or diminish violence against transgender people.  Dr. Alpert and Sabrina are dedicated to better serving transgender patients as well as other multiply marginalized populations.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Donna Walck, PhD, a therapist at Mt. Hope Family Center where she has practiced for 15+ years. Dr. Walck shares her expertise using Perinatal Child Parent Psychotherapy (P-CPP), an evidence-based trauma-informed therapeutic model for children ages birth to five years and their parents/caregivers. By exploring P-CPP and how it has been integrated into Project PROMISE, part of our TRANSFORM Research Center, Drs. Cerulli and Walck discuss the goals and delivery methods for administering the model. Additionally, and very importantly, Dr. Walck shares the impact of the social determinants of health on the population with whom she works, as well as how race and ethnicity play a role in the implementation and efficacy of P-CPP. There are challenges with providing services to participants who are part of research studies, as sustainability for the continuation of service provision might be cut due to lack of continued funding. In this case, Dr. Walck shares how creating sustainability for service provision is critical. Through training therapists and other providers on P-CPP, Mt. Hope is helping to grow a pool of therapist. The key takeaway Dr. Walck shares is that providing models that are racially and ethnically appropriate is imperative in the success of the model, as well as that providing early preventive interventions.  P-CPP may lead to better outcomes for the parent and baby to live their best lives.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Moses Robinson. Moses has been a police officer with the Rochester, NY City Police Department since 1985, was a school resource officer for 21 years, and is currently a community liaison officer. His time on the force has taught him the value of forming relationships with people including children in schools, victims of violence, and offenders, some who have been victimized themselves. Through Moses work as a school resource officer, he learned that building relationships with students, particularly students of color, is one of the biggest ways to transform the divide between law enforcement and children. He discusses how early childhood interventions and utilizing trauma informed care can help save lives by creating an environment where students can grow into health adults. Moses feels it is imperative officers understand trauma and how to approach tense situations when interacting with the public. This can be done through a greater understanding of developmental models and knowledge of how trauma affects the ways people respond as well as informing officers on how to engage with citizens through a trauma informed lens. Moses highlights community engagement research and how it can enable police officers to form strong connections with the community, build significant relationships with victims, and find best practices for handling strained or traumatic situations. Moses' overreaching message is that building relationships with the community in addition to understanding and utilizing trauma informed care approaches will give officers necessary tools to better impact society.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Mical Raz, MD, PhD, MSHP, the Charles E. and Dale L. Phelps Professor in Public Policy and Health at the University of Rochester, where she also works as an internal medicine physician at Strong Memorial Hospital in Rochester, NY. Dr. Raz explores themes of Poor Parenting vs. Poor Parents, mandatory reporting, Child Protective Services being used as a surveillance tool rather than a support tool, and how we can reframe and reimagine these systems. The war on poverty isn't a new concept and historically we blame and punish individuals for being poor. The privilege of place and space affords certain groups to have more autonomy over their decision making when it comes to parenting, while other parents may have to assess risk in a different way due to their lack of privilege within the system. Often, parents are judged based on their parenting decisions and in some cases those decisions are used as evidence of their unfitness to be a parent. In some ways the child welfare system has become a way to police parents and families rather than act as a force to support families in thriving. Dr. Raz explains the criticality of placing focus on how families can be supported and how the system can help them thrive, rather than break them apart. By divorcing the surveillance component from providing support and resources to children and families, we can begin to reimagine the systems in place and rather than punishing parents, reframe how we address the circumstances of parents who are in marginalized groups. Dr. Raz's key message focuses on the importance of systems level change in response to how we support children, parents, and family systems overall. She also challenges us to consider how we can give more autonomy to parents without fear of punishment through providing the tools families need to thrive. It is important to not confuse markers of poverty with markers of bad parenting.

Host, Dr. Catherine Cerulli, a Psychiatry professor at the University of Rochester, is joined by her guest, Justin Russotti, Ph.D., a licensed clinical social worker and child maltreatment researcher. Dr. Russotti's research focuses on the intersection of development and mental health specific to teen pregnancy. Child maltreatment is the strongest predictor of teen pregnancy and survivors are twice as likely to experience adolescent childbirth as opposed to those who do not experience childhood abuse and neglect. Dr. Russotti discusses his research with the Mt. Hope Family Center. He found that adolescent substance use behavior and pregnancy desire are the strongest indicators in determining a survivor's risk for adolescent pregnancy. Focusing on these risk factors in maltreated adolescents can help reduce teen pregnancy occurrence. Further, children of adolescent parents are at greater risk of maltreatment due to the stress of a young person raising a child, so it is imperative to offer comprehensive intervention programs that target adolescent parents and teaches them practices to become successful parents, while addressing the many other challenges they face such as school responsibilities and socioeconomic challenges. The episode also discusses ways frontline providers can help their patients and clients become great parents, including tailoring interventions to the individual, addressing their abuse history, and increasing understanding of the diverse experiences maltreatment survivors encounter. The episode closes with a brief discussion of reproductive social justice, reproductive coercion, and the need for accessible birth control methods.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Christie McGee Petrenko, Ph.D., a clinical psychologist and Fetal Alcohol Spectrum Disorder (FASD) researcher. FASD represents a range of conditions associated with prenatal alcohol exposure. Studies have documented that in the US 2-5% of the population have FASD, or one in 20, and as many as 80-90% of people go undiagnosed or misdiagnosed. This impacts their lives in challenging ways including growth delays, learning and behavioral problems, and struggling with ADHD, anxiety, or depression. Children involved in the welfare system have a higher rate of being diagnosed with FASD as well as children in mental health care and justice settings. Dr. Petrenko discusses resources professionals can utilize to learn about FASD and ways to help patients. She also discusses an initiative that uses the Extension for Community Healthcare Outcomes (ECHO) approach to create learning collaborations with primary care providers in the community by engaging with and training nurses and pediatricians. Lastly, the episode concludes by discussing ways society portrays people with FASD and what can be done to increase understanding and inclusiveness to help improve their lives.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Nila Bragg, MSN, CPNP, a certified pediatric nurse practitioner and a Medical Consultant for the New York City Administration for Children's Services (ACS). ACS's mission is to protect and promote the safety and well-being of New York City's children. As part of that work, child protective specialists from ACS conduct investigations to determine what is needed to best keep the children safe. For instance, to help keep families together, child protective specialists often connect families to services that can help, including counseling, substance abuse treatment, and access to concrete resources, like food, diapers clothing and even child care vouchers. Throughout this work, it is important that ACS child protective staff understand a variety of medical issues that the family may be coping with, as well as treatments, in order to better identify whether there are any potential safety risks.  As a Medical Consultant for ACS, Nila provides consultation to child protective specialists who have clients with complex medical histories. Nila helps CPS better connect children and their families with services that best support caregivers as they manage their child's medical needs. Nila's key message is that educating families and connecting them to resources is paramount to not only improve children's health, but connections also support the overall well-being of children and their families.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Elaine Spaull, Executive Director of The Center for Youth in Rochester, New York, to discuss the Center's work as they care for youth and families. Center staff supports clients in troubled situations due to issues such as abuse, neglect, and homelessness, and aids them in repairing their lives by building trust. Often, the result is long lasting relationships with staff and leadership. The Center offers emergency babysitting service for parents and caregivers through their Crisis Nursery, short-term housing for youth 12 years and older who are in unsafe living situations, and transitional housing for older youth who can live independently. Highlighted are real life stories of people who have faced trauma that led them to seek support from the Center. Also discussed throughout the episode is how trauma and neglect in childhood can affect people into adulthood.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Eileen Whitney, to discuss how children and families are supported in a court based daycare program and the barriers they face. Speaking from her own experience as the director of the Monroe County Family Court Children's Center at the Hall of Justice in Rochester, NY and as a foster mom to over 45 children throughout the years, eight of which she adopted, Eileen speaks about the work the Children's Center is conducting to help at-risk kids and their families who are involved in the court system. The Center provides childcare to parents and guardians when they have court dates so they are able to attend proceedings and serves as a connection point for families to find medical and human services they need. Eileen also discusses her life-long passion of being a foster mom, how foster care benefits children, and the joy it brings. Eileen's overarching message is that parents love and want to care for their children, but poverty and coping mechanisms often times get in the way of them being able to fully take care of their children.

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Dr. Laura Schwab Reese, to discuss national talk, text, and chat lines that respond to child abuse. Speaking to the need for translational science to prevent abuse, Dr. Schwab Reese delves into the importance of these technologies as they can directly respond to children using technologies children use every day. The anonymity can empower them to reach out about their abuse. Through various analyses, Dr. Schwab Reese has identified ways to improve how counselors relate to kids when using these services. These techniques can create greater trust between both parties and help build autonomy so kids feel confident to participate in decision making. A discussion of mandatory reporting and ways to best support children’s understanding of the process is also included in this conversation. Dr. Schwab Reese is an Assistant Professor of Public Health at Purdue University. Her research focuses on how young people use social media and other technology to share, process, and seek help related to child abuse and neglect as well as creating practice models that guide professionals to converse more effectively with victims through these networks. Sound engineering and music by Joe Hagen. (Recorded August 2020)

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Dr. Nancy Weaver, to discuss how we can apply communication sciences, analytics and public health principles to promote healthy and positive parenting to reduce the prevalence of childhood abuse and neglect. This podcast will inform us on how to develop our own resiliency to respond to this crisis by learning how to be a bystander through a novel intervention program, Support over Silence for KIDS. Dr. Weaver created the program to educate community member’s tangible skills to listen empathetically and non-judgmentally to parents and caregivers in situations where tensions rise to help deescalate what’s happening in the moment. Dr. Weaver has a Ph.D. in Health Behavior and Health Education and an M.P.H. in Biostatistics from the University of North Carolina at Chapel Hill, as well as a B.S. in Mathematics and Statistics from the James Madison University. Sound engineering and music by Joe Hagen. (Recorded August 2020)

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guest, Dr. Shaun Nelms, to talk about how schools can build resiliency in youth and grow partnerships with families and community-based agencies. By meeting the youth’s basic needs, we can improve health, prevent child abuse and neglect, and break intergenerational trajectories of poverty and violence. Dr. Nelms is the superintendent of East Upper and Lower Schools, a unique partnership between the New York State Education Department, Rochester City School District, and University of Rochester, where he is charged with creating a replicable school reform model that can transform the way we think about schools as centers for public health promotion. Please check out the following links from Dr. Nelms: Adverse Childhood Experiences: https://www.rochester.edu/warner/cues/wp-content/uploads/2019/09/PYRCH-Year-Three-Summary.8.28.19.pdf Family Group/Restorative Practices: https://www.rochester.edu/warner/cues/restorative-practices/ Bullying: https://www.rochester.edu/warner/cues/bullying/ Transforming East:  https://youtu.be/hmqSKpNbN5s Family and Community Engagement: https://vimeo.com/395096234 Sound engineering and music by Joe Hagen. (Recorded August 2020)

This podcast will focus on the role of race in child welfare, reporting, investigating, and responding. Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by guest, Dr. Natalie A. Cort to explore the intersection and complex relationship between race and the crisis of child abuse and neglect. Dr. Cort is a Clinical Psychologist who educates future mental health clinicians and seeks to end implicit biases sometimes held by social service providers and clinicians. Sound engineering and music by Joe Hagen. (Recorded August 2020)

This podcast will inform us on how to support childrens’ resiliency in the face of COVID-19 to prevent future child abuse and neglect. Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by guest, Dr. Jody Manly, an internationally recognized researcher and clinician at the Mt. Hope Family Center, in Rochester, New York, who examines developmentally appropriate interventions to reduce the harmful effects of child abuse and neglect. Sound engineering and music by Joe Hagen. (Recorded August 2020)