July 17, 2019 — Today I had the pleasure of meeting with the team at the Chadwick Center for Children & Families. Charles Wilson, senior center director, and Dr. Suzanne Starling, associate center director and medical director, met me in the Plaza lobby to fill me and a special guest — my wife, Anjie! — in on some of the center’s history and accomplishments before heading upstairs. We have quite an amazing program and facility here at Rady Children’s.
In the 1970s, a local team comprising experts from areas including health, public safety and social work united to address an issue that affected them all, and more importantly, affected kids and families healing from traumatic events: There was no single place offering the variety of assistive services they needed. In 1976, Dr. David Chadwick led the charge to found a hospital-based, centralized model through Rady Children’s. This particular program evolved into the Chadwick Center we know and appreciate today, which gives kids and families access to supportive services such as counseling, advocacy and connections to local resources in one welcoming, compassionate environment. And the center’s positive effects reach far beyond San Diego. To date, its model has served as the foundation of more than 800 similar initiatives across the United States.
After that debrief, we traveled a few floors up into the center itself. I found out our visit was being livestreamed to the entire Chadwick team, spread out between the conference room here and the center’s Oceanside facility via iPhone — pretty high-tech, huh? Anjie and I were given a scenario of a real-life Chadwick Center client, and were asked to imagine ourselves in her shoes as we learned about the center’s services. What a powerful way to get acquainted!
Depending on a family’s unique situation, Chadwick team members coordinate with external partners such as law enforcement and child welfare agencies or the District Attorney’s office to prepare a tailored plan of service before a child or family even sets foot in the center. Many initial visits begin with a forensic interview, and we received an overview of this process from Sheri Rouse.
“A forensic interview sounds scary, but my job, if I do it well, would be to make you feel like we’re just talking and playing games,” she explained. When a child visits Sheri or her colleagues for an interview, they are kept separate from parents or caregivers to ensure the child is able to be as forthcoming as possible about their feelings and experiences. This is important in all cases so the child gets the specific help they need, and especially so when the Chadwick Center is working with law enforcement and justice officials to provide evidence for investigations or court cases. “District attorneys and law enforcement can listen in on interviews,” Sheri said. “We tell the kids at the beginning. We’ll say, ‘someone is watching who is helping me do my job.’” Interviewers will ask developmentally appropriate questions, which are carefully crafted to ensure children are never led to a particular response. Once an interview in which law enforcement is involved is finished, Chadwick therapists will touch base with their partner in a separate area and address any additional topics they need for their cases. Sheri noted that last year, the Chadwick Center conducted 670 of these interviews. As heartbreaking as it is to think of how many children have gone through this process, it’s encouraging to see well-trained and compassionate experts like Sheri ready to help.
Next, we met with Dr. John Stirling to discuss medical exams. The Chadwick Center is home to seven designated child abuse doctors, which Dr. Sterling explained is quite a rare distinction for a pediatrician. In an effort to increase the number of child abuse-specific physicians in the United States, the center just launched its first fellowship program, which the aforementioned Dr. Suzanne Starling (a designated abuse doctor herself and a respected trainer in her field) leads. She actually trained a number of physicians at my former hospital in Atlanta! Dr. Sterling then walked us through the center’s medical exam process, and I appreciated his big-picture perspective on the role of exams in Chadwick clients’ cases. “Our purpose is larger than just looking for evidence,” he emphasized. “We’re doing this to help a family through a difficult time.” Exams may address abuse, but sometimes may help families find solutions if their children are struggling to thrive. If a clinical diagnosis or psychosocial factor is identified, kids can connect with further care at the Chadwick Growth Support Clinic.
We then moved on to learn about child and family traumatic stress intervention with Elizabeth Santana Ojeda. The center’s traumatic stress intervention therapists help kids, and often their parents or caregivers, find ways to cope immediately following a traumatic event. Elizabeth explained that the Chadwick team strives to connect clients with this type of care within the first 30 days, but optimally within the first week, based on the Yale University-developed model they follow. Over five to eight sessions, clients focus on reducing symptoms of trauma and learning how to identify symptoms and minimize responses in healthy ways. Andrea Hazen was also part of the conversation, and told us about how Chadwick is an active participant in the ongoing development of the Yale model used. The center regularly submits de-identified patient reports, which helps to inform outcomes research and ensure the model evolves to meet the needs of the many people it serves. Impressive!
Sometimes, after traumatic stress intervention, specialists determine a child or family would benefit from longer-term mental health support. That’s where trauma counselors like Teresa Grame come in. For most clients, trauma counselors initially hold sessions once a week for about a year. During sessions, counselors can draw upon a variety of evidence-based treatment models to help clients further process trauma, manage symptoms and work toward healing. Chadwick offers individual sessions, which all clients begin with and continue for the duration of treatment, as well as group sessions, which Teresa explained are encouraged for nearly all clients once they and their therapist mutually determine comfortability and appropriateness for their individual experience. I enjoyed seeing some colorful artwork around Teresa’s office, and she mentioned that she is certified in both art and play therapy. “It helps kids tell their stories and allows them to feel safer in expressing themselves,” she said. I also found out that Chadwick Center staff do regular self-care activities, which is so important — optimizing your own well-being is key to your ability to help others do the same.
Next up were Veronica Paris, Jackie Dietz and Xio Martinez, who walked us through the family advocacy component of the center. They began with a mock session between Veronica, acting as the advocate, and Xio, acting as a woman whose husband had been arrested for abuse toward her and her children. As a stay-at-home mother, Xio’s character was worried about her economic stability moving forward, as well as keeping her family safe during and after the legal process. I became very invested in their scenario, and was so impressed with the compassion, knowledge and sense of calm Veronica brought to the conversation. Veronica explained that family advocates can work with clients to prepare for court sessions, find safe housing, connect to community resources, seek employment or economic assistance, schedule appointments, file restraining orders, and even attend law enforcement interviews or court at the client’s request. I can’t begin to imagine the relief advocates like these women bring to the Chadwick Center’s clients, and am proud that we are able to offer their expertise and support to our community.
Maggie Knight then introduced us to the KidSTART Clinic, which serves kids ages 0 to 5 with complex needs in areas including mental health, family dynamics, and growth and development. The KidSTART team works with kids and caregivers to conduct assessments, create individual treatment plans and coordinate long-term care. Care can be offered at KidSTART and Rady Children’s exclusively, or in partnership with other community programs. Along with helping children, KidSTART also offers a caregiver wellness program, which links adults with a parent care coordinator. Coordinators can provide mental health assistance, refer caregivers to additional resources, and even introduce them to a peer mentor. Chadwick has a strong dedication to making care whole-person and full-circle, and KidSTART is no exception.
As a lawyer, my wife felt right at home during Leslie Peterson’s overview of the Kids and Teens in Court program. This three-part program helps the Chadwick Center’s youth and adult clients better understand and get more comfortable with the complex, and sometimes scary, process of testifying in court. “We have permission and support from the District Attorney and judges to use facilities after hours,” Leslie explained, emphasizing how unique this is (probably one of the many reasons Chadwick has been asked to help train leaders in similar initiatives). Often, attorneys will even volunteer to be present during sessions, helping with mock trials and answering questions. Program participants also have the opportunity to learn relaxation strategies, try on judges’ robes and lend support to fellow clients through avenues such as the “Power Box,” in which clients write empowering messages for one another to take to court. That one warmed my heart!
Cambria Rose Walsh’s office was our next destination, and she led us through the federal, state and local funding sources that help make all the Chadwick Center does possible, including outside our immediate community! For example, I discovered that U.S. Department of Justice funding is allocated for Chadwick to provide training and support to other child abuse centers throughout the United States. Right now, a particular point of emphasis is on mental health offerings, and increasing access to high-quality mental health care for kids and families. I also found out that the Chadwick Center has had visitors from more than 200 countries, all of whom are interested in learning more about the center’s multidisciplinary approach to care and evidence-based models and replicating them at home. How wonderful that we’re a part of making a difference in even the farthest corners of the world.
Our final stop was with Lisa Quinn, who is one of the Chadwick Center’s professional education experts. We gained insight into the many ways the center advances knowledge of child and family trauma intervention, services, and research. For instance, along with integrating with CME courses right here at Rady Children’s, the Chadwick Center works with organizations such as the American Academy of Pediatrics to manage maintenance education and certification for pediatricians. The center also brings together some of the field’s most innovative professionals each year at its signature conference, which typically draws more than 2,000 attendees. We even got an advance invite to next year’s 35th anniversary conference — we have our calendar marked!
After that extensive and inspiring information download, we were invited to refuel with a huge buffet of bagels, fruit, and even breakfast burritos with fresh salsa. Yum! Then, it was time for a stamp on the passport, a group photo and a big thank-you to the Chadwick team before saying goodbye. It is a huge point of pride to know Rady Children’s has such a rich array of services to help families going through incredibly difficult, frightening or emotionally challenging situations find their voice, know their strength and work toward healing.