Innovation Spotlight: Compassion, Practice, Relationships and Restoration
Embedding a mental health specialist in the pediatric primary care setting via the HealthySteps DC program has benefited children and families in many ways. It has also benefited the health care providers who work with families experiencing extreme social and emotional stress.
At the Children’s health center anacostia, Dr. charlot-swilley works side-by-side with primary care providers to support children and families as well as the providers themselves.
“Compassion fatigue develops over time. Bearing witness to patients’ stories of traumatic events can lead to emotional exhaustion and decreased feelings of professional accomplishment. Unmitigated compassion fatigue can result in loss of job satisfaction, high turnover rates, and burnout,” says Dominique Charlot-Swilley, Ph.D., clinical psychologist and HealthySteps Specialist at Children’s Health Center Anacostia. “Research supports the benefits of interventions to combat compassion fatigue and toxic stress. This is why it is so important to address these impacts in our health care providers.”
Two years ago, Dr. Charlot-Swilley and her colleagues Elva Anderson, Ph.D., and Emily Aron, M.D., launched a program in three clinics to teach the doctors, nurses, and support staff about the importance of caring for themselves through self-care and mindful practices. The Compassion, Practice, Relationships and Restoration (CPR2 or CPR-Squared) program aims to improve provider resilience to withstand the negative impacts of secondary toxic stress. A more resilient workforce is less likely to burnout and also more equipped to help young patients and families navigate stressful and traumatic experiences.
Though teams at all three potential implementation sites were eager to learn more about how to take better care of themselves and their patients, finding the time to sit down and learn the techniques was a major hurdle given the pace of their bustling clinics.
The initial program spanned eight sessions, for example, but providers often couldn’t commit that much time. Instead, the specialist at each location tailored the program to fit the unique workflow of each clinic. In one clinic, the training is held as a breakout session during the monthly mandatory staff meeting. In another, it is a full day, offsite retreat at a location far from the call of other clinical demands.
Dr. Charlot-Swilley also notes that “flexibility has been the name of the game here to make sure that participating members experience the curricula in a way and at a time that is meaningful to them.”
That flexibility has also been important to collecting vital data from participants to gauge the program’s effectiveness. Pre- and post-survey feedback has been difficult to consistently obtain across cohorts. Future iterations of the program will embed the surveys into the actual session programming to streamline collection.
“Research supports the benefits of interventions to combat compassion fatigue and toxic stress. This is why it is so important to address these impacts in our health care providers.”
The team is focused on refining the curricula both in person and online, to more effectively reach providers in every location, regardless of the presence of an embedded mental health specialist every day. The online module will launch in the next few months for all the care providers in Children’s National Health Centers and other primary care clinics.
New CPR2 cohorts will also pilot ways to encourage the program’s sustainability by appointing a physician or staff “champion” to help maintain office-wide commitment to mindful practices, finding better balance, and exercising self-care.
In the long term, Dr. Charlot-Swilley says it will also be important to explore adapting the training to a broader audience. “Compassion fatigue is not solely an issue for medical providers. Burnout impacts all those who are really committed to working with a population who has been historically and systemically marginalized—including churches, the child care workforce, and so many others.”
Read about CPR2’s impact on two care providers in the Children’s Health Center-Anacostia.
ECIN Speaks at...
DC Early Childhood Summit: Brighter Futures Start Here
ECIN team members attended the 2019 DC Early Childhood Summit alongside nearly 4,000 early childhood professionals, hosted by the D.C. Office of the State Superintendent of Education (OSSE). Various team members presented during many of the day’s sessions, sharing insight on topics including:
Breaking Down Silos in Perinatal and Early Childhood Health and Policy
Healthy Generations: An Innovative Teen-Tot Clinic Model
Supporting Educators and Practitioners: The Path of Self-Care and Well-Being
A Trauma- and Resiliency-Focused Approach to Care
Building Authentic Connections: Infant and Toddler Social Emotional Community of Practice
Early Childhood Mental Health Consultation in Early Care and Education: Practice, Research, Policy and Next Steps
Improving Parental Mental Health in a Pediatric Primary Care Setting
Mental Health and Autism Navigation: Understanding Services and Promoting Engagement
Building Systems with Families and Communities
Coordinated Cross-Sector Care: Partnering with Health Care Providers to Support Young Children
View the event details and see the full agenda.
ZERO TO THREE Annual Conference 2019
In October, ECIN team members attended the ZERO TO THREE Annual Conference to share their experiences and learn from like-minded innovators around the country about best practices for providing young children and their families the support they need to thrive.
Randall Baylor, Dominique Charlot-Swilley, Yvonne Garces, and Hope Rhodes prepared the presentation, “Improving Successful Early Intervention Referrals in the Primary Care Setting,” about the HealthySteps DC model of care coordination within the pediatric primary care setting that is designed to help families thrive despite systemic marginalization, and sought dialogue regarding best practices from participants.
Dominique Charlot-Swilley, Sharon Singh, Justine Wu, Karyn Hartz-Mandell, and Stacy Hodgkinson prepared a session called, “Parental Mental Health in a Pediatric Primary Care Setting,” which highlighted the ECIN model of parent mental health intervention within pediatric primary care, and encouraged an open conversation with participants about best practices.
Marcé of North America (MONA) 2019 Conference — 4th Biennial Conference on Perinatal Mental Health
Matt Biel, Aimee Danielson, Melissa Fries, Stephen Kane, Mimi Le, and Hillary Robertson prepared an ECIN presentation and team poster at the MONA conference entitled: “Beyond EPDS: Evidence for screening and implementation in obstetrics settings,” to share findings from a study that examined screening rates for postpartum depression (PPD) at two major obstetrical centers in the year after the American College of Obstetrics and Gynecology made their PPD screening recommendations. The team found varied screening rates which suggests that increased programmatic support, training, and access to direct referral sources for PPD treatment may help facilitate implementation of universal screening.
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