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NEAR Talk – How Childhood Trauma Affects Lifelong Health

Trauma… it’s the really horrific things that we go through as people… things that deeply impact us. For some, trauma is a single point in time while others experience ongoing trauma and instability.

The Merriam-Webster Dictionary includes these concepts when defining the word trauma:

Injury caused by an extrinsic (outside ourselves) agent

Results in severe mental or emotional stress or physical injury

In many cases when we experience trauma as adults we have gained the tools and relationships to carry us through. When we experience trauma as children we do not necessarily have those resources or the brain development that gives us the resilience needed. The more trauma or adverse childhood experiences (ACEs) that a child experiences, the greater the likelihood these experiences will have negative health impacts throughout their lifespan that can include obesity, heart disease, and substance use disorders.

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New Course Announcement!

Module-1-Announcement with YouTube Link

VCPI is excited to introduce our first module in the series of training curriculum focused on orienting new direct service providers to effectively partner with those who seek support within the Vermont System of Care. It seems most appropriate to start this series with the cornerstones of effective practice.With a focus on the values, principles, and beliefs, this first module in the series is designed to give new staff the opportunity to hear about the importance of these concepts directly from those who have participated in supports and services and encourage effective partnering with other professionals. In addition to an on-line video module and accompanying workbook, there are supplemental materials that will assist with integrating the information into practice.

Download Announcement

Check out Support Group Schedule & other events from NAMI- VT

Check out the Support Group Schedule & other events from Vermont Psychiatric Survivors

Executive Director Corner:

It’s been a busy year for VCPI as we continue to discover the many ways we can have a positive impact on the Vermont system of care.  Our membership is increasing and, with bigger numbers, the benefits also grow. Our collaborative participation allows us to add to our initiatives and the opportunities for members to participate in professional development opportunities at no cost.  If you and/or your organization are not VCPI members yet, visit the Membership area of the VCPI website where you can learn more about the membership process and access a listing of current members.  Any of us are happy to talk with you further and you are welcome to call the VCPI office, as well.

To be specific regarding initiatives, we are very excited to announce that we have published our first module in the series called Core Orientation for Direct Service Providers, which is considered an essential offering for our members and seems very appropriate to start with the module that focuses on the values, principles and beliefs that we share as the Vermont System of Care.  The module is designed to give new staff the opportunity to hear about the importance of these concepts directly from those who have participated in supports and services.  In addition to the on-line module, there are supporting materials to assist in integrating the information into practice.  We will provide regular updates on our progress with module 2, but for those who would like to play a more active role in development, we are currently looking for new project advisory committee members who are willing to participate in the process of development and review progress along the way.  If you’d like to talk more about this, please contact Amy Stonoha at or myself at Additionally, we kicked off the second iteration of the successful Co-Occurring Competency E-Learning Community Project, piloted in 2016-2017.

Please feel welcome to keep in touch and share your thoughts and ideas about VCPI and the places we are headed.  Maybe you’d like to submit a commentary for the newsletter, or join a work group or just chat about some things.  Call or e-mail anytime:  (802) 503-2857 Also, we welcome you to join us for our upcoming Steering Committee Meeting, March 12th from 9:30 a.m. to Noon with lunch following at the Waterbury State Office Complex. Please contact me for details and email us to be added to the invite list!

Flourishing/ Self-Healing Communities

The Vermont Cooperative for Practice Improvement and Innovation, VCPI, is quickly gaining recognition as being an aptly named organization.  As you will see throughout this newsletter, there are multiple initiatives underway that support the opportunity for Vermonters to work together in innovative ways to improve the practices and services we are able to offer across multiple settings and modalities of care.  The model allows for exponential increases in skills and knowledge, while being cost effective and efficient.  Importantly, the directions are informed by those with lived experience and/or in the role of representing advocacy organizations.

As outlined in the project descriptions here and on our website, there are several ways that VCPI plays a role in the success of the initiatives with which we are involved.  One of the approaches that has been particularly successful is the development of Learning Communities.  Sometimes also called Learning Collaboratives, this method of improving practice is not new.  It is a well-researched way of efficiently and effectively producing results.  When multiple sites across Vermont are focusing improvement efforts in the same topic area, the opportunity to have a regular and facilitated process for connecting with one another is invaluable.  VCPI provides the groups with access to national experts in particular subject areas, and adeptly manages the logistics of coordinating and organizing the process.   With those ingredients in place, the participants can focus on the important opportunities to grow and learn and on building a supportive community that will sustain that focus over time.  For all of those reasons, VCPI will continue to seek out opportunities to develop learning communities.

One such potential new initiative presented itself just this past week and I’d like to tell you about it. First of all, did you know that there is a county in Washington State that has reduced youth suicides and suicide attempts by 98% in the last 15 years?  We all know that here in Vermont and most other states, the suicide rate among adolescents is growing at an alarming rate.  Were you aware that similar statistics are popping up in many communities which have chosen to tackle issues such as high school dropout rates, substance use, and arrests?

Have you heard the newest findings in neurobiology, especially as related to early-trauma, and how they are quickly increasing our ability to develop effective interventions?  Or that the field of Epigenetics is revolutionizing our understanding of health, well-being and resilience?  Perhaps you’re just finding out that Epigenetics is the study of heritable changes in gene expression (active versus inactive genes) that does not involve changes to the underlying DNA sequence — a change in phenotype without a change in genotype — which in turn affects how cells read the genes.

Participants in The Flourishing Communities Summit, held December 1st & 2nd at Lake Morey, now know a great deal more about all of this and are gearing up to find ways to spread their knowledge and collaborate to develop exciting ideas for using the knowledge to support improvement in our Vermont communities.  Approximately 300 people, representing all geographic areas, professional roles, ages, personal histories and experience with the topic of trauma, spent two days together in an environment carefully orchestrated to actively engage them in the process of learning and planning together. Some of you were there for this experience.  The summit featured Laura Porter and a particular framework called Self-Healing Communities.  You can learn more about Laura and this approach at

I’m sharing this with you for a couple of reason. When 300 people in our small state get excited about something, you’re likely to hear about it within your own work and will have some foundational understanding of what the buzz is about when it comes your way. My other motive is to begin to think together about the potential role for VCPI in moving this work forward. The summit provided an opportunity for regional groups to begin to build a collaborative process for using the Self-Healing Communities Framework to address challenging issues in their own communities. We didn’t just talk about how that should happen- we actually met in regional groups and planned initial action steps. Momentum in building. Seems to me there will be ways that the Co-op can support these important efforts.

If this topic and potential VCPI focus area is of interest, we would love to hear from you. We can establish an e-mail group to keep us all up to date as the statewide conversation begins to take shape, and then we can morph into some specific planning meetings. Just drop me a line or give me a call!

Connect with Karen Crowley!

Read about SAMHSA’s Block Grant Funding surrounding FEP

Serious Mental Illness: A New Block Grant Priority

Mental health treatment practitioners have, over the years, observed that most individuals who have a serious mental illness (such as bipolar disorder, major depression, and schizophrenia) typically experience the first signs of illness during adolescence or early adulthood. Yet there are often long intervals between the onset of symptoms and diagnosis, referral, and treatment. In response, Congress has directed SAMHSA to require that states set aside 10 percent of their Community Mental Health Services Block Grant to address these needs.

Read the article

First Episode Psychosis Project- Washington State Department of Social and Health Services

Specialized Treatment Early in Psychosis (STEP)

Specialized Treatment Early in Psychosis (STEP)

STEP is a clinic staffed by mental health providers in different fields – psychology, psychiatry, nursing, and social work. This "interdisciplinary" team seeks to provide comprehensive care for individuals who are early in the course of a psychotic illness in order to prevent symptoms from becoming disabling.

Visit Yale School of Medicine

First Episode Psychosis: An Information Guide

The purpose of this information guide is to provide information about a first episode of psychosis, its treatment and recovery. It has been written for people experiencing a first episode of psychosis and their family members, to help them gain a better understanding of this illness. Increased awareness of the signs, symptoms and treatment may improve the outcome for people with a first episode of psychosis.

Go to: First Episode Psychosis: An Information Guide

First Episode- Results from a 2011 NAMI Survey

RAISE Early Treatment Program Manuals and Program Resources

NAVIGATE is a Coordinated Specialty Care (CSC) treatment model developed by the RAISE Early Treatment Program  (ETP). See available NAVIGATE resources  on the ETP project site including Director Manual, Family Intervention Manual, Individual Resiliency Training (IRT) Complete Manual, Psychopharmacology Manual, Supported Employment and Education (SEE) Manual, and Team Guide Manual.

Components of Coordinated Specialty Care for First Episode Psychosis Webinars

Components of Coordinated Specialty Care for First Episode Psychosis Webinars

Webinars were created for state mental health program directors in order to provide further guidance related to the development of CSC programs for FEP. These webinars were held on:

May 2, 2014 

May 12, 2014 

ILSA Supervision Workbook: Co-occurring Competency

ILSA-Basic Integrated Longitudinal Strength-based Assessment

The Integrated Longitudinal Strength-based Assessment (ILSA) is a template intended to help clinicians and/or clients walk through the recovery-oriented assessment process step by step and facilitate a recovery-oriented process for adults.

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ILSA Worksheet for Assessment Supervision

The Integrated Longitudinal Strength-based Assessment (ILSA) is a worksheet for Supervisors to assist staff in developing Co-occurring Competency. The material for discussion is drawn from an assessment recently performed by the staff member or from a video tape assessment.

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COMPASS-Prevention Prevention Provider Tool

COMPASS-PREVENTION helps programs being the process of developing "recovery and resiliency-oriented co-occurring capability." COMPASS-PREVENTION bring together critical knowledge of what we all have learned over the years about what helps individuals and families- knowledge about integrated services, trauma-informed services, person-centered interventions, cultural competency, population specific services, and most fundamentally, empathetic relationship that inspire hope and help. The most important purpose is to create a foundation for an improvement process through an empowered conversation that involves as many people as possible working together to make progress for the program and its services.

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CODECAT-EZ Recovery-oriented Co-ocurring Competency: A Clinical Self-assessment Tool

A tool for Behavioral Health Treatment and Service Providers Working with Adults, Children, Youth and Families CODECAT-EZ™ is a tool for clinicians working on their recovery-oriented co-occurring competency development. This tool provides a way for staff to evaluate their own attitudes/values and knowledge/skills related to helping people and families with complex lives make progress in recovery. CODECAT-EZ™ also provides supervisory staff with a structured process to assist staff with competency development. We hope that you find the process to be enjoyable and helpful to you.

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