Abstract
North Carolina has increased the percentage of its clinical workforce that is proficient in evidence-based treatment and adverse childhood experiences-informed care. Medicaid and managed care have contributed through standards and reimbursement that are consistent with treatment costs. Further progress requires a concerted response from payers, policymakers, providers, and families receiving evidence-based treatment.
Insights Results
Overview of the article/program
This article explores North Carolina’s efforts to tackle adverse childhood experiences and associated trauma through evidence-based treatment (EBT)
Both the North Carolina Child Treatment Program (CTP) at the Center for Child & Family Health and the North Carolina Institute of Medicine’s Task Force on Essentials for Childhood: Safe, Stable, and Nurturing Relationships and Environments to Prevent Child Maltreatment are examples of North Carolinian strides in evidence-based treatment for people with adverse childhood experiences and trauma
CTP promotes mental health through Trauma-Focused Cognitive Behavioral Therapy. Past pilots showed significant improvements in children’s posttraumatic stress, depression and emotional and behavior problems. Clinicians also showed high fidelity to the intervention
The North Carolina Institute of Medicine’s Essentials for Childhood: Safe, Stable, and Nurturing Relationships and Environments to Prevent Child Maltreatment Task Force uses a public health approach to provide care (e.g., screening, comprehensive clinical assessment) to youth experiencing adverse childhood experiences to identify treatment needs
In 2013, the North Carolina General Assembly budgeted an annual appropriation for CTP to develop and train mental health clinicians to practice 4 evidence-based treatments: 1) Child-Parent Psychotherapy; 2) Parent Child Interaction Therapy; 3) Structured Psychotherapy for Adolescents Responding to Chronic Stress; and 4) Trauma-Focused Cognitive Behavioral Therapy. CTP has conducted 34 Learning Collaboratives resulting in more than 800 rostered clinicians who serve 79 North Carolina counties. As a result, thousands of children have received evidence-based treatment, however there is still need for more
Key takeaways/implications
Medicaid, especially managed care organizations, presents an opportunity to further quality in a manner that addresses a number of existing barriers, including promoting the use of EBTs by providing a sustainable utilization management and reimbursement structure
