Responding to Childhood Abuse and Neglect: What’s Race Got To Do With It?

For part two, host Catherine Cerulli, JD, PhD is joined again by Liz Handley, PhD, the Director of Research at Mt. Hope Family Center and Associate Professor in the Department of Psychology at the University of Rochester to discuss the tips and tricks of excelling as a postdoctoral associate or recently completed post-doc in the field of psychology. Dr. Handley underscores that the first step for early-career professionals in the field is to define where you want to be – weather that be research, clinical work, or a combination of both. Take inventory of who has a job that you are interested in and seek mentorship and guidance from those who have experience where you hope grow. She notes, there is no one right way to get to where you want to go. The TRANSFORM Research Center has a rich data archive that Dr. Handley helps to maintain and support, she explains how using secondary analysis of data can lead to big impacts on the field. Collaborating with mentors and peers on secondary analysis is important, and having a foundational understanding of the literature surrounding the data is of utmost importance. She shares that understanding the theoretical underpinnings of the data will help with successful secondary analysis. Recognizing what we already know, where the gaps in the findings are, and understanding the study design and sample will lead to better analysis. Dr. Handley suggests early-career scholars seek pilot funding as a steppingstone to applying for federal grants. Kate offers various book recommendations that aim to grow ones writing skills. The episode concludes with Dr. Handley’s insight into finding the right mentor.

Host, Catherine Cerulli, JD, PhD, is joined by the Mt. Hope Family Center Director of Research and Associate Professor in the Department of Psychology at the University of Rochester, Liz Handley, PhD. Part one of this two-part episode explores Dr. Handley’s job evolution in the child abuse and neglect field. She shares that her interest in developmental psychopathology led her to Mt. Hope Family Center, one of the birth places of developmental psychopathology, as a research assistant after graduating college. This experience cemented Dr. Handley’s interest and thus her path towards her current role began. As she brings us along her journey, Dr. Handley explains the interconnectedness of the field, and how her mentors played a large role in guiding her path of growth. She was able to explore various areas of the child maltreatment field, in particular the impact of parent substance use on child development. This sparked an interest in the variety of risk factors that can impact child development. During her clinical internship at the University of Rochester Medical Center, Dr. Handley reconnected with the Mt. Hope Family Center, which ultimately led to her near current 12-year tenure at Mt. Hope. Dr. Handley’s experiences with her own mentors helped her develop mentorship skills. She notes, it takes a team of mentors, not just one, and that mentorship goes on long past graduation. Each of her mentors encouraged her in different ways – and she pays it forward by mentoring students and staff in her current work. Additionally, Dr. Handley shares the importance of collaboration and transdisciplinary teams to aid in professional growth and success. To close, Dr. Handley shares her tips and tricks for how she manages her time wearing many hats and while she herself continues to grow.

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.