Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

The Health Federation of Philadelphia

Name of Innovative Program: 
Multiplying Connections: Building and Sustaining a Trauma Informed System for Children
Sponsoring Organization
The Health Federation of Philadelphia
Name of Innovative Program Lead: 
Leslie Lieberman
E-mail Address of Innovative Program Lead: 
llieberman@healthfederation.org
Project Description: 
More than two decades of research confirm that trauma and early childhood adversity can result in lifelong physical and behavioral health problems. To address this, Multiplying Connections is a system change initiative focused on building capacity for trauma informed practice in the children’s service system in Philadelphia. Together, a coalition of dedicated champions representing key children’s services systems and organizations has developed a variety of cross-system tools and resources to promote a trauma informed approach. These include: a foundational curriculum on trauma-informed techniques to build resilience and reduce harm, delivered by a cadre of local experts; technical assistance services for administrators and managers to change practices and policies in organizations and systems; a set of competencies that can be used as performance standards; and quality indicators; evaluation measures to monitor and guide how we deliver services to children; and strategies to  foster  partnerships among these organizations and systems.
Creativity and Innovation: 
Embracing the vision of its primary funder, the William Penn Foundation, Multiplying Connections is built on the belief that the “best opportunities to achieve [a] mission come from encouraging, supporting, and yes even cajoling otherwise independent actors to unite around shared interests.” The Initiative has developed and nurtured a strong network of local champions, who are passionate about and now have a shared expertise in trauma informed practice. Furthermore the initiative has intentionally created a locally grown model we call “middle-out,” rather than more traditional “top down” or “bottom up” system change efforts.  Coalition members comprise more than one mid to senior level leader from each of the key systems serving young children.  These leaders are less vulnerable to losing their positions than high level appointed officials who are replaced when new administrations come to power. Coalition members are also likely to be promoted and broaden their spheres of influence.
Leadership: 
As the mission statement of Multiplying Connections asserts: “we believe that collaboration and relationships are the vehicles for individual, organizational and system change.” Under the steady and nurturing leadership of Leslie Lieberman, MSW, the Initiative has created a strong and sustained coalition of champions who work together and independently to influence change within their respective networks.  Additionally, through regular communication on its website, professional development activities, newsletters, symposia and partnerships with other organizations, Multiplying Connections actively encourages other organizations to embrace a trauma informed approach to care.  Increasingly, the Initiative has received national attention for its expertise, collaborative approach and useful tools and resources.
Sustainability: 
Multiplying Connections began as an unfunded coalition in 2004.  Since that time it has received two rounds of funding from the William Penn Foundation. Increasingly, the Initiative has grown its budget through fee for service professional development, technical assistance, and consultation to organizations and systems locally and nationally who are seeking to build capacity for a trauma informed approach to children’s services. Smaller grant awards from public and foundation sources have supplemented the work. The Coalition members, who are not paid to participate, are a critical component of Initiative’s sustainability.  The original leaders that convened in 2004 have stayed deeply involved and committed to the Initiative’s mission, continuing to strongly promote and advocate for trauma informed practice. Some coalition members have transitioned to new roles and brought their expertise and passion for trauma informed care to these new organizations and/or systems.  
Replicability: 
The model used by Multiplying Connections is highly replicable as it depends on identifying and developing a small but effective group of cross-system champions.  Many of the tools and resources developed by Multiplying Connections are available and have been used freely by other systems as they develop their trauma informed system change initiatives.  Notably, the State of South Carolina has created a statewide task force on trauma informed care and is using the Multiplying Connections Competencies as  the key source for developing their competencies.  Broward County in Florida is training a group of trainers in the Initiative’s foundational curriculum, Becoming Trauma Informed, as a component of their plan to improve service delivery to young children and foster collaboration between early care and education and the child welfare system.
Results/Outcomes: 
System change is a challenging outcome to measure.  Nonetheless, the Initiative has devoted significant effort to collecting and analyzing data to assess its impact.  These include data about our foundational training from training evaluations, follow-up surveys and focus groups; repeated interviews with key stakeholders both directly and indirectly involved in the program; and reviews of system documents, policies, curricula and other sources that reflect changes toward a trauma informed approach to care.  Indicators suggesting the Initiative is having the desired impact include high ratings from over 2000 participants who received our foundational training, increased requests for this curriculum locally and nationally, a tripling since 2007 in the number of trauma informed professional development activities offered by MC champions, inclusion of trauma informed language in contracts, significant increases in funding for trauma specific treatment for children, and adoption of the MC competencies by a number of local and national organizations.
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