Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Women's Therapy Center

Name of Innovative Program: 
New Beginnings
Sponsoring Organization
Women's Therapy Center
Name of Innovative Program Lead: 
Alison Gerig
E-mail Address of Innovative Program Lead: 
ed@womenstherapycenter.org
Project Description: 
 Women’s Therapy Center (WTC) established an innovative program called New Beginnings in 2009 to address the growing number of low-income women presenting with trauma. Women were calling desperate for help and with few financial resources. They reported experiences such as childhood physical abuse, sexual violence, witness to a crime, traumatic accidental death, hate crimes, and profound neglect.  Some had tried community mental health facilities and felt little results. They encountered long waiting lists, treatment capitations, high turnover of staff, and found that their symptoms remained. New Beginnings was designed to offer an evidenced-based approach called EMDR (Eye Movement Desensitization and Reprocessing) that specifically reprocesses and integrates trauma in a lasting and efficient way.  WTC offers a sliding fee scale, a strong therapist/client matching process, no treatment capiations, and a high show rate. WTC treats 50 women a year with EMDR and has seen an 88% success rate with lasting results. 
Creativity and Innovation: 
 New Beginnings is the first and only community-based program that offers a resolution-oriented trauma treatment approach to low-income women in Philadelphia. Its sole purpose is in promoting behavioral health through an evidenced-based psychotherapy technique called eye movement desensitization reprocessing (EMDR). As one of the most highly researched and effective treatments for trauma, EMDR is ingenuous and resourceful at its core. Therapist and client use an eight phase protocol where clients "unlock" the negative memories and emotions stored in the nervous system, and then help the brain to successfully reprocess the experience.  Clients who once reported a high level of distress or disturbance will report no distress or a neutral feeling after completing treatment. This technique creatively uses the internal resources coming from the client and allows them to remain in complete control while processing intense traumatic material. It tends to be more efficient and clients get better faster.
Leadership: 
 As an efficient and results-based clinical approach, WTC has pioneered offering EMDR to low income communities in Philadelphia. To date, the New Beginnings program has trained 9 clinicians at Women’s Therapy Center (WTC).  WTC’s success has spread and other agencies are interested in using this approach and model. Typically a costly training, WTC is responding to this and pursuing a project to offer a city-wide training at a reduced rate to other clinicians working with disenfranchised communities impacted by trauma. WTC is a member of the national EMDR association (EMDRIA) and is working with their president on publishing results from a study jointly conducted in 2011 on the effectiveness of using EMDR in a community-based feminist oriented setting.  Funders also have supported New Beginnings’ leadership with multi-year grants for program and training costs.
Sustainability: 
 The business model for New Beginnings is three fold. Therapist salaries are supported through the 30% of WTC’s client caseload who are at the top of our fee scale ($80+). WTC operates an individual giving campaign that subsidizes a service fee at 1/5th the market rate ($20) for EMDR services. Funders have supported training 9 clinicians as well as their required supervision for certification and practice. These include the Barra Foundation, who offered a grant to launch the New Beginnings initiative, and the Claneil and van Ameringen Foundations, who have supported the program over the last three years. This approach covers all program, supervision, and training costs.  To sustain intake and screening needs, WTC uses  new clinicians in the field seeking hours for clinical licensure. These therapists are paid a reduced fee and offer consistency to the agency as they gain experience in trauma work and EMDR.
Replicability: 
 Due to its clear 8 phase protocol taught through an intensive two weekend training and supervision that supports clinician efficacy, EMDR can be incorporated into behavioral health settings and duplicated to meet the needs of varying populations struggling with the impacts of trauma. It is easily used in conjunction with other therapy approaches such as prolonged exposure treatment, relational therapy, psychodynamic therapy, and trauma-informed cognitive behavioral treatment (TI-CBT).  The EMDR Humanitarian Assistance Program (HAP) offers trainings at reduced rates to clinicians working in agencies. Agencies with short-term treatment models could utilize EMDR because positive client outcomes are achieved over a shorter period of time.  Achieving positive results faster also improves client show rates – WTC has an 85% show rate compared to 50% in traditional community mental health programs. High compliance is also due to EMDR not requiring the client to re-live all the details of the trauma to resolve it. 
Results/Outcomes: 
 EMDR uses two specific metrics to assess treatment effectiveness. The Subjective Units of Disturbance (SUDS) measures the client’s reported level of disturbance at the beginning and end of sessions. The goal is for the client to still have the memory but report little to no upset around it. When the SUDS level is 0 then clinicians move into the end phases of treatment including “installation, body scan, and closure” [i].  The Validity of Cognition (VoC) measures how much you believe a positive cognition about yourself and evaluates how close you are to this belief.   We often feel negative cognitions about trauma like “I am bad” or “I am unwanted”.  EMDR helps you identify a positive belief like “I am lovable” that you want to believe about yourself.  When the scale reaches 7 (completely true) the client continues into the end phases.  [i] Handbook for EMDR Clients, Marilyn Luber, 2003, pg 5.  
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