In this podcast, Kari Kerr and Kristi Hall-Jiran talk about Safer Tomorrows, Grand
Forks, North Dakota’s Defending Childhood Initiative. Safer Tomorrows implemented universal violence prevention programming in public, private, and rural schools across
Grand Forks County, beginning with pre-kindergarten and extending to high school. The initative is part
of the Department of Justice’s Defending Childhood Demonstration Program, which funded eight sites
across the country to  respond to the problem of children’s exposure to violence. The Center
for Court Innovation has produced a report on Safer Tomorrows, a series of reports on five other sites, and a report that condenses lessons learned across the sites.

Resources
mentioned in this podcast:

Safer
Tomorrows

The Community Violence
Intervention Center

Al’s
Pals

Friendships at Work

Lessons
from Literature

Digital
Citizenship

Coaching
Boys into Men

Lutheran Social Services Restorative Justice

Healthy Families

The
Fourth R

The following is a transcript

AVNI MAJITHIA-SEJPAL: Hi. I’m Avni Majithia-Sejpal, senior writer at the
Center for Court Innovation. Welcome to another episode of our New Thinking Podcast. Today, we’re here to talk
about Safer Tomorrows. Safer Tomorrows was established in Grand Forks County, North Dakota, as part of the Department
of Justice-funded Defending Childhood Demonstration Project, which was designed to address children’s exposure
to violence through eight demonstration sites across the country.

We,
at the Center for Court Innovation, have just released individual process evaluation reports on six of these eight
sites, as well as a multi-site report that condenses the lessons learned through our research. Today, from Safer
Tomorrows, we are talking to: Kari Kerr, director of community innovations at the Community Violence Intervention
Center and leadership team member of the Safer Tomorrows project, amongst others; and Kristi Hall-Jiran, executive
director of the Community Violence Intervention Center. Kari and Kristi, welcome to our podcast.

KARI KERR: Thank you for having us.

KRISTI
HALL-JIRAN: Thanks. We’re glad to be here.

MAJITHIA-SEJPAL:
Let’s begin by talking a little bit about the project itself. Safer Tomorrows aimed to implement universal prevention
programming in Grand Forks County. My question is, what made you decide to focus on school-based prevention programming?

KERR: I think there are a couple of factors that went into our decision.
The main one was, our state had just actually passed anti-bullying laws requiring schools to develop some type of
a policy or a response, and so the timing was really good in terms of approaching the school system.

Then, we also know that, obviously, for our school system, we can have a
wide reach of youth that are attending school. Certainly, from kindergarten all the way up to 12th grade, and we
went beyond that and looked at some of the pre-schools in our community as well.

HALL-JIRAN:
I think just to add to that, too. We also had really spent some time developing a good, strong working relationship
with the schools in several years before the project. We really felt like we already had the leadership of the school
system on board, the superintendent served on our agency’s board of directors, and so really felt that the timing
was right. We already have the collaborative relationship and so the natural outcome was to focus on that way.

MAJITHIA-SEJPAL: When we talk about violence, what are some of the forms
of violence, specifically pertaining to children and teenagers, that need to be addressed urgently in your county?

KERR: When we first developed our Safer Tomorrows project, we, of course,
wanted to be very inclusive of all types of violence and really make sure that we were addressing anything that could
affect the child, and we also wanted to look at how to prevent violence and not just to intervene. We did want to
also look at the things that were most impacting our children. What we did before we even started developing our
programming was really to do a needs assessment as to what the most prevalent forms of violence were.

As we looked at existing statistics and then gathered additional data, what
we found was that the kinds of violence that we saw the most in our county was pertaining mostly to bullying in the
school system, or just anywhere, and then also children exposed to domestic violence at home. Though we had pure
statistics on dating violence, we heard from a lot of our stakeholders that they felt that that was a pretty primary
issue as well.

Though we tried to address all of
the issues, those are the areas that we’re really focusing on.

MAJITHIA-SEJPAL:
Can you talk to us a little bit about the different features or highlights of the project?

HALL-JIRAN: We’ve looked at it in three different areas. We designed
the program around intervention effort, so any child age 0 to 17 that is being impacted in some way by violence,
we wanted to make sure we were finding a way to intervene. Then, we also looked at prevention. How could we start
building the kind of programming in our community that would prevent this type of violence from happening so that
two generations from now we don’t even have to have these conversations anymore?

Then, the third piece, we really tried to build a very strong data and evaluation
component because we really wanted to base our decisions on available data and then ongoing evaluation so that we
could treat what we implemented as we found out if that was working or not, or as different types of violence change
and, hopefully, if we were seeing good results we could start making some of those adjustments.

As far as specific things that are under each of those areas, maybe I’ll
have Kari talk about that a little bit.

KERR: Sure.
We were able to implement a variety of different prevention programs, many of which are evidence-based. Some of those
included Al’s Pals, which is for our youngest population, that’s bullying prevention program. We also implemented
“The Fourth R” for health classes, Friendships at Work, which is a positive friendship curriculum.

A couple of different programs looking at some of the online issues that
can happen with students, that would be Digital Citizenship. Then, we also have one of our schools implement Lessons
from Literature. Then we did Coaching Boys into Men.

We
really had a variety of prevention programming starting from, again the early years all the way up to 12th grade.
As Kristi mentioned, we had a lot of intervention services offered as far as specialized therapy services and the
Lutheran Social Services of North Dakota has provided restorative justice programming and Healthy Families. We’ve
also been able to work with some of our families …

MAJITHIA-SEJPAL:
Given that you’re targeting children and teenagers in such a wide age
range, from 0 through 17, how did you adapt your methods to different ages and specifically to the youngest children?

HALL-JIRAN: You’re right. That’s a very wide age range for, not
just prevention, but also for area of intervention as well. As Kari mentioned, for the youngest kid, we implemented
Al’s Pals. It’s a puppet program. It’s basically working with kids as they’re playing, so we
really try to adapt to what would be age-appropriate.

As
we got more into elementary school, the curriculum focuses more on respect and being kind to each other and all those
kinds of things. Then as we moved in the middle school age, we looked a little bit more at anti-bullying and respectful
friendship, and what would healthy friendship look like, how do we treat each other, those kinds of things. Then,
of course, as we got to the high school level, we looked more at dating violence and healthy relationships.

Really just trying to adapt the programming that we picked to really sit
with these age groups and what would be most primary for that group.

MAJITHIA-SEJPAL:
How did you adapt evidence-based and promising practices and tools, especially given that your target audience spans
such a wide age range?

KERR: I think one of the ones
that we ended up having to adapt a little bit the most was our Friendships at Work curriculum, which is more of a
promising practice. It was initially designed for seventh grade classes. As we were implementing, we were receiving
feedback from some of the teachers, for a variety of reasons that they felt it would be better suited for fifth grade.

Again, the author of that curriculum went back in to adjust some of the
language that we used as we’re teaching it, some of the videos that she used, some of the examples that she
would give just to adjust that down to fifth grade level because, again, you’re going down three levels from
what it was initially designed for. We’re finding that it’s working really well in the fifth grade right
now.

HALL-JIRAN: One of the other adjustments that
we made was Lessons from Literature. That was something that we were originally going to do in our high school English
classes, but the curriculum was just designed in Canada and the literature that they used in Canada was not going
to work for our high schools here in Grand Forks. We basically did some research and decided to implement “The Fourth
R” in our health classes rather than Lessons from Literature.

It
was just some of the speed bumps along the way, just look at what else you can do instead and just always try to
adapt to your population.

MAJITHIA-SEJPAL: That’s
really interesting. What were some of the challenges you encountered as you went about implementing your various
programs?

KERR: I think anytime you are involved
in a whole county of people, which involves seven different school districts and thousands of kids, it’s really
hard to just make sure that it’s all being well-taught uniformly. We know that all the curriculum that we implemented
is only as good as it actually is at the level of the teacher implementing it or the staff person implementing it.
I think it’s always a challenge just to make sure that everybody is doing it and doing it in a consistent way.

HALL-JIRAN: I would just add to that, as Kari mentioned, just when you’ve
got seven different initiatives that are all trying to implement on a whole spectrum of ages 0 to 17, all the way
from intervention through prevention, you have got a lot of moving parts and I think you absolutely cannot over-communicate
at that point. Just trying to make sure everybody knew what each other was doing and that we were all keeping that
common vision in front of us was really a constant challenge.

MAJITHIA-SEJPAL:
What are some of the lessons learned that you can pass on to other counties that might be interested in implementing
prevention programming that is similar to yours.

HALL-JIRAN:
I think one of the biggest lessons that we learned is to just plan for more time than you think you’re going
to need. I think, especially if it is involving federal funds, it’s really important to have adequate time to
have the review process that you need in place for different publications and things like that. That was one of the
things that sometimes the schools have found a little bit.

KERR:
I think in addition to that, just having good communication that’s ongoing with your collaborative partners
is important. We had lots of committees that we’ve set up to make sure that everyone stayed on top of what was
happening in our project. We did that through actual face-to-face meetings, as well as email and phone conversations,
and then being flexible as the project continues to make adaptations as they’re needed.

MAJITHIA-SEJPAL: What are some of the results that you have been witnessing.

HALL-JIRAN: We will be continuing to monitor this on an ongoing basis. Some
of the most exciting results that we’ve seen thus far is that, at the elementary level, we’ve seen 42 percent
fewer fourth and fifth grade students who are reporting being bullied. We’ve also had 46 percent fewer high
school students who have reported that during the past six months someone has forced them to do something sexual
that they did not want to do. We’ve had 28 percent fewer fourth through 12th grade students reporting that they
witnessed violence in their home.

We’re very
excited about the preliminary results and really are interested to see where this will go in the future.

MAJITHIA-SEJPAL: Wonderful! Thanks so much for speaking to me. That was
really interesting.

KERR: Thank you so much. We really
appreciate it.

MAJITHIA-SEJPAL: I’m Avni Majithia-Sejpal
from the Center of Court Innovation and I’ve been speaking to Kari Kerr and Kristi Hall-Jiran about the Grand
Forks, North Dakota Defending Childhood Initiative, Safer Tomorrows. Visit our website at www.courtinnovation.org
to download other podcasts and reports on Defending Childhood Demonstration project. Thanks so much for listening.

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Jill Smialek and Dr. Jeff Kretschmar discuss the Cuyahoga
County Defending Childhood Initative, which  seeks to address violence against children in one
of the country’s most violent areas – Cuyahoga County, Ohio. Their
unique approach includes the creation of an integrated, county-wide screening, assessment, and service system for children ages
0-18 who have experienced violence and trauma. The initative is part of the Department of Justice’s Defending Childhood Demonstration
Program, which funded eight sites across the country to  respond to the
problem of children’s exposure to violence. The Center for Court Innovation has produced a report on the Cuyahoga County Defending Childhood Initative,
a series of reports on five other sites, and a report that condenses
lessons learned across the sites. 

The
following is a transcript

AVNI MAJITHIA-SEJPAL: Hi,
I’m Avni Majithia-SejpaL, senior writer at the Center for Court Innovation. Welcome to another episode of our
New Thinking Podcast. Today, we’re here to talk about the Cuyahoga County Defending Childhood Initiative. Cuyahoga
County, in Ohio, which includes the Cleveland Metropolitan Area, was one of eight sites across the country to be
funded by the Department of Justice to address and raise awareness about children’s exposure to violence. We,
at the Center for Court Innovation, have just released our process evaluation on six of those sites, which includes
individual reports on each site and a report that condenses lessons learned across them. Today, from Cuyahoga County,
we’re talking to Jill Smialek, manager of the Family Justice Center and of the Witness Victim’s Service
Center, and to Dr. Jeff Kretschmar, research assistant professor at the Mandel School of Applied Social Sciences
at Case Western Reserve University, and senior research developer at the Gun Center for Violence Prevention, Research,
and Education. Jill and Jeff, welcome to our podcast.

DR. JEFF KRETSCHMAR:
Thanks, Avni.

JILL SMIALEK: Thank you.

MAJITHIA-SEJPAL:
I want to start by talking about violence. I understand that the county, and Cleveland in particular, has one of
the highest violent crime rates in the country. What kinds of violence are kids exposed to?

KRETSCHMAR:
You’re right that the kids in Cuyahoga County witness and experience pretty high rates of violence. The kinds
of violence they’re experiencing or witnessing are similar to other kids in other communities. We have a lot
of kids saying that they are hit and attacked. They witness a lot of shootings. There’s lots of verbal abuse,
physical abuse. Our kids report high rates of bullying. I will say that of the kids who have been in our Defending
Childhood system and who have been assessed for violence exposure, 96% of those kids report at least one past year
victimization and 87% report as least two past year victimizations. Those numbers are really, really high.

SMIALEK: We also know that a lot of children who are coming through the Defending
Childhood system have witnessed domestic violence in their homes. From our most recent report, it looks like about
50% of our cases are kids who are dealing with domestic violence in the home.

MAJITHIA-SEJPAL:
The Defending Childhood initiative created a streamlined county-wide screening assessment and service system up to
the age of eighteen who have exhibited symptoms of exposure to violence or trauma. Can you walk us through that process?

SMIALEK: When we were first starting the Defending Childhood initiative, we
wanted to make sure that we were implementing something that was not a new program, not a standalone program, but
rather something that was embedded within the very robust social service menu, or environment that we have here in
Cuyahoga County. We made the determination that we would work with our agencies and organizations that were already
serving a large proportion of kids who were exposed to violence but at the same time, not necessarily focusing on
that as the number one issue. We determined that we would work with our Children and Family Services, Juvenile Court,
and a number of our community based mental health service providers. We worked with Jeff and others to develop a
screening tool. We used that screening tool in those existing agencies. They screen very quickly for trauma symptoms
and trauma behaviors. Then, once they reach a specific threshold, they move on to a central intake and assessment
agency where they receive a full blown, roughly four-hour mental health assessment.

From there,
the mental health professional makes the determination as to any diagnoses that may apply and also makes a decision
as to an appropriate therapeutic intervention. From there, the child is referred into services.

MAJITHIA-SEJPAL:
Jeff, do you want to talk about the tool that you developed?

KRETSCHMAR:
Sure. Very early on in the process, when we were first awarded the grant, one of the things that we quickly discovered
that while there was some screening going on for violence exposure and trauma in our child-serving systems, it wasn’t
consistent, it wasn’t uniform, and a lot of times, when kids were screened, nothing happened as a result of
those scores or that information. They knew that kids were exposed but they didn’t really have much unique services
to put these kids into. What we thought was it would be really beneficial if our entire system used the same screening
tool and had some training on how to use it. Then, that tool, the results of the information from that tool, could
then be used to refer children to fuller assessments and then if necessary, into trauma-focused CBT or other trauma
informed services designed specifically for cases like this.

We first thought to use an existing
tool that would look at trauma and violence exposure but confine any that were really short and free and that would
span kids from zero to eighteen. We created our own. We came up with two screeners. One’s for the younger kids,
zero to seven. One is for the older kids, eight and older. We ask them or their caregiver about what kind of violence
they’ve seen and what trauma symptoms are also co-occurring at that time. If kids score a certain level in that
screener, they are referred in for a fuller assessment, to really get a handle on what they’re experiencing
and if that’s had some mental health consequences for them.

The worker who’s administering
the screening, regardless of the score on the screener, can also decide to refer that child for additional assessment
if they feel like they need it.

MAJITHIA-SEJPAL: I understand that
research was integral to the initiative from the very beginning of the planning process. How did you and your colleagues
go about this research? What were some of your insights?

KRETSCHMAR:
The most important thing we learned in the beginning was that there was just a lack of uniform screening for childhood
exposure to violence and trauma. We put a lot of effort into the development of the screener. We took information
from existing screeners, took data that we had collected previously on thousands and thousands of kids who have been
exposed to violence and trauma, and identified the questions that we could ask that best predicted how kids would
answer a much longer assessment. We were able to create these very short screeners. There are about fifteen questions,
they take on average four, five minutes, and essentially what we’re finding out is that these screeners are
really good at predicting who really has seen a lot of violence, who is experiencing trauma associated with that
violence. I think we’re probably close, at this point, to twenty thousand kids who have been screened since
July of 2012.

A lot of our research effort has focused on understanding what the kids in our community
were seeing and experiencing, figuring out how best to measure that in a consistent and uniform way, and then understanding
after the screening what needs to happen. What does a full assessment need to look like? What are the best treatments
for these kids? These kids, as you said, we’re talking about zero to eighteen. What might work in terms of a
therapy for an eight year old might not be appropriate for a seventeen year old.

MAJITHIA-SEJPAL:
That leads me to another question. Given that you address the needs of children and teenagers in such a wide age
range, zero through eighteen, how did you adapt your methods to different age groups, and specifically to the youngest
children?

SMIALEK: I think in addition to the screening methods that
we use, we made sure when we were selecting the various evidence-based treatment modalities, that we were encompassing
some or selecting some that were appropriate for younger children. One of those that we selected was PCIT, the Parent-Child
Interactive Therapy, which we know is especially effective for younger children, and we also are able to use trauma-focused
cognitive behavioral therapy for younger children.

We also recognize that this is a really tough
area. It’s hard to find an appropriate way to intervene with children who are so young, because of the age that
they’re in in development. Here in Cuyahoga County, in addition to Defending Childhood, we have a number of
social service agencies and initiatives at the large scale level that deal with child well-being. One of those is
an initiative that’s dedicated to early childhood mental health. We do have the ability to refer into one of
the early childhood mental health services, which are separate and apart from Defending Childhood but again, I think
it kind of illustrates how we have fit Defending Childhood into the existing system and the existing infrastructure
that we have in Cuyahoga County so that if we come across a child who we can’t fit into PCIT or TFCBT, we know
that we have this additional referral source that we can tap into.

MAJITHIA-SEJPAL:
How did you adapt and make use of evidence-based and promising practice into–

SMIALEK:
we worked a lot with a number of community based partners who have far more expertise than I do and that anybody
in my office has. When we were planning for the Defending Childhood initiative, there was a sub-committee that was
put together to specifically look at various services or various trauma modalities that would be appropriate for
Defending Childhood. We tapped into their brain power, their experience, their expertise, in order to come up with
some options that really made sense. We reviewed a number of different programs. We looked at not just therapies,
but also some community based group interventions, like the Families and Schools Together program, to make sure that
we were making smart decisions that would lead to good outcomes for us.

KRETSCHMAR:
In terms of the tools, we did a lot of work in establishing the screeners. Then, in the assessment process, we’re
using validated assessments, using validated and previously used questionnaires like the Child Behavior Checklist,
the Trauma Symptom Checklist for Children, to make sure we’re really measuring what we need to measure to best
be able to then refer kids into the appropriate services for them.

MAJITHIA-SEJPAL:
In addition to providing direct services, you also focused on creating an infrastructure that would span the entire
county. Can you talk a little bit about that?

SMIALEK: What we wanted
to do was ensure that whatever we started was first of all, taken to scale, because as you said earlier, we have
a lot of crime in Cuyahoga County, and particularly in the city of Cleveland. I think that we are very well aware
of the number of kids who are exposed to violence. We want to be able to make a difference for as many of those children
as possible. If we’re going to take it to scale given the resources that we have, we knew that we had to work
with what’s already in place. It just made sense, as we were thinking through how to make the biggest impact
with the amount of resources that we had, how exactly would we do that. The answer to that was to build on top of
what we already have so that we can sustain it long term and make the biggest difference possible.

MAJITHIA-SEJPAL:
What are some of the lessons for other counties that want to make changes on the level of infrastructure?

SMIALEK: I think there are several that kind Cuyahoga County can bring to the
table. The first is just to make sure that you take your time and do a thoughtful and thorough planning process.
I think that starts with doing a full environmental scan of the groups that are already in the neighborhood or in
the county or in the community, both groups who are interested in this issue, and who have the desire to be at the
table, and bringing them in and making sure that they have a relevant and meaningful role to play while they’re
engaged with the process.

I also think probably one of the most important lessons that we learned
here locally is that planning takes time and over time, things change. You have to make a promise to one another
that you will be flexible because the plan you write today, you may need to implement it a little differently tomorrow
when you’re finally ready to implement.

KRETSCHMAR: Something
else that we knew but was confirmed is that while you can have service providers and county employees and research
folks at the table, we’re talking about a program for and about kids. You need to have the involvement of the
kids. You need to understand what they’re experiencing, what their comfort level is with what we’re planning.
If you don’t have it, we can have a really, really great plan but if it’s not something that kids and families
are comfortable with, then it’s not going to work. Having that level of consumer involvement in the planning
process is really important. Also important is from day one, planning for sustainability of whatever it is you want
to implement, so thinking out a year or two years or three years ahead and say, “How are we going to make this
sustainable?” Which goes back to an earlier question around why we also focused on system issues in our project
is because if we can change the system, that’s a sustainable change. It doesn’t necessarily cost anything
to change the system like we’ve started to change it, but it can be really lasting.

MAJITHIA-SEJPAL:
That’s really interesting. Thanks so much for taking the time to talk to me.

KRETSCHMAR:
Sure.

MAJITHIA-SEJPAL: I’m Avni Majithia-Sejpal, from the Center
for Court Innovation and I’ve been speaking to Jill Smialek and Dr. Jeff Kretschmar about The Cuyahoga County
Defending Childhood Initiative. To read our report on the initiative, as well as our multi-site report, you can visit
our website at www.courtinnovation.org. Thanks very much for listening.

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