Victims of Violence: The Antifragility Initiative at UH Rainbow Babies and Children’s Hospital
The Antifragility Initiative (AI) is a holistic, person-centered pediatric Hospital-based Violence Intervention Program (HVIP) serving youths and families in the greater Cleveland area. The program equips and empowers children, adolescents and families with healing, restoration and growth following an incident of violent injury. The AI is centered on the premise that children and families who have experienced major trauma due to violence benefit greatly from coordinated support as they begin to heal and reorder their lives.
Bringing an Antifragility Initiative to Victims of Youth Violence in Cleveland
Many children in the U.S., especially black and brown children living in low-income neighborhoods, experience tragically high levels of violence in their communities. Spearheaded by Edward Barksdale, Jr., MD, Surgeon-in-Chief at UH Rainbow Babies & Children’s Hospital, the AI was launched in June 2019 to combat youth violence in the communities of Greater Cleveland.
At the time of its establishment, the AI looked to four similar initiatives in Chicago, Milwaukee, Philadelphia and Pittsburgh and assessed the best practices used by those programs to help young survivors of gun violence and other forms of assault. Like the HVIPs that came before it, the Cleveland-based AI is designed to address community violence from a public health perspective, recognizing that violence can be prevented with positive social support, mentorship and the development of coping skills.
How to Help
If you would like to support the Antifragility Initiative, please consider purchasing items from our wish list. All purchases support the Antifragility Initiative participants.
What is Antifragility?
We believe resilience following an incident of violent injury – a victim’s ability to return to being the person they were before the traumatic event – is not enough. We aim for children and teens who have sustained injuries due to violence to become antifragile: this term encapsulates the idea of a victim of violence growing stronger than they were before the incident. We adopted the name Antifragility Initiative to reflect this important focus.
Who We Serve
The AI serves children and teens ages 6 through 17 treated for interpersonal and/or community violence at UH Rainbow Babies & Children’s Emergency Department at UH Cleveland Medical Center. This includes youths treated for gunshot wounds, stabbings and other forms of physical assault.
The Golden Hour
One of the key operating principles of the AI is acting quickly after someone has been shot or assaulted. Often in the immediate aftermath of violent injury, a victim who might not otherwise want or seek help is more open to receiving it. We call this critical time the “golden hour.” While the golden hour is vital for treating physical injuries, it’s also best time to enroll children and teens into programs such as the AI.
- Goals of the AI
The specific goals of the AI include:
- Provision of trauma-informed care
- Engaging with new participants at the bedside soon after hospital admittance and through intensive case management following hospital discharge
- Providing and coordinating longitudinal, holistic and person-centered services, including medical care, safety, academic support, emotional and social support systems, creative and physical activities, vocational services and spiritual care
- Leveraging multidisciplinary collaboration and rigorous evaluation to optimize success for all participants
- Helping our youths develop a strong sense of antifragility following the experience of violent injury
- Objectives of the AI
The most important objective of the AI is to decrease the occurrence of violent re-injury among youths ages 6 to 17 who are treated at UH Rainbow Babies and Children’s Hospital for a violent injury. To reach the larger goals of the program, we pursue a number of strategic, measurable objectives, including:
- Provide culturally competent services
- Provide developmentally appropriate interventions
- Identify and address symptoms of traumatic stress, grief and loss
- Improve self-efficacy
- Reduce propensity for physical aggression and interpersonal conflict
- Improve academic performance
- Decrease school absenteeism
- Services for Youth Crime Victims
The AI’s services for youth crime victims include:
- Crisis intervention and safety planning
- Education and skill building
- Intensive case management services for up to one year
- Emotional support and advocacy
- Assessment and planning
- Linkage to other services and coordination of care
- What We Offer
Our program offers:
- 1 year of community support from qualified UH Rainbow Babies & Children’s social workers
- A personalized plan to fit your child’s and the family needs.
- Opportunities to connect your child to mentors and/or positive activities such as sports or the arts.
- Connect to community resources:
- Safe housing
- Health & wellness
- Mental health
- Academic & career resources
- Academic support and help to navigate school-related issues
- Trauma Focused Cognitive Behavioral Therapy (TF-CBT): counseling that involves both the child and the caregiver and is indicated for young people, ages 3-21, who have experienced a traumatic event with significant symptoms of acute stress. Treatment is between 12 and 25, 60-90 minute sessions and involves: education, parenting skills, relaxation techniques, affect modulation skills, cognitive coping, trauma narration and processing, in vivo mastery of trauma reminders, enhancing safety and future development, and traumatic grief components. The Antifragility team have been specially trained to provide TF-CBT. TF-CBT is considered among the most effective and well researched interventions for trauma.
Education & Research
In addition to its direct services for violently injured children and their families, the AI functions as an education and research initiative. Through a partnership with the Center for Urban Poverty and Development at Case Western Reserve University, we study best practices and identify social determinants of health to guide our interventions, disseminating our findings to the broader research and healthcare communities. Through a partnership with FrontLine Service, we are engaged in building a trauma-informed hospital staff to better meet the needs of our patients.