The Violence Intervention Program (VIP) provides direct services to CHOP patients who have already been injured by assault. It is a community-focused, trauma-informed program designed to reduce re-injury and retaliation among youth ages 8 to 19 years by working with them in the hospital and after discharge.
Violence against children is a serious public health issue; from among the 14,000 adolescent patients who present to the CHOP Emergency Department each year, roughly 200 youth meet criteria for the VIP and are eligible to receive our intensive case management services.
The overarching goals of VIP are to reduce retaliation, re-injury, and readmission to the hospital and to promote healing from current and prior traumatic events. A long-term goal is to reduce the odds that the youth will be involved in crime or perpetuate violence in adulthood.
The VIP Approach
CHOP’s VIP began in 2012 with the generous assistance of the Healing Hurt People program at Drexel University. Along with a number of similar programs across the country, VIP capitalizes on the teachable moment for youth who seek medical care after a violent event. Treating violence as a public health issue, CHOP VIP brings medical care to the patient’s home and establishes a direct and sustainable connection between the hospital and the community through individual and family-directed interventions. Engaging patients in the hospital during their recovery is an opportunity to change their lives and reduce retaliation and recidivism.
VIP uses a trauma-informed approach that considers the impact of an individual’s prior traumatic experiences on how he or she responds to clinical treatment. Often, youth who experience trauma exhibit a disconnection with hospital-based support personnel and will experience shame, guilt and rage in response to common medical and social interventions. A trauma-informed approach can foster a stronger connection to the clinicians and medical institution, ameliorate these negative experiences, and pave the way for youth to engage in positive and protective activities. CHOP VIP encourages hospital-based clinicians to recognize and familiarize themselves with a specific patient’s trauma history so that it is easier to engage him or her into medical care and follow-up, as well as other support services.
Youth enrolled in VIP receive comprehensive assessment, case management, and navigation to services such as medical follow-up; emotional support for post-traumatic stress; mentoring; working with their schools to help them transition back to school; housing; substance abuse treatment; recreation; legal services; after-school program referral; job training and placement; and parenting education and support.
Building Resilience After A Violent Event (BRAVE):
CHOP VIP provides psycho-educational peer groups for youth ages 13-18 who have experienced a violent event, to promote healing and foster development of positive emotion regulation. The group curriculum was first introduced in 2015, to provide:
- Psycho-education around trauma and trauma symptoms
- Coping skills to reduce post-traumatic stress
- A safe space for youth to express their concerns and receive support from their peers
BRAVE is a group intervention model, facilitated by Masters’-level clinicians, that builds on youth’s individual strengths and resilience through age-appropriate skill building activities and group therapy.
StressBusters is a group supervision model facilitated by the VIP clinical supervisor to help our program staff and trainees maintain their own health while providing trauma-informed care to violently injured youth and their families. First implemented in 2015, StressBusters provides a safe space for staff and trainees to share how violence intervention work affects them individually, and offers a way to provide support and encouragement to one another. Each group session begins with a learning opportunity that addresses individual strengths and resiliency. Team members share responsibility for introducing new resiliency activities to the group and encourage one another to regularly practice these new skills in an effort to address vicarious trauma and staff-burnout.
National Network of Violence Intervention Programs
The National Network of Hospital-based Violence Prevention Programs (NNHVIP) is led cooperatively by Youth Alive!, a California-based nonprofit organization, CHOP, and Drexel University. NNHVIP is the main outreach and education force behind violence prevention through 22 hospitals and medical centers across the country that offer intervention services to individuals who have experienced violent injuries. NNHVIP hosts an annual conference that is attended by more than 200 participants from member programs, including hospital-based staff, and community and municipal partners. This conference serves as the main venue for sharing new information about program successes and challenges, and offers an opportunity for mutual education and collaboration.
Recommended Reading on Hospital-based Violence Intervention Programs
- Aboutanos, M. B., Jordan, A., Cohen, R., Foster, R. L., Goodman, K., Halfond, R. W., Ivatury, R. R. (2011). Brief Violence Interventions With Community Case Management Services Are Effective for High-Risk Trauma Patients. Journal of Trauma and Acute Care Surgery, 71(1), 228-237 210.
- Becker, M.G., Hall, J.S., Ursic, C. M., Jain, S., & Calhoun, D. (2004). Caught in the Crossfire: the effects of a peer-based intervention program for violently injured youth. Journal of Adolescent Health, 34(3): 177-183.
- Cheng, T. L., Wright, J.L., Markakis, D., Copeland-Linder, N, & Menvielle, E. (2008). Randomized trial of a case management program for assault-injured youth: impact on service utilization and risk for reinjury. Pediatric Emergency Care, 24(3): 130-136.
- Cheng, T. L., D. Haynie, et al. (2008). Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial. Pediatrics, 122(5): 938-946.
- Cooper, C., Eslinger, D.M., & Stolley, P.D. (2006). Hospital-based violence intervention programs work. Journal of Trauma-Injury Infection & Critical Care, 61(3): 534-537.
- Corbin TJ, Purtle J, Rich LJ, Rich JA, Adams EJ, Yee G, Bloom SL (2013). The Prevalence of Trauma and Childhood Adversity in an Urban, Hospital-Based Violence Intervention Program. Journal of Health Care for the Poor and Underserved, 24(3): 1021-1030.
- Corbin TJ, Rich JA, Bloom SL, Delgado D, Rich LJ, Wilson AS (2011). Developing a Trauma-Informed, Emergency Department-Based Intervention for Victims of Urban Violence. Journal of Trauma and Dissociation, 12(5): 510-525.
- Naneen K, Cunningham RM, Becker MG, Fein JA, Knox LM (2011). A Best Practices Guide for Launching & Sustaining a Hospital-based Program to Break the Cycle of Violence. Online PDF courtesy of the National Network of Hospital-based Violence Intervention Programs and Youth ALIVE!
- Purtle J, Dicker R, Cooper C, Corbin T, Greene MB, Marks A, Creaser D, Topp D, Moreland D (2013). Hospital-based Violence Intervention Programs Save Time and Money. Journal of Trauma and Acute Care Surgery, 75(2): 331-333.
- Shibru, D.,E. Zahnd, E., Becker, M., Bekaert, N., Calhoun, D., & Victorino, G. P. (2007). Benefits of a hospital-based peer intervention program for violently injured youth. Journal Of The American College Of Surgeons, 205(5): 684-689.
- Zun, L. S., Downey, L, & Rosen, J. (2006). The effectiveness of an ED-based violence prevention program. American Journal of Emergency Medicine, 24(1): 8-13.