Developmental & Behavioral Pediatrics

Treating trauma: shaping healthy futures for the affected children and their families

Homicide mortality is substantially higher on the South Side than in the city overall, with some community areas experiencing more than double Chicago’s rate. Through Comer Children’s integrated health model for violence intervention and trauma resiliency, care teams can treat young patients and their families — inside and outside of the hospital walls.

Late into the night, a young boy who had been shot was transported to the University of Chicago Medicine Comer Children’s Hospital in critical condition. UChicago Medicine’s trauma team immediately provided expert medical care to the boy, while UChicago Medicine’s integrated Violence Recovery Program (VRP) swiftly swung into action.

A violence recovery specialist and a chaplain offered emotional and spiritual support to his family members, including other children who were with him at the time of the shooting, and those who gathered at the hospital. A Comer child life specialist provided assistance directly to the patient, helping the little boy to understand what was happening and why, and reassuring him. When the trauma surgeons and nurses were finished performing lifesaving procedures, the VRP team was there to facilitate communication between the lead surgeon and the patient’s caregivers.

Healing Hurt People-Chicago, another key component of the VRP, also stepped in to offer trauma psychoeducation and support and introduced the family to a trauma intervention specialist, a master’s level social worker who provides ongoing support outside the four walls of the hospital and helps patients and family members process, understand and recover from both the current trauma they are facing and past trauma.

“Many of the patients we see have gone through a lot of trauma, so it’s important to remember that the most recent injury may not be their first traumatic experience,” said Brad Stolbach, PhD, associate professor of pediatrics and co-director of Healing Hurt People-Chicago (HHP-C), a nationally recognized violence intervention program implemented at UChicago Medicine and the John H. Stroger Jr. Hospital of Cook County, through a partnership with the Stroger Trauma Unit. “Our violence recovery and trauma teams take into account the context and complexity of our patients’ lives — both how much they’ve had to deal with, as well as how incredibly strong and resourceful they are in the face of very difficult circumstances.”

To address the high levels of violence in Chicago’s neighborhoods, Stolbach’s work with partners like Stroger HHP-C Co-Director Reverend Carol Reese, LCSW, focuses on the development of trauma-informed programs and services, particularly for children and young adults in UChicago Medicine’s service area who’ve been affected by intentional violence. In addition to HHP-C, Comer Children’s patients and families have access to specialized psychological and psychiatric services through UChicago Medicine’s REACT Program (link). Many HHP-C patients also work with Project FIRE (link), a partnership with ArtReach Chicago that combines glassblowing, glass arts education, mentoring, trauma psychoeducation, and employment to support trauma recovery in teens injured by violence.  Stolbach’s scholarly activities also focus on developmental trauma disorder in urban children, cumulative trauma in young children, links between poverty and trauma, and the role of developmental trauma in the lives of children and youth affiliated with armed groups.

About 30,000 children visit Comer Children's emergency department each year for everything from sprains to life-threatening gunshot wounds. The hospital is home to the South Side's only Level 1 pediatric trauma center, where children with the most severe injuries and illnesses receive the highest level care. In 2015, more than one-quarter of the trauma patients who arrived at Comer Children's had violent injuries such as shootings and stabbings — a rate five times higher than what's seen at pediatric trauma centers nationally. More than 93% of these Comer Children's trauma patients survive. These numbers highlight the need for integrated violence intervention programs like UChicago Medicine’s VRP, which was launched in 2018 when the academic medical center opened a Level 1 trauma center for adults.

Since that time, the VRP has engaged over 2,000 violently injured patients, family members and friends. UChicago Medicine’s VRP is unique among hospital-based violence intervention programs due to its interdisciplinary approach to both pediatric and adult patients. In fact, Comer Children’s may be the only hospital where patients and their families not only get top notch care for their physical injuries, but also routinely receive care from child life specialists, social workers, chaplains, outreach workers, psychologists, and psychiatrists, all working together to bring their respective expertise to support physical, emotional, psychological and spiritual recovery.

Much of this unique, interdisciplinary approach to care is made possible by the Block Hassenfeld Casdin (BHC) Collaborative for Family Resilience, established in May 2019 with a $9.1 million gift from the Ellen & Ronald Block Family Foundation and the Hassenfeld Family Foundation. The BHC Collaborative is based on the premise that trauma caused by violence is best treated holistically — starting with personalized care of the child and family in the medical center and continuing through discharge and recovery, and extending into the home, school and neighborhood — through a network of community resources. Thanks to the BHC, the VRP and its component programs now provide 24/7 child life and violence recovery services, have more trauma psychologists, psychiatrists and trauma intervention specialists, and offer specialized trauma-informed training opportunities for early career psychologists, social workers, psychiatrists and pediatricians.

Most important, today, through the care provided by Comer Children’s trauma and violence recovery teams, the young boy has recovered. Alert and oriented, he is now talking and playing with his family members. While the boy’s physical wounds may have healed, he and his family still face psychological and social challenges. The expert medical care that saved his life wasn’t the end of Comer Children’s commitment to supporting his and his family’s recovery; it was the beginning. The VRP, HHP-C and the REACT Program continue to work and walk alongside them as they heal.

"Chicago's struggles with gun violence mean the day-to-day lives of so many of our children are often shaped by community violence,” Stolbach said. “At UChicago Medicine and Comer Children’s, we believe that the care we provide can play an important role in addressing that violence and helping to shape healthy futures for them.”

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Bradley Stolbach, PhD - Associate Professor of Pediatrics, Co-Director of Healing Hurt People-Chicago (HHP-C)

Dr. Brad Stolbach is a licensed clinical psychologist focusing on developing trauma-informed programs and services. He applies his work to a variety of settings, including the Pediatric Mobile Medical Unit and the Center for Community Health and Vitality.