The Lourie Center for Children's Social and Emotional Wellness

Issue Background

A recent report from the Centers for Disease Control and Prevention estimates that roughly 20 percent of American children experience a mental health disorder in a given year, and that treatment for those conditions costs the Nation $250 billion each year.1 Among all children enrolled in Medicaid, approximately 10 percent use behavioral health services each year, but the cost of care for that small group accounts for 38 percent of total Medicaid expenditures for children each year.2 In 2014, a peer-reviewed article in Pediatrics found that nearly half of children with diagnosed mental and behavioral health needs had an unmet need for care coordination.3

The Patient Protection and Affordable Care Act outlined a number of care models and incentives for improving care quality for children with mental and behavioral health needs that focus on improved care coordination and patient-centered care, including patient-centered medical homes and home- and community-based services for Medicaid populations. Increased national emphasis on coordinated health care delivery efforts that provide quality mental and behavioral health services to children hold promise that such individualized, youth- and family-friendly services delivered across provider networks can improve the overall health of American children.

About the Lourie Center for Children's Social and Emotional Wellness

Since 1983, the Lourie Center for Children's Social and Emotional Wellness has sought to improve the social, emotional, and mental health and sufficiency of young children and families by delivering coordinated prevention, early intervention, education, research, and training services.

Each year the Lourie Center serves approximately 4,000 children and families in the Washington, DC, metropolitan area, and approximately 80 percent of the families it serves are enrolled in Medicaid. In 2006, the Center became a member of Adventist Healthcare, LLC.

Overview of Activities

The Lourie Center operates four core programs designed to strengthen families by helping young children and their parents or caregivers to develop increasingly secure relationships, and providing a coordinated series of services that support the social and emotional competencies needed for success in life. One of the Center's onsite programs is the Therapeutic Nursery Program (TNP). One classroom is a full day, federally-funded TNP and the other classroom is half-day and State-funded. These specialized preschools address the early childhood education and therapeutic needs of young children from 3 to 5 years of age with emotional and behavioral problems that interfere with success in regular preschool settings. In the classroom, children in the program learn to regulate emotional expressions and improve classroom behavior while building trusted relationships with other students and teachers; outside of the classroom, the program provides family-focused services to address the needs of the children's caregivers. The Lourie Center School, an onsite Special Education Elementary School serving children from kindergarten through fifth grade, integrates an educational curriculum with therapeutic services to strengthen children's emotional resources, social capacities, cognitive development, motor abilities, and speech and language skills.4

In the Parent–Child Clinical Services Program, which is a licensed outpatient mental health clinic, the Center uses a family-centered developmental approach to provide a wide range of assessment, treatment, and consultation services to families and children up to 12 years of age that promote children's healthy development, enhance parenting capacity, and foster positive parent-child relationships.5 The Early Head Start Program, a federally funded initiative, provides comprehensive, year-round child and family development services to low-income families with children from birth to 3 years old through weekly home visits and parent–toddler activity groups. Families who participate in the program are also connected with community resources such as food, clothing, housing, child care, employment, English classes, health care, and mental health counseling to ensure that families receive coordinated care that best addresses the social determinants of individual health.6 The Center also engages in model public-private partnerships that include collaboration with Montgomery County's Child Welfare and Infants and Toddlers Early Intervention Programs. As a best practice, the Center is integrating the empirical based Circle of Security Parenting Program throughout the Center and in local homeless shelters.7

Results

A peer-reviewed study published in the January 2016 issue of the journal Attachment & Human Development examined the efficacy of the attachment-based experiential intervention program used in the Center's Parent-Child Clinical Services Program through examination of 32 mother–child pairs enrolled in the Program. The study assessed changes in parental insightfulness and emotional availability of those mother–child pairs, and found that the Clinical Services Program's intervention was effective in making positive changes in parental perceptions, behaviors, and emotional availability as well as their children's behaviors.8

Though the study had a small sample size, the authors found that the strong empirical evidence of positive behavioral change in study participants demonstrated that the Center's coordinated intervention approach delivered appropriate and effective care for patients. By establishing a link between parental perceptions and emotional availability, the Center's efforts hold promise that coordination of mental health care enhances the capacity for changes in functioning and behavior between parents and their children.9 The Lourie Center currently has three additional research intervention-outcome studies under way. For the Early Head Start program study, preliminary data are expected at the end of summer 2016; for the Lourie Center School study, complete data are expected in summer 2016; and for the Therapeutic Nursery Program study, preliminary data are expected in January 2017.

Alignment to the National Quality Strategy (NQS):

The Lourie Center for Children's Social and Emotional Wellness NQS Priorities: Ensuring that each person and family are engaged as partners in their care. Working with communities to promote wide use of best practices to enable healthy living.

These efforts promote:

  • Ensuring that each person and family are engaged as partners in their care.
  • Working with communities to promote wide use of best practices to enable healthy living.

Contact

The Lourie Center for Children's Social and Emotional Wellness is a private, nonprofit agency. In July 2006, the Center affiliated with Adventist HealthCare, Inc. Learn more about the Lourie Center for Children's Social and Emotional Wellness.


1 http://www.cdc.gov/features/childrensmentalhealth/ 
2 http://www.chcs.org/resource/examining-childrens-behavioral-health-service-utilization-and-expenditures-3
3 http://pediatrics.aappublications.org/content/early/2014/02/11/peds.2013-2590 
4 http://www.adventisthealthcare.com/LC/programs/school
5 http://www.adventisthealthcare.com/LC/programs/parent-child/ 
6 http://www.adventisthealthcare.com/LC/programs/early-head-start/ 
7 http://circleofsecurity.net/for-professionals/resources/publications/ 
8 Yair Ziv, Betty Ann Kaplan, and Jimmy Venza. (2016). Practicing attachment in the real world: improving maternal insightfulness and dyadic emotional availability at an outpatient community mental health clinic, Attachment & Human Development 2016 Jun;18(3):292-315. 
9 Yair Ziv, Betty Ann Kaplan, and Jimmy Venza. (2016). Practicing attachment in the real world: improving maternal insightfulness and dyadic emotional availability at an outpatient community mental health clinic. Attachment & Human Development 2016 Jun;18(3):292-315.

Page last reviewed March 2017
Page originally created November 2016
Internet Citation: The Lourie Center for Children's Social and Emotional Wellness. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/workingforquality/priorities-in-action/lourie-center-for-childrens-social-and-emotional-wellness.html