The Early Life Stress & Pediatric Anxiety Program (ELSPAP), part of Stanford’s Department of Psychiatry and Behavioral Sciences, consists of an integrated, multidisciplinary team that seeks to address the devastating impact of trauma exposure on child development through three core components: research, clinical work, and community outreach.
For nearly 20 years, ELSPAP has conducted multi-method evaluations in children with posttraumatic stress and offered interventions (including education, treatment, and prevention programs) through strong community partnerships at clinics, agencies, and schools. The multi-method approach includes studies on the phenomenology, neurobehavioral outcomes, physiology and endocrinology, and brain structure and function of children with PTSD. This investigation has not only informed development of innovative interventions, but also their application methods. Along with other investigators in the field of developmental traumatology, we have identified unique pediatric manifestations of this syndrome highlighting the impact of trauma-exposure and PTSD early in development. ELSPAP researchers and collaborators supplement evidence-based assessment of psychosocial functioning with advanced, cutting-edge measurement of neurobiological markers including magnetic resonance imaging (sMRI and fMRI), functional near-infrared spectroscopy (fNIRS), ambulatory polysomnography, and endocrine assays. These neuroscience tools evaluate outcomes related to stress and trauma exposure in childhood, as well as responses to individual- and systems-level interventions.
Current research projects aim to develop and evaluate interventions including Cue-Centered Treatment, a manualized therapy protocol for youth exposed to chronic adversity and trauma; school-wide yoga and mindfulness-based health education; mental health consultation and wellness programming in community settings; virtual reality for the treatment of anxiety disorders; and therapy services delivered in outpatient care at a large children’s hospital.
Our research on the biological, psychological, and behavioral correlates of early life stress and trauma, and related interventions, has been published in numerous high-impact journals (e.g., Journal of Traumatic Stress, Biological Psychiatry, Journal of the American Academy of Child & Adolescent Psychiatry) and has been presented at national and international conferences (e.g., International Society for Traumatic Stress Studies, American Psychiatric Association, American Psychological Association, American Academy of Child and Adolescent Psychiatry).
The protocol manual for our clinical intervention, CCT, has been published by the Oxford University Press in their series Treatments That Work, and we have currently established a program for training CCT, which we will continue to develop and adapt in the current project. Additionally, he is the author of Neuroscience of Pediatric PTSD that examines the advances in the neuroscience of executive function, memory, emotional processing and associated features such as dissociation, self-injurious behaviors and sleep regulation.
Through our partnership relationships, we have helped to develop service systems and programs with community agencies in our region, including the Center for Youth Wellness, the Ravenswood City School District, and the Ravenswood Family Health Center. We have a long history of success in gaining funding for these activities from a range of sources, including government grants, university initiatives and programs, and private donors.
ELSPAP program efforts and activities are led by Dr. Victor Carrión, Program Director and PI, who has dedicated his career to disrupting the cycles of suffering for children exposed to trauma and to developing the best possible interventions for children who have experienced violence and trauma. Dr. Carrión is making significant contributions to the field of psychiatry and the community through a highly productive, multi-faceted approach to research, clinical practice, and advocacy. He has actively and successfully disseminated this work so that children everywhere can benefit from successful evidence-based practice. He has earned numerous awards, including three National Institutes of Health Clinical and Translational Science Awards for his work with developing community partnerships and community-based mental health interventions to prevent the transmission of trauma. Dr. Carrión is the Vice Chair and Professor of the Department of Psychiatry and Behavioral Sciences. He has served as the chair of the California Mental Health Services Oversight and Accountability Commission. In this role, Dr. Carrión has developed relationships with directors of mental health services at each county in California; these relationships and experiences informs efforts to disseminate trauma interventions such as CCT within the scope of the current project. Through the empirically-supported, neuroscience-based evaluation of the fore-mentioned interventions, Dr. Carrión and his team seek to disseminate results regarding promising, efficacious practices in order to inform and impact institutional, state, and national policies to address the needs of children and families exposed to trauma and adversity.