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Parenting after traumatic loss: reinventing the lives of women of color

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Parenting after traumatic loss: reinventing the lives of women of color

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Content 1
Parenting After Traumatic Loss: Reinventing the Lives of Women of Color
Carlos A. Hernández
A Capstone Project Presented to
The Faculty of the Suzanne Dworak-Peck School of Social Work
The University of Southern California
In Partial Fulfillment of the Requirements for the Degree of
Doctor of Social Work (DSW)
November, 2021
May 2023
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Capstone Project Paper
Executive Summary
The urgency to ensure the healthy development of children in the United States is
influenced by the fact that every year, more than six million children, youth, and adolescents
endure mental health problems for various reasons (American Academy of Social Work & Social
Welfare, 2020). According to the Adverse Childhood Experiences (ACEs) study (Felitti et. al.,
1998), these problems can lead to serious physical, social, and psychological problems for young
people later in life. The study also indicates that the root causes of these problems are associated
with childhood physical or sexual abuse, violence at home, or living with an adult with a
substance abuse or mental health problem (Felitti et. al., 1998).
Organizations that provide services through funding from the Victims of Crime
Assistance Office (VOCA) serve families with children who are at-risk of ACEs. An analysis,
conducted by stakeholders that included victim assistance providers and beneficiaries, was
conducted at Jewish Family and Children’s Services of Southern Arizona (JFCS), a community-
based social services organization, in early 2020. These stakeholders completed in-depth
interviews of other stakeholders consisting of victim services experts and other providers and
beneficiaries. The information they gathered confirmed what they have long suspected: Parents
who have lost a spouse or partner as a result of a homicide experience unique psychological
stress that impacts their ability to meet the needs of their children. Specifically, stakeholders
expressed that relationships deteriorate between caregivers and their children when parents
become consumed by their loss. In the midst of their crises, parents also lose the ability to
address the emotional and developmental needs of their children. Furthermore, even though
parents receive treatment, their mental health condition persists. Other findings included that
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most program participants are low-income women of color with resource needs (e.g., childcare,
food insecurity) who also need treatment for a history of other problems (e.g., domestic violence
and substance abuse), and that these women are often extremely socially isolated.
While research directly related to this topic is scarce, parallel studies help clarify the
problem. For example, it is now understood that losing a loved one suddenly and unexpectedly
can produce more emotional strain than other kinds of deaths, and that traditional types of
services for this problem are often not effective. Parents and children in victim assistance
programs often experience traumatic events that impact their relationship. Women in victim
assistance services also need mental health and social services for other problems. Finally,
trauma-exposed families endure severe social isolation.
The information gathered by stakeholders points to the need for victim assistance
programs to address the multiple needs of homicide survivors. A lifetime of racial and gender-
based attitudes and beliefs deeply rooted in American society have oppressed these parents and
prevented them from obtaining the resources necessary to meet their needs and the needs of their
children. These intractable problems exacerbate the emotional impact of losing a close loved
one. Under these conditions, parents lose the ability to form meaningful relationships with their
children. An innovative program is needed that helps parents more effectively overcome their
trauma, provides them with vital resources and opportunities, and increases their knowledge
about the attachment needs of their children.
Parents who have unresolved complicated grief due to traumatic loss cannot provide for
the mental health or developmental needs of their children, thereby making their children
vulnerable to ACEs and interfamily conflict. A new approach is needed to tackle this problem
and address the many other needs of these families. Under development is a new program called
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Parenting After Traumatic Loss: Rebuilding the Lives of Women of Color. It contains the
following features: Restorative Retelling (RR) treatment, known to be more effective for
addressing the emotional impact of traumatic loss; detection and treatment for other behavioral
health problems; Mom Power (MP) parenting training to enhance parental knowledge about the
attachment needs of children; access to critical resources through intensive case management
services; and structured social activities to help improve social support networks.
The program aims to increase the well-being of parents in two important ways. The first
is by improving the emotional functioning of parents by decreasing their symptoms of depression
and symptoms of traumatic grief. The methodological tools that will be used to measure this are
the Patient Health Questionnaire-9 and the Inventory of Complicated Grief. The second aim is to
improve relationships between parents and children by decreasing parental stress and improving
parent-child interaction. The Parent-Stress Index will be used to measure progress in these areas.
RR and MP will likely have the most direct impact on these goals, while the other program
components will facilitate progress towards these goals by eliminating other significant barriers.
Parents will be assessed periodically throughout their participation in the new program and
afterwards to determine if there is improvement. Various stakeholders have joined to design this
new program. This includes professional staff from various victim assistance organizations
throughout the state of Arizona (e.g., agency executives, therapists, victim services advocates)
and, more importantly, current and former recipients of victim assistance services.
This new program will have a lasting impact on the Grand Challenge of Ensuring Healthy
Development for All Youth (American Academy of Social Work & Social Welfare, 2020). Like
other efforts devoted to this initiative, the project will improve the mental health outcomes of
children by addressing the diverse needs of parents (Hawkins et. al., 2015). A critical first step is
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to help relieve the severe emotional distress that parents are feeling as a result of their loss.
Services must therefore initially focus on getting parents to participate in RR. As their symptoms
of complicated grief subside, they will have the opportunity to participate in MP training. This
training focuses on improving parental capacity to develop empathic relationships with their
children through workshops designed to increase knowledge about the attachment needs of their
children. When appropriate, parents will have access to resources such as childcare, financial
assistance; services for other problems, such as domestic violence and alcohol or substance
abuse; and socialization activities with friends, family members, and other program participants
as a way to enhance their support networks. The program contributes to the Grand Challenge of
Ensuring Healthy Development for All Youth because by improving the lives of parents, they are
afforded the opportunity to tend to the wellbeing of their children. This, in turn, will help to
prevent the physical, social, and psychological consequences that children in these families are
susceptible to as a result of living with parents with mental health problems.
An implementation team, led by JFCS’s CEO, has been meeting since July of 2020 to
launch the new program. In April of 2021, a mental health clinician was trained in RR. In
September, the team met with JFCS quality management staff to develop the process for
measuring client outcomes using the methodological tools described. A case manager has been
appointed as the program coordinator, and she will provide the intensive case management.
During the first quarter of 2022, two mental health clinicians will participate in the MP training
through Zero To Thrive, an organization devoted to reducing the generational effects of inequity,
trauma, and adversity between mothers and their children through training and technical
assistance (Zero To Thrive, 2020). In January, five beneficiaries will participate in RR pilot
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services. By April of 2022, the same five beneficiaries will participate in MP pilot services. In
October of 2022, 20 individuals will participate in the program’s first full year of operation.
Envisioning the implementation of this vital program beyond the local context is critical
given the current gap in services. A market analysis (Attachment B) of other victim assistance
programs outside of southern Arizona revealed that organizations typically limit their services to
grief and loss support. The absence of special services for the problems identified could indicate
that the needs of low-income women of color who receive victim assistance services everywhere
are not being met. In other words, no victim assistance programs have been identified that
simultaneously target parenting problems, complicated grief, other behavioral health problems,
lack of basic resources, and social isolation. In fact, the market analysis did not reveal any victim
assistance programs that identify and address the parenting problems presented by stakeholders
in southern Arizona. A program manual will be developed to inform providers throughout the
country about this problem and to encourage them to adopt the new program. On a larger scale,
this initiative may help survivors of other types of traumatic loss (i.e., suicide, fatal accident,
death due to a sudden and unexpected health condition) because of the common psychological
stressors among these individuals. As such, this program will be replicated so that similar groups
may benefit. However, the immediate goal is to improve the lives of children and parents who
are homicide survivors. If successful, this initiative will replace services in a system of care that
is limited in its ability to help these vulnerable families.
Conceptual Framework
According to the American Academy of Social Work & Social Welfare (2020), over six
million children, adolescents, and young adults experience mental health problems for a variety
of reasons, making the Grand Challenge of Ensuring Healthy Development for All Youth an
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urgent issue. Felitti et. al. (1998) described the consequences of not addressing this problem in
their seminal study of Adverse Childhood Experiences (ACEs). This study revealed the link
between exposure to abuse and household dysfunction during childhood to social, physical, and
psychological problems in adulthood. Over 9,000 study participants described experiencing
childhood adversities such as physical or sexual abuse, violence in the home, or that they lived
with an adult with a substance abuse or mental health disorder. Over half of the participants had
at least one of these problems, and one quarter had two or more. There was a correlation between
adverse experiences and adult health and behavioral health problems such as alcoholism,
depression, and heart disease (Felitti et. al., 1998).
The experiences of children enrolled in a program at Jewish Family and Children’s
Services of Southern Arizona (JFCS) serves as a microcosm of youth across the country with
behavioral health problems, according to stakeholder interviews conducted by the organization
(See Appendix A). Funded by the Victims of Crime Assistance Office (VOCA) of the U.S.
Department of Justice, the program provides counseling to help individuals heal from the impact
of a variety of crimes (Arizona Department of Public Safety, n.d.). Those interviewed included
program recipients, professional staff, and victim services experts. The majority of these
individuals reported that parents, many of whom are women with children who have lost a
spouse or partner to a violent homicide, become so consumed by the trauma of their loss that
they lose sight of the needs of their children. They further reported that as parents become
emotionally unavailable, they neglect attending to their children’s social and emotional needs,
including helping them process the grief and loss that their children are also experiencing. This
results in relationships between parents and children that often become contentious. Many
stakeholders reported that although families receive a variety of services through JFCS and other
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victim assistance organizations in southern Arizona, these problems often do not improve.
Interviews revealed many other important trends: most survivors are low-income women of
color, symptoms of grief persist among parents regardless of mental health treatment, social
support from friends and family is often absent, families lack important resources such as
childcare and transportation, and parents have treatment needs for a history of problems
unrelated to their loss such as domestic violence and alcohol and substance abuse. Although
interviews produced other important information, the stakeholders who conducted the interviews
felt that these problems were most the most common and the ones that needed the most attention.
Stakeholder insights contributed to the following problem statement: Parents who have
unresolved complicated grief due to traumatic loss cannot provide for the mental health or
developmental needs of their children, thereby making their children vulnerable to ACEs and
interfamily conflict. Little information exists in the literature about this problem. In fact, the
Center for Victim Research (CVR), an arm of VOCA, indicated that “few services specifically
address homicide co-victims’ needs, and even fewer have been evaluated” (Center for Victim
Research, 2016, p. 1). However, studies involving similar populations help to shed light on the
problem.
To further inform stakeholders in southern Arizona about the needs of the people that
they serve, knowledge was drawn from research that has been done on populations with similar
characteristics and needs. For example, studies have indicated that people who have lost a loved
one as a result of a sudden and unexpected death experience more emotional agony than those
who have lost someone for other reasons (Barlé et. al., 2017; Keyes et. al, 2014; Teach Trauma,
2020). In fact, symptoms are similar to those associated with PTSD and complicated grief, and
those symptoms can persist longer than the symptoms that people experience when they lose
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someone as a result of a natural death (Amick-Mcmullan et. al., 1991; Asaro, 2009; Kersting et.
al., 2011; Murphy et. al., 2003; Shear, 2015; Williams & Rheingold, 2018). Given the unique
strain that a traumatic death can inflict on survivors, general grief and loss interventions often do
not work (Saindon et. al., 2014; Shear et. al., 2005; Teach Trauma, 2020). Parents who have
experienced trauma throughout their lives, like those in victim assistance programs, have a
difficult time forming positive relationships with their children (Grasso et. al., 2015; Muzik et
al., 2013a), while children exposed to psychological trauma are not able to properly form
attachments to their caregivers (National Child Traumatic Stress Network, n.d.). Rosenblaum et.
al. (2017) found that low-income women of color with trauma histories, a characteristic that is
common among participants of victim assistance services in southern Arizona, may also need
treatment for problems such as depression, interpersonal violence, and substance abuse. Studies
suggest that women from minority groups who live in low-income communities have extreme
resource needs (Muzik et. al., 2013b; Muzik et. al., 2015; Yehya & Dutta, 2015), especially
women in victim assistance programs given the financial dependency they had on those they lost
(Vincent et. al., 2015). Finally, the literature indicates that trauma-exposed families endure
extreme social isolation (Rosenblum et. al., 2017; Vincent, 2009; Vincent & McCormack, 2015).
The information gathered through the interviews and literature review suggests that there
are two serious problems for consumers of victim assistance services. First, even though the
primary goal for many victim services providers is to help their clients overcome their severe
emotional distress, those services are inadequate. Even though general grief and loss
interventions may be a viable option for those who experience certain kinds of losses, those
interventions are not suited for people who experience the unique type of distress caused by a
sudden and unexpected loss (Saindon et. al., 2014; Shear et. al., 2005; Teach Trauma, 2020).
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What results for consumers of victim assistance services is perpetual emotional agony even
though providers try desperately to help them overcome their emotional trauma, sometimes by
overstressing the need to continue therapy even when the anticipated outcomes seldom or never
come to fruition. Second, the interviews and literature review has uncovered deep-seated
problems for this population. According to the Center for Victim Research (2016), individuals
who seek publicly funded victim assistance services, like those in JFCS’s program, are likely to
represent a demographic group that also have many other needs. These are Latina, African
American, and Native American women who have significant resource needs, are socially
isolated, and face multiple other barriers related to economic hardship. Yet, programs for
survivors of traumatic loss do not recognize these needs. As a result, they overlook highly
critical issues. On the one hand, providers’ assessment of what their clients are experiencing
emotionally is incorrect; they believe they are exhibiting general symptoms of grief and loss
when in reality, their grief is much more profound. As such, they use general grief and loss
mental health interventions when what their clients require is an intervention that more
appropriately matches what they are truly experiencing emotionally. And providers often do not
consider the context in which their clients live, previous life experiences, and the many
additional challenges that their loss has created for them. When providers overlook these factors,
they omit critical services for their clients, thereby compounding the impact of traumatic loss.
This has implications for the entire family. The information gathered by JFCS through
stakeholder interviews sheds light on another, and likely the most, unrecognized problem. As the
emotional consequences of losing a close loved one begins to take a toll on the lives of
consumers, intensified by their inability to find relief through the services they seek, there are
additional consequences if they have children. As parents struggle to recover from their loss—
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while also dealing with the hardship of being low-income, socially isolated, and other
problems—they set aside the needs of their children. At times, they may not help their children
process the loss that they too have experienced. With time, parents neglect their responsibilities
in other areas. For example, parents not emotionally present may also not respond to their
children appropriately as they progress through their developmental stages. The consequences
can be severe for their children, especially when parents respond with corporal punishment when
conflict occurs, as many stakeholders learned through the interviews (See Appendix A). What
transpires for these parents and their children is an inability to form healthy relationships, and
some children develop their own mental health or behavioral problems (See Appendix A).
A market analysis has revealed that this problem is more pervasive than anyone seems to
have ever noted (See Appendix B). Other victim assistance organizations were reviewed to
determine if they recognize any of the findings discovered by the stakeholder group in southern
Arizona. Only two of the 17 organizations provide specialized treatment for emotional grief. The
rest do not promote specialized services beyond general grief and loss support and basic
advocacy, support, and financial assistance for consumers’ need immediately after a traumatic
loss. The absence of unique interventions for the issues that have been identified by stakeholders
in Arizona could signal that the needs of survivors of homicide or other types of traumatic loss
around the country are not being met. This further substantiates the social significance of this
problem. There may be a much large gap in services than the gap identified in Arizona if
providers across the country are also unaware of the complex needs and barriers of the
population that they serve.
Although many theoretical frameworks can contribute to a solution for these problems,
the proposed intervention is guided by Feminist Theory. According to Bem (2008), social
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policies and gender stereotypes prevent women, especially non-white women, from equal access
to economic resources. This is a fitting lens since a common characteristic among consumers of
victim assistance services is that most of them are low-income women of color who experience
additional financial burdens after losing a spouse or partner that they depended on for economic
support (Center for Victim Research, 2016; Vincent et. al., 2015). This prevents them from being
able to provide for their families financially. Furthermore, social role theory dictates that society
assigns homemaker and childrearing responsibilities mostly to women (Eagly et. al., 2000). This
also applies to survivors of traumatic loss with children. For many, it is difficult to obtain well-
paying jobs when, throughout their lives, their caretaking responsibilities have prevented them
from advancing their education or accumulating work experience. Samuels & Ross-Sheriff
(2008) stress the importance of understanding the unique ways that women face oppression
beyond looking at the problem through a single lens that applies to all women. They point out
that race, class, immigrant status and similar factors intersect to create unique experiences of
oppression among women. Recipients of victim assistance services are mostly Black, Latina, and
Native American women who likely experience the compounding effects of inequality and
oppression given their multiple identities. These gender-based issues are root-causes of the
problems that women in victim assistance program experience. Mental health problems, social
isolation, and parenting problems are symptomatic of other problems related to their gender.
These concepts of feminist theory form the basis for a theory of change that contributes
to a comprehensive solution to the problems that survivors of homicide experience. Consumers
of victim assistance services often receive services that address their immediate needs without
consideration of the historical and systemic issues at play. While the immediate circumstances
may have caused a crisis for them and their children, gender-based attitudes and beliefs
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contribute to the subsequent challenges they face because these norms and practices cause them
to have less power, control, and resources. An innovative solution should be based on a theory of
change that considers this important fact. According to the beneficiaries and other stakeholders
involved in the design of the new program, the lives of low-income women of color can only
change if they are provided with the necessary knowledge, skills, and resources that they have
lacked throughout their lives in addition to the necessary treatment to help them overcome their
immediate psychological trauma. The logic model (Appendix C) explains how a new program
for this population can accomplish this. The program’s inputs and activities, consistent with each
of the program’s components, are designed to help parents take advantage of resources and
opportunities that they may never have been offered throughout their lives.
Problem of Practice and Innovative Solution
The proposed solution to the complex needs of survivors of traumatic loss will consist of
a new program with the following components:
1. Parents will participate in Restorative Retelling (RR), a 10-session mental health
group treatment intervention for people who experience complicated grief.
2. Parents will participate in Mom Power (MP) workshops, a 13-session curriculum-
based training for parents to help them form healthier attachments with their children
and improve their knowledge about their children’s development.
3. Parents will receive additional behavioral health treatment for other problems
unrelated to their traumatic loss.
4. Parents will receive intensive case management services so that they may obtain
access to critical resources and opportunities.
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5. To improve their support networks, parents will participate in structured social
support activities with friends, family members, and other program participants.
These components were chosen by the stakeholders involved in the analysis of the needs
of beneficiaries in victim assistance services. Their selection was based on two important
considerations that became apparent to them after they interviewed other stakeholders that
included providers of victim assistance organizations, experts, and current and program
beneficiaries of services. First, the components address each of the problems that most
beneficiaries have in common. Second, stakeholders felt that these problems should be given
priority given how intense they were for families when compared to other problems. RR and MP
were selected after searching for programs in the literature that effectively address the first two
problems discovered by the stakeholders. There was a consensus that the other three components
would most logically help beneficiaries with the other problems. Although MP includes
suggestions for enhancing social support and connecting families to additional resources, JFCS
stakeholders recommended similar interventions prior to learning about MP. As such, only the
components of MP that directly address parent-child interactions will be used.
RR has been proven to be more effective than general grief and loss support for adults
who have experienced the sudden and unexpected death of someone close to them, particularly if
the death was violent (Rynearson, 1998; Rheingold et al., 2015; Saindon et. al., 2014). As these
researchers have argued, these kinds of deaths result in emotional suffering that is distinct when
compared to deaths that occur for other reasons. For example, complicated grief (whereby grief
symptoms last at least 12 months), post-traumatic stress disorder, and separation distress are
common for adult survivors. RR is unique in that one of the primary components of the
intervention is that it stabilizes these psychiatric conditions through activities to commemorate
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the lives of those lost. This includes reimagining intrusive thoughts about the loved one’s death
so that the thoughts can be drawn and shared with others. Unlike general grief and loss support
that emphasizes detachment from these thoughts and closure, RR encourages the opposite. RR
will be implemented by JFCS therapists who have already been trained in the intervention.
Similar to the methods used in RR open trials, to determine if the intervention is effective,
participants will be assessed for a reduction in depressive symptoms and complicated grief using
the Patient Health Questionnaire-9 and the Inventory of Complicate Grief, respectively.
MP was developed by Rosenblaum et. al. (2017) and endorsed by the National Institutes
of Health (2016) for improving mental health and parenting outcomes for parents who have been
exposed to poverty, ACEs, and, as adults, to interpersonal violence. MP is also designed to
prevent the transmission of ACEs to the children of these parents. Although MP was not
specifically designed for survivors of traumatic loss, individuals in victim assistance services
have many of the similar problems that the target population for MP has been designed to help,
as evident through stakeholder interviews. Rosenblaum and her team have argued that MP is
more effective than programs with similar goals, such as Early Head Start, Healthy Families, and
Nurse Family Partnership, because of the high dropout rates in those programs, and because
those programs do not consider the resource needs that may prevent parents from participating in
services, such as transportation and childcare. JFCS’s stakeholder group chose MP over other
programs because of this distinction, and because of the intervention’s focus on improving the
quality of a parent’s caregiving skills in the midst of current and historical trauma.
Of the five pillars that MP offers to trauma-exposed parents, only two will be used. The
first is the Attachment-Based Parenting Pillar. The goal of this pillar is to improve parental
knowledge of parenting and child development using Bowlby’s attachment theory (Bowlby,
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1969). Parents are taught how to improve their relationship with their children by using a tree
metaphor. They learn how the roots of a tree form a foundation that secures the tree to the
ground. This foundation is similar to a secure base that parents develop for their children. The
branches of a tree represent when children engage in exploring their environment knowing that
they can return to their secure base when needed. And the sunlight above a tree represents the joy
that parents and children should experience as they go through this process together. Parents
learn more about these concepts through a series of facilitator-guided activities that include
group and video observations, modeling, role playing, and group discussions. As parents
improve their knowledge about their children’s attachment needs, they participate in The
practice Pillar. This pillar is designed to help parents apply what they have learned in the first
pillar. For example, parents are asked to respond to their children’s emotional needs as they join
and separate from each other during group time together. Group facilitators then lead discussions
to help parents explore what those interactions may have felt like for their children and what
kinds of needs their children’s behaviors represent from a social and emotional perspective.
Other activities are geared towards helping parents and children interact in developmentally
appropriate ways through games, songs, and play. The objectives of both pillars are met in a total
of 13 sessions which are facilitated by master’s level mental health clinicians trained to
implement the program to fidelity. JFCS’s CEO has spoken to Zero To Thrive, the organization
that will train JFCS staff to implement MP, who have indicated that detailed information about
the training’s modules and topics will be shared during the training. However, the project’s
stakeholder design team has decided that the information gathered about MP through the
literature review is sufficient for the decision to adopt the model for JFCS’s new program. The
Parenting-Stress Index, Short Form was used in the study by Rosenblum et. al. to assess if there
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was a decrease in parental stress and improvement parent-child interaction. JFCS will use the
same assessment instrument to determine if MP is effective with survivors of traumatic loss.
Survivors of traumatic loss require behavioral health services for problems unrelated to
their traumatic loss, according to the information gathered through the interviews. This includes
treatment for a history of domestic violence, alcohol and substance abuse, and abuse and neglect
experienced by adults when they were children. The gravity of these problems can prevent
survivors from recovering from their immediate crises. Another important component of JFCS’s
new program is to thoroughly assess participants to determine if they are experiencing these
other types of problems so that they can receive additional treatment. Fortunately, JFCS has the
capacity to refer clients internally to other therapists for these issues.
Another common problem discovered through the stakeholder interviews is more directly
related to the low-income status of families. Many of the stakeholders expressed that families
lack basic resources such as childcare, transportation, affordable housing, or that they are food
insecure. Many are also unemployed or underemployed. Using an ecological perspective,
families will be thoroughly interviewed to determine the exact nature of their resource needs, as
Okun & Kantrowitz (2014) recommend. This type of interview considers the many systems that
families are embedded in at the micro level (e.g., individual, family), mezzo level (e.g., work,
community), and macro level (e.g., larger socio-cultural systems). Okun and Kantrowitz argue
that by understanding how individuals interact with each system, factors that influence their lives
in positive and negative ways become apparent. For example, some individuals rely on family
for childcare, while others do not have that option. Similarly, some people live in communities
where employment opportunities are abundant. For others, no such opportunities exist. JFCS’s
case managers will integrate this systems perspective when interviewing families so that they can
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refer them for services that will help them obtain these vital resources. JFCS is a multi-service
organization that can provide some of these resources such as financial assistance. For other
resources, such as employment services, referrals will be made to other organizations.
Social isolation is another prevalent issue for families. The information gathered about
this problem through the interviews also included a request by some parents to help them
connect with other program participants or social groups in the community. One stakeholder
described that by losing a spouse or partner, the social isolation that some parents experience
intensifies. The final program component will help families improve their social support
networks by organizing structured social activities with friends, family members, and other
program participants who have the capacity to empathize with their needs and form close, long-
term relationships. Because the priority is to help parents obtain critical services through the
other program components, especially related to their inability to overcome their grief and form
healthier relationships with their children, the stakeholder design team will decide later the exact
format and frequency in which these activities will occur.
As stated, the victim assistance field lacks sufficient evidence to properly address some
of the needs of survivors of homicide (Center for Victim Research, 2016). This is why evidence
about the potential impact of the new program was drawn from studies that assist similar
populations, particularly as it pertains to the program component that will attempt to repair the
contentious relationships that develop between parents and children. Knowledge about the MP
intervention for trauma-exposed families can be extremely valuable to families in victim
assistance programs because of the similarities in life experiences. Therefore, the evidence
produced about the effectiveness of MP is sufficient for recognizing the likelihood that the
intervention will also work with trauma-exposed families in victim assistance services. On a
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broader level, MP promotes the protective factors framework (Rosenblaum et. al., 2017). As
Rosenblaum and her colleagues have described, this framework works to promote resiliency
among families by reducing risky behaviors and focusing on strengths that are conducive to
positive outcomes. This type of framework seems to align with interventions endorsed by the
American Academy of Social Work and Social Welfare to address the Grand Challenge to
Ensure the Healthy Development for All Youth because of the framework’s features to reduce
risk for youth and their families through the recognition of positive individual and environmental
qualities that minimize such risk (Hawkins, et. al., 2015).
This program is innovative because it is unlike any other program that seems to exist for
survivors of traumatic lost. Victim assistance programs funded by VOCA offer limited services.
They are designed to address problems that develop immediately for families after they lose
someone (Office of Justice Programs, n.d.). For example, they assist families with expenses
related to funerals and burials, travel and temporary lodging, and legal representation. Other
funds support families with counseling, even though, as the market analysis (Attachment B) has
demonstrated, those counseling services seem to consist mostly of general grief and loss support.
Yet, VOCA acknowledges that those affected by homicide come from the most marginalized
groups in the United States (Center for Victim Research, 2016). As a result of the social and
economic disadvantages that these groups experience throughout their lives, VOCA-funded
victim assistance programs can only superficially help the population that they try to help, or
they may not be able to help them at all, as JFCS’s stakeholders discovered through interviews.
JFCS’s new program takes these important factors into consideration, thereby making it one of
the most innovative programs in the victim assistance field.
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As was noted earlier, the various parts of the program components as they are described
in the logic model (Appendix C) do not merely represent inputs, throughputs, and outputs. The
model also represents the desire to help parents take advantage of opportunities that they have
been denied throughout their lives as oppressed women of color who have experienced multiple
traumatic events. The stakeholders involved in co-designing the new program have expressed
that the impact of the program cannot be measured just by whether each of the components are
able to achieve the desired goals. They believe that a new program must be based on the
hypothesis that services provide women with a way to overcome the tremendous obstacles they
have endured throughout their lives given their role in society.
The proposed innovation is very likely to succeed. All of the providers, system partners,
and beneficiaries involved in the design and implementation of the new program whole-heartedly
support the project. They have expressed appreciation for the joint effort to identify the barriers
that traumatic loss survivors experience as well as the proposed interventions for each of those
barriers. They also agree that families in victim assistance services could benefit from an
innovative approach to helping them progress further in their recovery. Support for the project
cuts across various levels of staff at each of the organizations involved. At JFCS, staff have
enthusiastically volunteered to help implement the program directly and make the program a
success. Finally, JFCS’s board of directors has supported the project by approving to pay for the
program’s start-up costs through the organization’s financial reserves.
The likelihood of the program’s success is also dependent on the funding that JFCS is
relying on to operate services beyond the start-up period. Fortunately, the organization has a
successful track record of generating revenue from various funding sources. For more than
twenty years, the organization has had a close relationship with VOCA. Unlike other local
21
VOCA providers, JFCS does not limit its services to individuals who are victims of a specific
type of crime. Instead, it provides services to people involved in any type of crime as long as the
impact has resulted in psychological trauma. As such, for more than 20 years, the organization is
a preferred VOCA provider. This contributes favorably to the likelihood that JFCS will continue
to receive funding from VOCA for many years to come. JFCS has also contracted with Medicaid
for many years, a funding sources that can be used for the new program. Once the organization
has moved beyond the start-up activities, these two funding sources will certainly contribute to
the long-term sustainability of the new program. This funding advantage will allow JFCS to
focus on the development of the new program instead of its financial sustainability.
Project Structure, Methodology, and Action Components
A Video Storyboard has been created to demonstrate how the various components of the
new program will work. The storyboard presents the journey of Esmeralda, a program
participant. She is shown receiving services from a mental health counselor who attempts to help
her overcome the tragic loss of her husband. Her emotional state does not improve, however, due
to the ineffectiveness of the general grief and loss counseling sessions she has been receiving,
and because of the many other problems she is experiencing for which she is not receiving help.
This negatively impacts her well-being and the well-being of her daughter. A critical point in the
story is when she is introduced to a new program that addresses each of her problems. A
combination of RR to more effectively help her overcome her grief; MP parenting training to
help her learn about the attachment needs of her child; access to resources and other services;
and opportunities for social interactions with other program participants drastically improved the
circumstances for Esmeralda and her daughter.
22
A video storyboard format was chosen for two reasons. Esmeralda’s journey reflects the
journey of many women who receive victim assistance services. They participate in counseling
for the loss of their spouses or partners but often do not improve regardless of the amount of time
they participate in services as they are typically designed. The new program is an alternative
approach. A storyboard conveys in a clear and simple way a break between the way something
was previously done and how things can be done more effectively. This way of comparing two
distinct approaches can be a powerful tool for gaining support for the project.
More importantly, however, the video storyboard unleashes the emotions associated with
this sensitive issue. Survivors of traumatic loss experience intensive emotional agony. The
beneficiaries involved in the design of the program have expressed that because no one can
understand this agony, there will always be limitations to the extent to which others can help. As
such, the video storyboard was also chosen because of its ability to connect others to the
emotional distress that survivors of traumatic loss experience.
The stakeholders closely involved in the analysis of the needs of survivors of traumatic
loss have an in-depth knowledge of the problem. The information gathered from the beneficiary
interviews and the literature review has contributed to this knowledge. Once stakeholders began
moving beyond problem identification, they put forth strategies to help solve that problem. The
video storyboard consists of a compilation of the most salient recommendations (i.e., the five
program components). The prototype will be used to test their design concepts by helping them
visualize these problem-solving strategies through a format that feels very realistic. This will
serve as a basis for determining if the strategies will be adopted or not, and if alternative
strategies will need be sought. If the prototype succeeds in gaining the approval of the
stakeholders, there will be no delays in implementing the pilot and the first full year of operation.
23
If design concepts are not accepted, the nature of potential delays will be dependent on the types
of alternative strategies they suggest.
The solution landscape analysis (Appendix D) summarizes services to homicide survivors
by organizations in southern Arizona. Homicide Survivors, Inc. is funded by VOCA to provide
short- and long-term financial assistance and case management. The Pima County Attorney’s
Office, Victim Assistance Division, another VOCA-funded organization, provides case
management immediately after a homicide. And JFCS’s current program provides general grief
and loss support to people suffering from the emotional impact of losing a close loved one. JFCS
will be the first organization in southern Arizona to provide a comprehensive set of services to
address the multifaceted needs of people affected by a homicide.
The program is being implemented at JFCS, a private, nonprofit 501(c)(3). This is an
ideal setting given the organization’s 20-year history of providing psychotherapy to the target
population as a VOCA funding grantee. JFCS is also well-equipped to provide some of the
resources required of the new program through the other services that the organization offers.
For example, JFCS offers financial assistance, case management services, and psychotherapy for
other mental health problems. The organization has approximately 75 staff, of which 30 are
licensed therapists who are trained in trauma-specific interventions such as Trauma-Focused
Cognitive Behavioral Therapy and Eye Movement Desensitization and Reprocessing. JFCS’s
CEO has been overseeing all aspects of the program’s implementation. He meets once every
quarter with the stakeholders who participated in the initial needs analysis and design of the
program. The stakeholders in this group include staff from other victim assistance or traumatic
loss organizations (i.e., Homicide Survivors Inc., Tu Nidito, Pima County Attorney’s Office) and
current and former victim assistance services beneficiaries who provide vital feedback about the
24
program’s implementation. The CEO also convenes the JFCS staff who are directly responsible
for implementing the program. This includes JFCS’s VP of clinical services, quality management
supervisor, case management supervisor, and the therapists who will implement RR and MP.
The following activities have been developed to guide the roll-out of the program, some
of which have already been completed:
• A case manager will be selected as the project coordinator to oversee the program’s
day-to-day activities.
• Therapists will be trained in RR and MP. They will have prior experience in
implementing similar workshops in group settings.
• Quality management staff will determine what requirements are necessary for
administering the assessments that will be used to measure the impact of services.
• The project coordinator will be responsible for referring participants for additional
clinical and non-clinical resources and services (e.g., financial assistance,
employment training, substance abuse counseling).
• Design team members will determine which types of social support activities will best
support the objectives of the intervention.
• Marketing materials will be developed for recruiting participants and disseminating to
other stakeholders, including to other victim assistance organizations.
• RR pilot services will begin in January of 2022, and pilot services for MP in April of
2022. Both pilot interventions will target the same five families.
• The first full year of operation will begin in October of 2022. It will include all
components of the new program. About 20 people will participate.
• Manualization of the program will begin during the summer of 2022.
25
The new program will be offered to participants in the current program for survivors of
traumatic loss as an alternative approach to the services that they are currently receiving.
Participants in victim assistance services at other organizations, such as Homicide Survivors,
Inc., Tu Nidito, and the Pima County Attorney’s Office, will also be asked to participate.
Leadership at those organizations has already consented to offering services to their clients.
Direct service staff are fluent in Spanish and English. This will accommodate the linguistic needs
of Latinx clients. JFCS will accommodate the language and interpretation requirements of other
clients, as needed, through one of the many companies that it contracts with for those services.
These companies also provide services to people who are hearing or visually impaired. Services
may be offered through telehealth to address health and safety concerns related to COVID.
A plan has been developed to address potential obstacles to the program’s
implementation. The program is expected to achieve the outcomes of improving the emotional
functioning of parents and improving relationships between parents and children. If those
outcomes are not achieved, the program design team will reconvene to determine what obstacles
prevented them from achieving those outcomes and to brainstorm alternative strategies.
Fortunately, this team has already committed to meeting quarterly to discuss the program’s
progress. Additional staff will be trained in RR and MP in the event that staff currently involved
in the program’s implementation resign. This would ensure that there is no disruption to
delivering services to families. However, considering that these staff have volunteered and are
enthusiastically involved in all implementation efforts, the likelihood that they will resign is very
low. Also, while there is funding to support the short- and long-term goals of the project,
unforeseen expenses could potentially derail implementation plans. To circumvent this, the
agency’s CEO and grant writer have been actively pursuing additional financial support. For
26
example, a proposal was recently submitted to the Women’s Foundation of Southern Arizona, an
organization whose mission directly aligns with the goals of JFCS’s new program.
Although staff and volunteers from various victim assistance organizations are
contributing to the design and implementation of the program, JFCS’s staff and resources are
leading the program’s implementation, led by the organization’s CEO who is overseeing all
aspects of the project. Line-item budgets for the start-up and first full year of operation (FFYO)
are attached (Appendices E and F). A summary of these budgets is included here:
Start-up FFYO

Revenue $77,878 $182,944

Expenses
Personnel $53,040 $151,680
Other Operating Expenses $14,880 $7,402
Indirect Expenses $10,158 $23,862
Total Expenses $77,878 $182,944

Surplus $0 $0

Project start-up will cost $77,878. During this phase of the program, most expenses relate
to the amount of time staff spend attending training, creating marketing materials, writing the
manual, and developing other procedures. Since VOCA covers expenses when direct services are
provided, they will contribute $12,975 for the time that staff spend providing pilot services to
five families. However, almost half of the expenses ($31,225) will come from staff in-kind
support. JFCS’s board of directors has approved withdrawing $33,678 from JFCS’s financial
reserves to pay for benefits, indirect support, training, and incentives for families to participate.
Refer to the start-up line-item budget for more information (Appendix E).
The FFYO will cost $182,944. Most of this is to pay for staff who, at this point, will
spend most of their time providing services. Fortunately, all of these expenses will be covered by
27
VOCA and Medicaid revenue. The Medicaid billing rate includes revenue for indirect support
and other program expenses. See FFYO line-item budget for more information (Appendix F).
The impact of the new program will be measured by assessing changes in parental
emotional functioning and changes in the relationship between parents and their children:
1. Goal: To improve the emotional functioning of parents.
•
Outcome Objective #1: To decrease the symptoms of depression by 60% after 10
weeks of RR group treatment as measured by scores on the Patient Health
Questionnaire-9 (PHQ-9).

o Process Objective: To conduct 1.5-hour sessions of RR for 10 weeks as
demonstrated through documentation in the electronic medical record (EMR).
• Outcome Objective #2: To decrease the symptoms of traumatic grief after 10
weeks of RR group treatment as measured by scores on the Inventory of
Traumatic Grief (ITG).
o Process Objective: To conduct 1.5 hour sessions of RR for 10 weeks as
demonstrated through documentation in the EMR.
2. Goal: To improve the relationship between parents and children.
• Outcome Objective #1: To decrease parental stress by 60% by the end of the 13-
week MP parenting training period as measured by scores on the Parenting-Stress
Index, Short Form (PSI-SF).
o Process Objective: To conduct 13 curriculum-based workshops for parents on
the topic of the emotional and developmental needs of children as
demonstrated through documentation in the EMR.
28
• Outcome Objective #2: To improve parent-child interaction by 70% by the end of
the 13-week treatment period as measured by scores on the PSI-SF
o Process Objective: To conduct 13 curriculum-based workshops for parents on
the topic of the emotional and developmental needs of children as
demonstrated through documentation in the EMR.
JFCS’s Quality Management Department will help to coordinate the activities related to
measuring the impact of the program. Department are supervised by JFCS’s CEO who is a
nationally certified in quality management, certification that includes training in program
evaluation. Department staff will follow the same process they use to measure the impact of the
organization’s other programs. This will consist of ensuring that participants complete the
assessment instruments before to they begin services, intermittently throughout their
participation in the program, and after they complete the program. The mental health staff who
conduct RR and MP will administer the instruments directly for which no additional training or
certification is required. The information collected will be entered into JFCS’s EMR system
which stores information securely and is HIPAA compliant. The results of the program’s
outcomes will be used to determine if services are effective and or if adjustments must be made.
Outcome information will be distributed to program staff, stakeholders, board members, and
others, including the state and federal VOCA offices.
A campaign is required to communicate the program’s objectives for two reasons. First,
beneficiaries currently participating in services for traumatic loss must be encouraged to
participate in the innovative new program. This will require communications materials that
compels them to consider an alternative path towards healing. To succeed at this, messaging
must convey how services are rooted in a thorough understanding of their experiences, obstacles
29
towards healing, and knowledge about a more effective way to help them. This information will
be developed digitally and placed on JFCS’s website, Facebook page, YouTube page, and
Instagram account. The information will also be posted on the organization’s electronic
newsletter, Latest From JFCS, which is distributed weekly to thousands of stakeholders. This
information will be distributed to providers throughout southern Arizona who work with this
population so that they can make the information available to their clients.
A communication campaign is also necessary so that the program can be scaled
nationally. To accomplish this, providers must also understand why the program is being
proposed as an alternative approach to current services. To gain their support and encourage
them to adopt the components, a campaign strategy must also properly convey to them why the
program was developed (i.e., an explanation of the problems that current services do not address)
and the proposed alternative solutions. However, unlike communications strategies that target
beneficiaries, the campaign must also contain elements that helps providers implement the
program. To achieve this, a manual will be developed that outlines the critical elements of the
program. This includes background information about the problem that the target population
faces, unsuccessful attempts to tackle those problem, the process taken to identify alternative
solutions, and information about training and implementing each component. The manual will
also help to increase buy-in. This is a critical step for scaling the program. If providers do not
understand why the new program was developed and how the proposed solutions will impact
families, they may not see the value in changing how they currently work with their clients.
Another strategy for recruiting providers to use the new intervention will require the
assistance of CVR. CVR is responsible for sharing data and other information related to the
needs and experiences of victims of various crimes, including survivors of traumatic loss. JFCS’s
30
CEO has informed CVR about the new program, and they have indicated that they may be
interested publishing information about the new program on their website. Because CVR is well
respected by providers and a source they turn to for guidance and information about best
practices, the likelihood that other organizations adopt the new program, once they see it on the
website, increases dramatically. This is a critical strategy for a successful communication
campaign, especially since one of the goals is for the program to be used nationwide.
The most important ethical consideration is to not assume that all survivors of traumatic
loss will need the services that are being developed. Although the strategies chosen for the new
program were based on the number of people who had similar experiences (e.g., nineteen out of
20 people interviewed expressed significant parenting problems among families in victim
assistance services), clients should participate in the new program if there is evidence to support
that they would benefit from any of the components. The best way to determine this is to conduct
a thorough assessment to gather information about program’s appropriateness for each family, a
process that will also allow parents to determine if the program is a good fit for them.
A potential negative consequence is that the program has the potential of overwhelming
families. Unlike the current program which consists of a single counseling component, the new
program offers beneficiaries the opportunity to participate in as many as five additional services.
This may cause undue stress on families already overwhelmed due to their circumstances. To
avoid this, some families may need to complete the program on a timeline that is convenient for
them.
Conclusions, Actions, and Implications
Parenting After Traumatic Loss: Rebuilding the Lives of Women of Color has several
important features that will give providers in the victim assistance field the opportunity to
31
improve the lives of survivors of traumatic unlike they have ever been able to before. The new
program addresses the many critical needs of families who have lost a loved one to a homicide,
particularly as it relates to the needs of children—family members often overlooked during these
types of crises. If adopted, providers across the country will be much more capable of helping
parents in these families because of the comprehensive services that more appropriately target
the emotional impact of their loss while also addressing other barriers related to their race,
ethnicity, gender, and socioeconomic status that significantly impede their ability to recover.
The program must first be implemented on a smaller scale to determine its feasibility and
effectiveness. Steps are being taken to implement services at JFCS of Southern Arizona. The
organization’s CEO continues to convene quarterly meetings with the stakeholders who helped
design the program, and every other week with the staff who will implementation services
directly. Although these individuals have already approved each of the program’s components,
the prototype will be shared with them in December of this year for feedback. Both of these
groups have agreed to begin piloting RR groups in January of 2022, and MP groups immediately
afterwards in April. The hope is to implement all program components in October of 2022. The
only potential barrier to the program’s success is related to whether it will be accepted as a viable
solution by the individuals that it has been designed to help. Fortunately, the program’s design
was informed by the direct experiences of current and former beneficiaries who will continue to
be a major voice in the development and implementation of this important program.

32
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37
Appendix A
Stakeholder Interviews
Part 1: Interviews
Name Organization Title Expertise/Reason
1 James Gierke Homicide
Survivors, Inc.
(HSI)
CEO National expert on trauma and one of the individuals who
initially expressed that children who have lost a parent or
caregiver are not having all their needs met.
2-
10
Nine parents and
caregivers of
children
HSI and JFCS Beneficiaries/clients Survivors of homicide and currently or formerly enrolled at
HSI and/or JFCS. They are the closest to the problem and can
also assist with potential solutions.
11 Melissa
Zimmerman
JFCS VP of Clinical Services Leads all mental health services as JFCS. Expert in trauma-
informed therapy. Chosen for interview in order to obtain
more knowledge about the type of therapy that families
currently get.
12 Kate Lyon Victims of
Crime
Assistance
Office, AZ
Depart of
Public Safety
Director Director of the office that funds services for victims of crime
at both HSI and JFCS. Has extensive knowledge about the
needs of victims and the various programs and services that
exist throughout the state.
13 Charlotte Peper JFCS Clinical Supervisor Supervises staff and interns that provide services to victims
of crime, including homicide survivors. Also provides
therapy.
14 Vanessa Helms Pima County
Attorney’s
Office, Victim
Services
Division
Director Has extensive experience with survivors of different types of
trauma and therefore understands the needs of this
community. Also has extensive knowledge of related
services. Former CEO of HSI
15 Liz McCusker Tu Nidito Executive Director System partner whose organization specializes in non-clinical
grief and loss support to children, teens, young adults, and
38
families affected by the serious medical condition or death of
someone close to them.
16 Neil Websdale Northern
Arizona
University
Professor and Director
of Family Violence
Institute.
Scholar who studies impact of violence on families including
psychological impact on children.
17 Rita Silverberg JFCS Board member Retired therapist who specialized in services to children.
18 Jennifer Parks JFCS Therapist Provides individual therapy to children and caregivers.
19 Georgia
Fitzsimons
JFCS Therapist Provides individual therapy to children and caregivers.
20 Donna Bartos Bloom365 Founder and CEO Runs a prevention organization for teens. Conducts extensive
needs assessment directly with youth. All other interviews are
focused problem definition with adults. This interview
provided a better understanding of the problems youth have
expressed they are experiencing, including youth who have
lost a close family member.

39

Part 2: Interview Trends Analysis

1. In majority of homicides, women of color are the survivors who are left to care for children.
2. Those affected similarly are not just parents but various types of caregivers.
3. Many caregivers endure prolonged grief and complex trauma even after long periods of treatment. Providers use a variety of
treatment approaches, and therefore are possibly not using most effective treatment for traumatic death.
4. Significant problems develop in relationships between caregivers and children. Reasons provided: Lack of parental
knowledge or skill to address the specific needs of children given the circumstances or because caregivers are consumed by
the emotional effects of traumatic death.
5. There needs to be better coordination of services and resources available to families.
6. Caregivers do not help their children with the prolonged, complex trauma that they are experiencing, and other problems can
develop for children such drug use and problems at school.
7. There is a need to ensure that crisis services are available immediately after death occurs and beyond that since prolonged,
complex trauma often cause mental health crises.
8. Social supports: Many do not have it, and many expressed that they would like to some.
9. Many families struggle with lack of basic resources such as childcare, financial resources, transportation, food assistance,
resources related to school, transportation, and housing.
10. Many caregivers have trauma histories unrelated to traumatic loss such as domestic violence.
11. Men have expressed desire to meet with other men who have had similar experiences in support group.
12. Anger and frustration are persistent emotions that families experience.
13. Telehealth may facilitate services for families that otherwise might not be willing to engage in.

40
Appendix B
Market Analysis
Organization
Organization
Description Comments
1. Homicide Survivors Non-clinical support to
homicide survivors that
includes legal and financial
assistance

Provides financial
assistance and case
management:
information and
referrals, advocacy, and
resources
2. Tu Nidito Grief support for children
who have a medical
condition or lost someone
due to a death
Provide general grief
and loss support when
there are socio-
emotional problems in
the family
3. JFCS of Southern
Arizona
Mental health counseling
and social services agency
Provide general grief
and loss support when
there are socio-
emotional problems in
the family
4. Kids Matter Provides a variety of
services to abuse and
neglected children
Component of the
organization that
provides services to
homicide survivors
provides general
provide grief and loss
support
5. National
Organization of
Parents of Murdered
Children
Grief and loss support for
parents
- 48 chapters throughout
the US.
- Some of these chapters
are embedded within
organizations that
provide a variety of
services
Five organizations with
multi-services were
randomly reviewed. All
promote general grief
and loss support
6. The Compassionate
Friends
Grief support for all family
members after a child dies
Provide general grief
and loss support
7. Victim Connect Grief support referral
helpline
Provide general grief
and loss support.
8. Center for Family
Services
Organization that provides
services for losses due to
homicide, overdose, and
other traumatic events
Provide general grief
and loss support
41
9. Everytown for Gun
Safety
Organization that
advocates for ending gun
violence
They direct survivors to
get general grief and
loss support
10. Institute on Aging Organization that supports
caregivers of older adults
Their approach to
helping survivors of
sudden death is general
grief and loss support
11. Trauma Intervention
Programs, Inc.
National organization that
supports victims and
families who experience
various forms of traumatic
incidents
They provide
information about
general grief and loss
support
12. Rachel’s Fund:
National Coalition to
Abolish Death
Penalty
A coalition to abolish the
death penalty
Promote general grief
and loss support
13. Sudden Organization that supports
people after sudden death
Promote general grief
and loss support.
14. National
Organization for
Victim Assistance
(NOVA)
Organization that
advocates for people
harmed by crime and crisis.
Also provide training to
victim advocates and crisis
responders
Promote general grief
and loss support
15. Virginia Mason
Medical Center
Healthcare organization Provide Restorative
Retelling as an
alternative to grief and
loss support
16. Survivors of Violent
Loss Network
A San Diego based
organization that
specializes in violent death
treatment for survivors
Provide Restorative
Retelling as an
alternative to grief and
loss support
17. Pima County
Attorney’s Office
A division of this office
helps victims of crimes,
including survivors of
homicide
Provide case
management:
information and
referrals, advocacy, and
resources
42
Appendix C
Logic Model

INPUTS ACTIVITIES OUTCOMES
What we invest What we do Who we reach
Why this project:
short-term results
Why this project:
intermediate results
Why this
project: long-
term results
• Clinicians, victim
assistance staff,
volunteers
• New knowledge
about the needs of
low-income
women of color
who are homicide
survivors
• Curriculum-based
parenting
workshops on
bonding and
attachment
• Tx for
Complicated Grief
and other needs
• Case management
• Social support
groups
• Existing funding
• Network of
partners
• Implement Mom
Power workshops on
bonding and
attachment
• Provide opportunities
to practice new skills
and knowledge during
workshops
• Restorative Retelling
treatment
• Treatment for other
problems
• Case management and
coordination of non-
clinical services
• Create opportunities
for increasing social
support
• Parents and
children who
are homicide
survivors
• Other providers
of victim
assistance
services
• Funders of
victim
assistance
services such
as VOCA and
Medicaid
• Other survivors
of traumatic
death

• Parents will use the
new knowledge and
skills related to
bonding and
attachment to meet the
needs of their children
• Parents will be able to
cope better with the
loss of their loved one
• By removing other
barriers related to
being low-income,
such as transportation,
childcare, and
financial assistance,
parents will feel less
consumed by their
immediate problems
associated with their
loss and the stress they
experience as parents
• Parents will be able to
meet the social and
emotional needs of
their children
• Other providers of
victim assistance
services will use the
program model to help
families with similar
needs
• Program model is
effective for survivors
of other forms of
traumatic death
• Improved
relationships
between
parents and
children
• Improved
mental health
for children
• Positively
impact the
developmental
needs of
children
43
Appendix D
Solution Landscape Analysis
Design Criteria Homicide Survivors
Pima County
Attorney’s Office
Current
JFCS Program
JFCS
Parenting After
Traumatic Loss
General grief and loss support

X X
Restorative Retelling

X
Mental health treatment for other
issues

X
Parenting education on
bonding/attachment (Mom Power)

X
Case management: financial
assistance, information and
referrals, advocacy, and resources
X X

X

44
Appendix E
Start-up Budget (April 1, 2021 – June 30,2022)
Category - $'s (000's) - ---------------- Comments ---------------

REVENUE
Contract $12,975 Victims of Crime Assistance Office (VOCA)*
Other Revenue $33,678
JFCS financial reserves (donations, budget surpluses,
and other sources of unrestricted revenue)
Donation - In-kind $31,225 Services by existing JFCS staff
Total REVENUE $77,878

EXPENSES
Personnel Exp
Wages/Salaries
Project Coordinator $15,200
Current case manager @ .5 FTE. (50% VOCA expense,
50% in-kind expense**).
Lead Therapist $10,750
Current therapist @ .25 FTE (50% VOCA expense,
50% in-kind expense**).
VP Clinical Services $8,300 Current VP at .10 FTE (In-kind expense)
Quality Management Specialist $5,400 Current specialist @ .10 FTE (In-kind expense)
Grant Writer $4,299 Current grant writer @ .10 (In-kind expense)
Marketing Director $250 Current director @ 10 hours total (In-kind expense)
CEO (Design Team Lead) $1 Current CEO @ .10 FTE (In-kind expense)
Sub-Total $44,200
Benefits (@20%) $8,840 _______ Covered by JFCS financial reserves.
Total Pers. Exp $53,040

Other Operating Exp
Comm & Mat'ls $500 Marketing materials: $500.
45
Trng/Prof Dev $8,700
Restorative Retelling training in Seattle for 1 staff:
$900.
Mom Power Training for up to five staff, virtual:
$7,800
Travel & Enter. $1,578
Restorative Retelling flight and hotel: $778, $800
incidentals.
Office Supplies $1,402
Parenting Stress Index-SF: $302; Patient Health
Questionnaire: $100; Other supplies and materials for
workshops: $1,000.
Transportation $1,000 For families to and from workshops and other services.
Incentives $1,500 For families to participate in the workshops.
Total Other Op Exp $14,880 Covered by JFCS financial reserves.

Total Direct Expenses $67,720

Total Indirect Expenses (15%) $10,158 Covered by JFCS financial reserves.

Total Direct/Indirect Expenses $77,878

SURPLUS/DEFICIT 0

Notes
* VOCA revenue covers direct services to clients by case manager and therapist.
** It is estimated that half of this person's time will be spent providing services and half on start-up activities.

46

Appendix F
FFYO Budget (October 1, 2022 - September 30, 2023)
Category - $'s (000's) - ---------------- Comments ---------------

REVENUE
Contract $82,325 Victims of Crime Assistance Office (VOCA)*
Fee-for-service $100,619 Medicaid**
Total REVENUE $182,944

EXPENSES

Personnel Exp
Wages/Salaries
Project Coordinator $30,400
Case manager @ 1 FTE responsible for providing
case management services and general coordination
of project
Therapist $48,000
Therapist @ 1 FTE responsible for individual
therapy, Restorative Retelling, and workshops
Therapist $48,000
Therapist @ 1 FTE responsible for individual
therapy, Restorative Retelling, and workshops
Sub-Total $126,400
Benefits (@20%) $25,280 _______
Total Pers. Exp $151,680

Other Operating Exp
Comm & Mat'ls $500 Marketing materials: $500
47
Office Supplies $1,402
Parenting Stress Index-SF: $302; Patient Health
Questionnaire: $100; Other supplies and materials for
workshops: $1,000
Transportation $2,500
For families to and from workshops and other
services
Incentives $3,000 For families to participate in the workshops
Total Other Op Exp $7,402

Total Direct Expenses $159,082

Total Indirect Expenses (15%) $23,862

Total Direct/Indirect Expenses $182,944

SURPLUS/DEFICIT 0

Notes
* VOCA revenue covers direct services to clients by case manager and therapist.
** Medicaid will be billed for larger proportion of expenses since revenue covers indirect expenses.

Abstract (if available)

Abstract Low-income women of color who are survivors of traumatic death (i.e., homicide, suicide, fatal accident, terrorist act, or death resulting from a sudden and unexpected illness) often face multiple barriers that prevent them from benefitting from existing victim assistance programs. A proposed pilot program is being developed that considers the systemic oppression that these women have experienced throughout their lives. This innovative approach addresses their complicated grief and includes parenting education on bonding and attachment, treatment for problems unrelated to traumatic loss, case management to help parents and children obtain needed resources, and strategies to increase their social support networks. The primary goal of the innovative approach is to empower parents so that they can provide for their children—individuals who have also been severely affected by their circumstances. This project aligns with the Grand Challenge of Ensuring Healthy Development for All Youth. An environmental scan of other providers of victim assistance services across the country revealed that those programs could also benefit from this new practice approach.

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Asset Metadata

Creator Hernandez, Carlos Alberto (author)

Core Title Parenting after traumatic loss: reinventing the lives of women of color

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work / Planning

Degree Conferral Date 2023-05

Publication Date 05/31/2023

Defense Date 02/04/2022

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag adverse childhood experiences,childhood trauma,OAI-PMH Harvest,restorative retelling,traumatic death,traumatic loss,victims of crime

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Smith-Maddox, Renee (committee chair)

Creator Email Carlosah@usc.edu,Carlosintucson@yahoo.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113141742

Unique identifier UC113141742

Identifier etd-HernandezC-11903.pdf (filename)

Legacy Identifier etd-HernandezC-11903

Document Type Capstone project

Format theses (aat)

Rights Hernandez, Carlos Alberto

Internet Media Type application/pdf

Type texts

Source 20230601-usctheses-batch-1050 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

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Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu