“Helping Every Child Thrive” Through the Pandemic:
The Weissman Children’s Foundation COVID-19 Relief Initiative
Adam S. Weissman, Ph.D.
The Weissman Children’s Foundation, The Child & Family Institute,
and Columbia University Teacher’s College
The proliferation of empirically-supported behavioral health treatments into “real world” practice settings (e.g., community health clinics, private practices, schools, hospitals) over the past several decades has led to more U.S. children and families receiving high quality treatments and improved treatment outcomes (Reddy, Weissman, & Hale, 2013; Mohlman, Deckersbach, & Weissman, 2015; Weissman, Antinoro, & Chu, 2008; Weissman et al., 2019; Weissman, 2020; Weisz et al., 2018; Weisz et al., 2019). Even so, the overwhelming majority of these specialized evidence-based treatments (EBTs; e.g., for anxiety, depression, attention, speech, sensorimotor, learning, habit, and behavioral challenges) are still almost exclusively accessible at expensive out-of-pocket private clinics. What’s more, the national healthcare system has not adequately prioritized coverage for evidence-based services in the mental and behavioral health arenas, and insurance reimbursement for most specialized out-of-network treatments is limited at best. The result is an overwhelming majority of the U.S. population, uninsured and underinsured children and families nationwide, left without access to affordable gold standard mental and behavioral healthcare. In addition, there remains a significant dearth of evidence-based service providers and training programs nationally, particularly in more remote communities.
During the current COVID-19 global economic and public health crisis, it is perhaps more important than ever to increase accessibility of affordable and pro bono evidence-based care for children, families, and communities in need. The Weissman Children’s Foundation (WCF; Weissman, 2020) is a national dissemination-based behavioral health non-profit founded on six core unifying initiatives to address these mounting public health concerns: 1) Dissemination of EBTs Through Crisis Relief: COVID-19 Relief Initiative, 2) Dissemination of EBTs Through Training, 3) Dissemination of EBTs Through Community Partnership, 4) Dissemination of EBTs Through Integrated Behavioral Health, 5) Dissemination of EBTs Through Technology, and 6) Dissemination of EBTs Through Multi-State, Multi-Site, Program Development and Implementation, all with a common goal of raising awareness and leveraging local and national resources to disseminate and implement accessible, affordable, and pro bono evidence-based care to underserved children, families, and communities across the United States, throughout the current pandemic and beyond.
As such, WCF’s innovative EBT “Clinical Practice Dissemination and Implementation” model (CPDI, Weissman, 2019) is rooted in these six initiatives.
Dissemination Through Crisis Relief COVID-19 Relief Initiative
WCF’s chief initiative is a comprehensive COVID-19 Relief Initiative (CRI; Weissman, 2020; Weissman, in press) featuring pro bono and donation-based virtual support groups for coronavirus-related anxiety, depression, OCD, trauma/grief, social isolation, parenting challenges, and marital/family stress. The relief initiative also includes many additional virtual behavioral health services, including individual and family cognitive-behavioral therapy, psychiatry, neuropsychology, virtual reality therapy, biofeedback, creative arts therapy, speech therapy, occupational therapy, holistic health and nutrition, educational consulting, tutoring, home-schooling help, college prep, a Center for Chronic Medical conditions, and more. The CRI actively engages and synthesizes the below five stages and initiatives, leveraging strategic partnerships and thinktanks, and expeditiously rolling out relief programming to at-risk communities in crisis with the greatest need. Several additional relief-based partnerships are currently being developed with local schools, hospitals, government agencies, community organizations, training programs, community practitioners, and corporations to help scale CRI efforts to broaden our impact nationally and reach more families and communities in need.
WCF’s “Dissemination-Through-Training” (DTT, Weissman, 2019) initiative comprehensively trains student clinicians in EBTs for youth emotional, behavior, attention, and habit disorders to help increase the number of evidence-based providers pursuing licensure, as well as the provision of low-fee and no-fee services to underserved communities, including immediate COVID-19 relief services nationwide. To accomplish this, clinical psychology and social work training programs were first developed in-house, based on a modular-based CBT approach (e.g., MATCH-ADTC; Chorpita & Weisz, 2009; as well as evidence-based protocols for Selective Mutism; Kotrba, 2014; Obsessive-Compulsive Disorder; March, 2006; Tic and Habit Disorders; Woods, 2008, Dialectical Behavior Therapy; Rathus & Miller, 2014; and the full array of youth psychiatric disorders and related issues). All WCF trainees receive funding for external EBT training opportunities (e.g., workshops, conferences, CE’s) through WCF’s “Scholarship Training Initiative” (STI, Weissman et al., 2019), including stipends to attend conferences and workshops on cutting edge evidence-based practices, and in turn, the trainees present relevant updates back to the group.
In addition, external collaborations were subsequently developed with local clinical psychology and social work training programs, fostering further access to high quality evidence-based care through a growing collective of pro bono and low-fee student clinics, including a collaboration with Columbia University Teacher’s College PhD program and student clinic in the works, servicing Harlem, the Bronx, and surrounding neighborhoods, some of the most highly COVID-19-afflicted, under-resourced communities in the nation. These students, in turn, receive expert EBT training and supervision from WCF’s renowned training team.
Finally, WCF directors are also encouraged to apply for pro bono supervisory positions at local mental health training programs to help train students more broadly in EBTs, and further scale affordable evidence-based service delivery to children and families in need. Indeed, many WCF-trained students have gone on to start their own clinical practice and training institutes throughout the country (e.g., www.marincabt.com).
Dissemination Through Community Partnership
The next WCF initiative is a community partnership model, promoting outreach, consultation, advocacy, and community education/engagement around EBTs. As part of this initiative, WCF staff present and consult frequently to schools, parents/families, clinicians, and community organizations throughout the U.S., including many currently in crisis, partnering with community stakeholders and renowned experts in the field to expand the scope of EBT community education and access (recent speakers from the WCF Master Clinician Series included Drs. Bob Leahy, Leslie Sokol, Dennis Tirch, and Dean McKay). In addition, WCF’s directors reside on city, county, state, and national CBT and psychological association governance boards, and utilize these platforms to forge collaborative efforts and local crisis relief initiatives, host community-wide events, and advocate for best practices with youth from both a clinical and public policy standpoint. Finally, WCF is in the process of launching a school-based CRI, partnering with local schools to increase direct EBT access to children and families during the pandemic and beyond, who, otherwise, might not have the knowledge and/or resources to access evidence-based mental health services on their own.
In addition to these collaborative efforts, WCF has recently launched a comprehensive educational and resource-rich CRI social media campaign, via Instagram, Facebook, Twitter, and LinkedIn to disseminate the most current information about COVID-19, its mental health sequelae, and related evidence-based resources available through WCF, CDC, WHO, State and City Departments of Health, and the community at large.
Dissemination Through Integrated Behavioral Health
The fourth WCF initiative is to develop local partnerships among expert evidence-based providers across a wide range of behavioral health disciplines, to foster an integrated behavioral health platform promoting best practices for youth, not only within the field of clinical psychology, but also pediatrics, psychiatry, neuropsychology, occupational therapy, speech therapy, holistic health and nutrition, educational consulting, academic remediation, and more. In doing so, WCF’s two-pronged goal was to create an ongoing dialog with, and educate, one another, about evidence-based therapies, as well as to provide more integrated behavioral health programming and coordinated care for families requiring multiple ongoing services throughout this crisis period and beyond.
WCF’s “Dissemination-Through-Technology” (D-TECH; Weissman, 2020) initiative leverages innovative evidence-based technologies and tracking systems to enhance treatments, assessment of treatment outcomes, and overall program evaluation. Central to the D-TECH initiative, WCF is currently piloting a new evidence-based tracking EHR software (Fuller, 2019), designed to facilitate within and across-session EBT fidelity tracking, data collection, and program evaluation, including global assessment of treatment outcomes, with the hope of replicating these efforts, including the CRI, more widely to scale funding and site development efforts and overall access to treatments that work.
In addition, WCF’s D-TECH initiative utilizes innovative technology-based alternative and/or supplemental EBTs to optimize hard-to-access symptoms and/or treatment content (e.g., virtual reality-enhanced exposure therapy paired with biofeedback for anxiety and phobias, Barton & Weissman, 2019), contributing putative models for enhanced EBT outcomes, particularly while families are in social isolation due to COVID-19 and are unable to access and engage in typical EBT protocols (e.g., social anxiety exposures, as well as OCD, trauma, selective mutism, separation, panic, and phobia exposures that may occur in a public forum).
Finally, WCF employs innovative video- and telehealth technology platforms to reach families adhering to social distancing and “stay-at-home” orders throughout the country, and internationally, including the most geographically remote families in need.
Dissemination Through Multi-State, Multi-Site Program Development and Implementation
The sixth and final stage of WCF’s CPDI model, currently underway, is a multi-state, multi-site program development initiative to promote greater geographic dissemination and implementation of EBTs, in an effort to reach the needs of more geographically and socioeconomically diverse communities, with an emphasis on those with limited means and/or access to EBTs. To accomplish this, WCF leaders have collaborated with local practitioners, organizations, and stakeholders, community by community throughout the U.S. (NY, NJ, CT, FL, MI, CA, PA, DC, WA, AK to start) to assess the mental health landscape, barriers to EBTs, and the impact of COVID-19, for the full range of youth mental health conditions, developing 15 sites to date, 12 in the Northeast- midtown Manhattan, Park Slope, Prospect Heights, Downtown Brooklyn/Boerum Hill, and Carroll Gardens, Brooklyn, Queens/Long Island, Bergen County, NJ, Greenwich, CT, Scarsdale, NY, Harrison, NY, and Mt. Kisco, NY, one Southern site- Aventura/South Florida, two Midwestern sites outside of Ann Arbor, Michigan, and one West Coast satellite office in San Diego, CA, with prospective plans on the horizon to service the San Francisco Bay Area, Philadelphia, Washington D.C., Washington State, and Alaska. Central to this initiative, WCF strategically engages in specialized niche program development based on the unique mental health needs of each community (e.g., developing a “Brave Voices” Selective Mutism Program, Center for Chronic Medical Conditions, IOP for OCD, Tics, Trich, & Habit Disorders Program, Adoption/Attachment Service, Maternal and Infant Mental Health Service, LGBTQ+ Program, Virtual Reality Therapy & Biofeedback Program, etc. in communities where no such services previously exist).
As mentioned prior, in addition to its on-site programming, WCF offers virtual EBTs broadly throughout the world, employing innovative video- and telehealth technology to reach more geographically remote families in need, which has been a welcome initiative amid the current COVID-19 pandemic.
Implications for Public Health, Policy, and Practice
Perhaps most central and unique to WCF’s six initiatives, and its overall core values and mission, is the accessibility and affordability of services for each and every child regardless of socioeconomic limitations and ability to pay, including completely free evidence-based care for uninsured and underinsured families, breaking down generations-old barriers to EBT access in the nation’s most disadvantaged, marginalized, and often highest-needs communities. This guiding vision is perhaps more essential now than ever, with so many families in economic and mental health crisis, simultaneously, throughout the U.S. and around the world.
Preliminary feedback from patients, students, collaborators, local politicians and stakeholders, partner organizations, and the broader communities in the regions served has been enthusiastic, and many children and families in need are already receiving life-changing support from WCF and its CRI.
As WCF continues to build upon its six core missions, disseminating EBTs to communities across the U.S.—many now in crisis, its leaders recently launched a seventh initiative at the 2019 World Congress of Behavioral and Cognitive Therapies in Berlin—teaching international EBT practitioners and students how to develop their own dissemination-based behavioral health organizations using the CPDI model, to further disseminate EBTs for youth and increase access to evidence-based programming—including timely evidence-based CRI services—on a global scale (Weissman et al., 2019).
Barton, M., & Weissman, A. S. (2019, July). Virtual Reality Treatment for Aviophobia (Fear of Flying). Presented at The World Congress of Behavioral and Cognitive Therapies, Berlin, Germany.
Chorpita, B.F., & Weisz, J. R. (2009). Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC). PracticeWise, LLC: Satellite Beach, FL.
Fuller, J. R. (2019). My Best Practice Electronic Health Record. www.mbpractice.com.
Kotrba, A. (2014). Selective mutism: An assessment and intervention guide for therapists, educators & parents. Pesi Publishing & Media.
March, J. S. (2006). Talking back to OCD. Guilford Press.
Mohlman, Deckersbach, & Weissman, A. S. (2015). From Symptom to Synapse: A Neurocognitive Perspective on Clinical Psychology. Edited Book: NY, NY: Routledge.
Rathus, J., & Miller, A. L. (2014). DBT Skills Manual for Adolescents. Guilford Press.
Reddy, L. A., Weissman, A. S., & Hale, J. B. (2013). Neuropsychological Assessment and Intervention for Emotional and Behavior Disordered Youth: An Integrated Step-by-Step Evidence-Based Approach. Edited Book: Washington, DC: APA Press.
Weissman, A. S. (2020). “Helping every child thrive” through the pandemic: The Weissman Children’s Foundation Corona Relief Initiative. New York City Cognitive Behavior Therapy Association Spring Newsletter.
Weissman, A. S. (in press). Biography of Adam S. Weissman, Ph.D., Winner of the 2020 American Psychological Association Award for Distinguished Contributions to Independent Practice. American Psychologist.
Weissman, A. S., Antinoro, D., & Chu, B. C. (2008). Cognitive-behavioral therapy for anxiety in school settings: Advances and challenges. In M. Mayer, R. Van Acker, J. E. Lochman, & F. M. Gresham (Eds.), Cognitive-behavioral interventions for students with emotional/behavioral disorders. NY, NY: Guilford Press.
Weissman, A. S., Denenberg, A. M. W., Barton, M., Becker-Weidman, E., Yates, P., Schreiber, S., Wernick, A., Grashow, L., Kudla, L., Little, K., Ciubotaru, L., Johnson, E., Cunningham, L., Braunstein, M., Romey, E., Hatcher, S., O’Brien, K., Kurtz, P., Cabral, A., Liebman, R., Tucker, L., Horowitz, J., Athineos, C., Rose, R., Vitagliano, D., Castaldo, K., Fox, J., Riseman, D., Danzig, A., Dumont, E., Kotrba, A, & The Child & Family Institute. (2019, July). Clinical dissemination and implementation of EBTs from the ground up: How to develop a multi-disciplinary, multi-site CBT “Clinical Dissemination Practice” (The case example of The Child & Family Institute). Presented at The World Congress of Behavioral and Cognitive Therapies, Berlin, Germany.
Weisz, J. R., Bearman, S. K., Ugeto, A., Herren, J., Evans, S., Cheron, D., Alleyne, A., Weissman, A. S., Tweed, J. L., Pollack, A., Langer, A., & Jensen-Doss, A. (2019). Testing the robustness of Child STEPS effects: A randomized controlled effectiveness trial. Journal of Clinical Child & Adolescent Psychology, 00, 1-14.
Weisz, J. R., Ugueto, A., Herren, J., Marchette, L., Bearman, S. K., Lee, E. H., Thomassin, K., Alleyne, A., Cheron, D., Tweed, J. L., Hersh, J., Raftery-Helmer, J., Weissman, A. S., & Jensen-Doss, A. (2018). When the torch is passed does the flame still burn? Testing a "train the supervisor" model for the Child STEPS treatment program. Journal of Consulting and Clinical Psychology, 86, 726-737.
Woods, D., W., Piacentini, J. C., Chang, S., Deckersbach, T., Ginsburg, G. S., Peterson, A. L., et al. (2008). Managing Tourette Syndrome: A Behavioral Intervention for Children and Adults Therapist Guide (Treatments That Work). Oxford University Press.