The Center for Resilience is a Sign of Hope for the City of New Orleans

By: Ana Paula Gonzalez

agonzalez7@tulane.edu

A trauma-struck city, New Orleans is no stranger to violence, natural disasters, poverty, and housing security. The effects of these factors would be detrimental to anybody’s mental health – but in a city where the Health Department is not even in the top 10 departments receiving the most funding in the city, it is difficult for many to have access to the mental health resources they may need. 

Founded in 2015 by Dr. Liz Marcell Williams, The Center for Resilience, the only therapeutic day treatment program in Louisiana, was created “in response to [the] lack of continuum of behavioral healthcare services, especially in the wake of Hurricane Katrina, but not exclusively due to that single traumatic event.”  

Abigail Randall, better known to some as Abby, is an eighteen year old student at Tulane University who is in awe of the work that the Center is doing. Growing up a quick thirty minute drive out of New Orleans in Belle Chasse, LA, and now living in Slidell, LA, she has witnessed the absence of mental health resources and believes there is limited discussion surrounding the topic of mental health within the city.

“When I grew up in Belle Chasse, it was right after Katrina, and a lot of people’s homes and families were being split up and people were getting divorces because of money, and it was just this really big problem.” 

Christy Speakman, a parent at CfR, agrees with Abby in that she thinks the resources in New Orleans “could improve.” 

“I grew up here and I was gone for 15 years and moved back and I know it takes time to find the right resources but it was really hard to find the right school for [for my son].” 

Christy’s son, a fifth grader who recently joined The Center for Resilience last November, lives with Autism, a “developmental disability caused by differences in the brain.” Those with Autism may have “challenges with social skills, repetitive behaviors, speech and nonverbal communication.”

For Christy, she has found it difficult to find places for her son to thrive and receive any support he may need. 

“There’s places that are not available to people with autism which is strange, but yeah I think [New Orleans] could do better.” 

According to CfR, “Studies suggest that approximately 60 percent of children in New Orleans suffer from Post-Traumatic Stress Disorder, and New Orleans children are 4.5 times as likely as their peers nationwide to demonstrate signs of Serious Emotional Disturbance. And, although approximately 10 percent of students with behavioral disabilities are served outside of typical school settings nationwide, just 0.4 percent of students in Louisiana are served in alternative settings, highlighting the absence of appropriate placement and intervention options.”

After learning about the Center for Resilience, Abby thought about what could’ve been for her peers in her hometown, and sees how valuable the Center is to children – “Living in Belle Chasse…there were a lot of kids in my grade with a lot of mental health issues because they started off their life basically in a trailer or in no home at all, so I think if maybe they had a Center like this or if we had known about this, I think this maybe would’ve been a major game changer for mental health for people my age.”

Partnered with the Tulane University Medical School Department of Child and Adolescent Psychiatry, The Center for Resilience offers three programs: the Day Program, Prism, and PLAAY. Their day program, more formally called the Relationship Spaced Day Treatment Programming, is open to kids K-12 and is for kids who, as Dr. Marcell Williams describes, “have diagnosed behavioral health needs and most typically have had some very significant traumatic experiences in their life.” 

Working on building trusting and caring relationships between the children themselves, and between the children with the adults, the Day Program is “a very intentionally interdisciplinary setting where we’re bringing together folks like myself who have backgrounds in education, people who have clinical or therapy backgrounds, and then people who have medical backgrounds so that when we’re developing treatment plans, we’re taking into consideration the best approaches from all of those fields.” 

In this program, the environment is “intentionally constructed as a therapeutic setting,” meaning they think deeply about the Setting Condition. This means that the lights are off in a lot of the buildings because students find it less overstimulating, the staff think about how to use a particular tone of voice to build more trustful relationships, and the schedule is built in a way where opportunities for conflict or power struggles are eliminated. 

Students in the Relationship Spaced Day Treatment Programming have been referred to the Center for Resilience from their schools, and spend time at the Center continuing to get academic instruction, and also receiving therapy services, both individually and in a group setting. Therapeutic activities can include music or art therapy, yoga, dance, and field trips out into the community. 

Christy is a big fan of these therapeutic art activities as they have her son smiling and having fun at school. She is very appreciative of the amount of creativity the children are allowed to have through arts, crafts, and music, and even activities like one that her son has recently taken up which is designing logos.  

Though Christy’s son takes part in these therapeutic activities, he is not part of their Day Program, but is rather part of Prism. Formally known as the Prism Program for Children with Autism and Related Spectrum Disorders, Prism is very similar to the Day Program in that they use many of the same interventions and format, however with the addition of Applied Behavior Analysis, also known as ABA therapy. 

According to Dr. Marcell Williams, “there’s a lot of criticism of [ABA therapy], particularly within the Autistic community, in that it sort of privileges a single way of being and does not reflect the diversity or respect the unique identities of people with Autism, and so if you’re trying to be sensitive and trying to think about trauma and relationships and validating identities, being 100% ABA, it’s sort of a tricky place to be… however we come back to it’s the only proved evidence based intervention, so we’re trying to be really creative about how do we apply all the principles of ABA, how do we provide that level of support intervention and training, while also creating a setting that’s really respecting kids dignity and not expecting them all to have a cookie cutter experience.” 

As a parent, Christy’s favorite part about the Prism program is that “it’s all customizable…I like that if something is working, they can do more of it, and his day can be structured however he needs it to be that day, no school has ever been like that, so one on one, I feel like he is really supported there.” 

The Center for Resilience’s third and final program, PLAAY, was developed by Howard Stevenson, a Professor of Education at the University of Pennsylvania. It is “the first intervention that’s really being thoughtful about the unique needs of African American youth at risk of or with behavioral challenges.” 

Standing for Preventing Long Term Anger and Aggression in Youth, PLAAY was initially designed for African American males; however, CfR has worked with UPenn in expanding the design for female students as well – “The idea is that PLAAY takes situations where conflict occurs naturally, like sports, and uses those conflicts as opportunities to teach kids stress management and conflict resolution skills. It’s also really attentive to racial stress and the trauma and stress that comes with racially charged situations, and so there’s a protocol, it’s about a sixty minute intervention that takes place multiple days a week where the kids talk first, they come together, they review their ground rules, and they go and engage in whatever the conflict rich activity is.” 

A program where kids have built skills at a phenomenally high level, as Dr. Marcell Williams enthusiastically told me, they have found ways to implement this program even in times of stress and isolation, such as the COVID-19 pandemic, by playing video games when virtual. For PLAAY in particular, the Center for Resilience feels strongly about “wanting to seminate it throughout New Orleans because we think it’s a really appropriate resource for the needs of the kids in the community.” 

A potentially huge resource and program for educational institutions to put in place for New Orleans, one does not need to be a licensed clinician in order to implement PLAAY. As long as the teachers, coaches, or whomever would like to implement the program goes through the proper training, PLAAY can be replicated and implemented anywhere – The Center for Resilience is being a massive leader in the city when it comes to implementing these vital programs for children, as they are “hoping to actually do a training for all of the football coaches in the New Orleans recreation department over the summer.” 

With how limited mental health resources are, to have programs such as PLAAY would be paramount in a city like New Orleans. 

Abby has expressed concern for this limitation, for as someone who attends therapy herself, she says it is a tumultuous process to receive any kind of help in the city, especially due to insurance and funding issues – “My family, we’re comfortable, and to get a therapist for me was even difficult because insurance is so hard to navigate, and so especially the people in this city, they don’t have insurance, so I think talking about that is definitely something that is very very very important.” 

Abby also believes that the limited access to mental health resources has had a grave affect on the uprise in crime that New Orleans has been seeing in recent years – “Most people who are doing these carjackings are essentially close to my age and have grown up in a post-Katrina world where, you know, they’ve grown up in poverty and I mean just the cycle of you know a poor rebuilding of the city and how that plays in with poverty and how they can’t get out of it at all, and so they obviously don’t have access to these mental health resources, and they’re far and few.”

 According to the Program Psychologist at CfR, Dr. Kristen Pearson, though, getting the children the help that they need at a young age is just one piece of the puzzle when it comes to fixing the future crime rates. 

“I think there’s a lot of systems that need a lot of work, and it doesn’t just exist in the child, the problem doesn’t just lie in the child’s mental health problems, it’s the system and the larger system that needs a lot of love, but I do think it’s certainly one piece, one piece that we can help with.” 

Programs like the Center for Resilience are a blessing to cities like New Orleans. With a lack of crisis receiving services, limited availability of substance use treatment services, delays in access to outpatient mental health services, and few residential treatment options, New Orleans is in dire need of services like CfR. By helping children with their mental health needs, The Center for Resilience is setting up children for greater success and a greater understanding of themselves upon leaving the Center. Allowing children of all ages to have access to mental health services is incredibly valuable anywhere, because as Abby emphasized, “mental health is part of health,” and there is a concern that the access will simply not be there for New Orleanians for a long time. 

Dr. Liz Marcell Williams does believe that the restricted access to mental health services in New Orleans is most certainly a funding issue. Not being funded by Medicaid or private insurance, most of the Center’s funding comes through education, which “is not sustainable for organizations who do this work.” 

There is some hope, however. Abby believes that her generation will be the one to improve these services and have them become more available – “I do have hope that we will be able to cater to more mental health issues…when people my age start graduating college and start getting into mental health, like psychiatrists, when they start taking up those jobs in the city, because I believe that my generation is I think one of the most understanding and one of the most careful generations.” 

Christy also has hope for the future and describes finding CfR as “a relief, honestly, it was just something that I didn’t even know was possible…it’s been really really great for us to have them–to feel like we have a team…This program feels really like a hopeful start that there is something like this for Autistic students and I know it’s still in the early stages so I think it will definitely grow.” 

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