THIS PROGRAM IS MADE BY MPT TO SERVE ALL OF OUR DIVERSE COMMUNITIES AND IS MADE POSSIBLE BY THE GENEROUS SUPPORT OF OUR MEMBERS.

THANK YOU.

LIVE FROM MARYLAND PUBLIC TELEVISION, THIS IS "DIRECT CONNECTION" WITH JEFF SALKIN.

♪♪] >> JEFF: GOOD EVENING AND WELCOME TO YOUR "DIRECT CONNECTION."

WE BEGIN TONIGHT WITH TOP HONORS FOR A FAST GROWING MARYLAND NEWS OUTLET.

THE BALTIMORE BANNER WHICH IS NOW THE PULITZER PRIZE WINNING BALTIMORE BANNER.

JOINING US IS KIMI YOSHINO THE EDITOR-IN-CHIEF OF THE BANNER AND BOB COHN THE C.E.O.

THANK YOU FOR JOINING US.

IF WE CAN BEGIN WITH YOU, KIMI YOSHINO, TELL US ABOUT THE STORY, THE JOURNALISM THAT WON THIS PULITZER PRIZE?

>> THANK YOU FOR HAVING US.

YEAH, THE PACKAGE OF STORIES THAT WON WAS A SERIES ABOUT BALTIMORE'S OVERDOSE CRISIS, WHAT WE FOUND WAS THAT ABOUT 6,000 PEOPLE HAD DIED OVER THE COURSE OF SIX YEARS.

AND BALTIMORE HAD THE WORST OVERDOSE RATE IN THE COUNTRY.

>> Jeff: AND YOU AND YOUR TEAM OF REPORTERS HAD TO FIGHT TO GET THIS INFORMATION, IT WASN'T EASY?

>> DEFINITELY NOT EASY.

WE THOUGHT THAT WE WERE ASKING FOR ROUTINE PUBLIC RECORDS.

THE STATE MEDICAL EXAMINER'S OFFICE DECLINED OUR REQUEST TO TURNOVER AUTOPSY REPORTS AND WE HAD TO SUE THEM TO GET THEM.

AND IT TOOK ALMOST TWO YEARS.

>> Jeff: WHAT IMPACT WOULD YOU SAY THIS STORY HAS HAD SO FAR?

>> ONE OF THE REASONS WHY WE TACKLED THIS STORY WAS BECAUSE WE REALLY FELT LIKE NO ONE WAS TALKING ABOUT IT.

ABOUT THREE TIMES THE NUMBER OF PEOPLE WERE DYING OF OVERDOSES AS WERE DYING OF HOMICIDES IN BALTIMORE AND IT JUST WASN'T ON THE PUBLIC RADAR.

SO WE FEEL LIKE ONE OF THE BIGGEST CHANGES IS THAT IT'S BACK FRONT AND CENTER ON THE AGENDA OF CITY LEADERS.

>> Jeff: AND Mr. BOB COHN ON THE BUSINESS SIDE, THE JOURNALISM SIDE IS DOING GREAT.

HOW ARE THINGS GOING TO THIS POINT?

AND FOR PEOPLE NOT FAMILIAR WITH THE BANNER PERHAPS, HOW WOULD YOU DESCRIBE THIS ORGANIZATION?

>> WELL, WE ARE A NONPROFIT NEWS ORGANIZATION COMMITTED TO SERVING COMMUNITIES ACROSS MARYLAND.

BUT WE'VE CENTEREDDED OUR CENTER OF GRAVITY IS IN BALTIMORE AND THE SURROUNDING COUNTIES BUT WE ARE MOVING BEYOND THOSE OVER TIME.

AND OUR GOAL IS TO INFORM, STRENGTHEN AND INSPIRE THE COMMUNITIES THAT WE SERVE THROUGH THE GREAT JOURNALISM THAT KIMMIE OVERSEES AND WHAT THE PULITZER PRIZE WINNING SERIES IS ONE EXAMPLE.

AND THEN WE RELY ON A MODEL THAT INCLUDES SUBSCRIPTIONS, ADVERTISING, EVENTS AND PHILANTHROPY TO DRIVE REVENUE TO PAY FOR THE COSTS OF A LARGE NEWSROOM.

>> Jeff: AND THAT IS THE CHALLENGE, BECAUSE EVEN LONGSTANDING NEWS ORGANIZATIONS IN LOCAL NEWS ARE HAVING ALL KINDS OF TROUBLE THESE DAYS?

>> WE'RE IN A REAL CRISIS IN LOCAL NEWS AND IT'S NOT RECENT IT'S THE LAST 20 YEARS OR SO.

NATIONALLY THERE ARE HALF AS MANY LOCAL NEWS ORGANIZATIONS AROUND TODAY THAN 20 YEARS AGO.

5,000 VERSUS 9,000.

AND THOSE STILL AROUND ARE DRAMATICALLY SCALING BACK THE SIZE OF THE NEWSROOMS.

UNIVERSITY OF MARYLAND STUDY FROM LAST YEAR, FOUND THAT 40% OF LOCAL NEWS ORGANIZATIONS IN THE STATE ARE SKEPTICAL THAT THEY WILL HAVE ENOUGH -- THEY WILL BE ABLE TO SURVIVE TWO MORE YEARS.

SO THERE IS A CRISIS.

>> Jeff: I GUESS MOST PEOPLE UNDERSTAND WHAT HAS CHANGED.

WE HAVE THE INTERNET THING WE ARE NOT RELIANT ON THE DEAD TREE EDITION OF THE PAPER SHOWING UP ON THE LAWN IN THE MORNING.

AND THAT HAS JUST COMPLETELY DISRUPTED THE BUSINESS MODEL, ESPECIALLY ON THE LOCAL ADVERTISING SIDE?

>> EXACTLY.

THERE'S STILL DEMAND FOR GREAT JOURNALISM BUT ADVERTISING HAS BEEN DISRUPTED BY GOOGLE AND FACEBOOK AND OTHER DIGITAL INTERMEDIARIES.

AND AS A RESULT, YOU'VE SEEN THIS LONG, SLOW, DECLINE IN THE OLD MODEL, WHICH BOTH OF US WORKED AT IN MOST OF OUR CAREERS.

THERE HAS BEEN AN ERUPTION OF LOCAL NEWS START-UPS SOME OF WHICH LIKE US ARE NONPROFIT.

THAT TRY TO RELY ON CONSUMER REVENUE AND NOT JUST ON ADVERTISING.

>> Jeff: THE BIG DIFFERENTIATOR OF YOUR START UP IS THE SIZE OF IT, AND THE AMOUNT OF MONEY THAT STEWART BANEHAM WHO IS A LOCAL ENTREPRENEUR USED TO BE IN MARYLAND POLITICS HAS COMMITTED TO THE VENTURE BUT THAT DOESN'T NECESSARILY GUARANTEE SUCCESS, BUT IT DOES MEAN THAT YOU ARE ABLE TO MAKE A SPLASH AS YOU HAVE DONE WITH THIS PULITZER PRIZE?

>> STEWART'S GENEROSITY TO GET US OFF THE GROUND WAS A HUGE SHOT IN THE ARM.

WE WOULD NOT BE HERE TODAY IF IT WEREN'T FOR THE FAMILY'S COMMITMENT TO LOCAL NEWS AND TO JOURNALISM IN MARYLAND.

BUT THE MODEL IS BUILT ON US GETTING TO SUSTAINABILITY WITHIN A REASONABLE PERIOD OF TIME.

AND WE ARE ON TRACK FOR THAT, THANKS TO THIS RESILIENT MIX OF SUBSCRIPTION TO ADVERTISING EVENTS AND PHILANTHROPY.

AND ABSOLUTELY WE HAVE A TWO-PART MISSION.

THE FIRST IS TO DO HIGH QUALITY JOURNALISM TO SERVE THE COMMUNITIES AND THE SECOND IS TO REACH SUSTAINABILITY.

SO WHEN THE BANEHAM FAMILY GENEROSITY RUNS OUT WE ARE AN ONGOING CONCERN AND WE TAKE THAT SERIOUSLY.

>> Jeff: KIMI YOSHINO HOW BIG IS THE NEWSROOM AND HOW DOES IT COMPARE TO WHERE YOU THOUGHT YOU WOULD BE ON DAY ONE WHEN THIS STARTED?

>> IT'S HARD TO BELIEVE WE ARE NOT EVEN THREE YEARS OLD, BUT OUR NEWSROOM NOW IS ABOUT 85 JOURNALISTS.

WE ARE THE LARGEST NEWS ORGANIZATION IN MARYLAND.

I MEAN, STEWART BANEHAM'S VISION WAS TO GO BIG BUT I THINK HE WOULD NOT HAVE PREDICTED WE WOULD HAVE BEEN HERE AT 85 JOURNALISTS WINNING A PULITZER PRIZE.

>> Jeff: LET'S DIG INTO THE BUSINESS STUFF, I SEE NUMBERS LIKE WE HAVE TENS OF THOUSANDS OF PAYING SUBSCRIBERS.

MY QUESTION IS: ARE THEY PAYING THE INTRODUCTORY $1 RATE OR PAYING THE FULL STICKER PRICE?

>> WE DO HAVE 64,000 PAYING SUBSCRIBERS.

ONE-THIRD OF THOSE ARE ON THE INTRODUCTORY OFFER A $1 FOR SIX MONTHS AND CONVERTS TO FULL PRICE.

TWO-THIRDS OF THOSE ARE ON FULL PRICE.

AND THAT IS A STANDARD INTRODUCTORY APPROACH THAT HAS BEEN WORKING WELL FOR US.

BECAUSE WE DO RETAIN ABOUT HALF OF THOSE WHO COME ON IN THE INTRODUCTORY RATE STAY WITH US WHEN THEY GET TO FULL PRICE.

>> Jeff: AND THAT IS GOOD COMPARED TO OTHER PUBLICATIONS LIKE THIS?

>> YEAH, I DON'T HAVE THE FULL PICTURE OF WHAT NONPROFIT START-UPS LIKE US WOULD BE.

INDUSTRY BENCHMARK MAINTAINING HALF OF YOUR SUBSCRIBERS WHEN YOU GET BEYOND THE INTRODUCTORY RATE IS A VERY GOOD MARK AND IT'S THE KEY TO US GOING FORWARD.

BECAUSE WE DON'T EARN ANY REVENUE IN THE FIRST SIX MONTHS BUT WE NEED PEOPLE TO GIVE US A CHANCE TO SAMPLE TO UNDERSTAND THE BRAND AND FALL IN LOVE WITH US AND BECOME ESSENTIAL TO THEM.

WE'VE DETERMINED THAT A GENEROUS INTRODUCTORY RATE IS THE WAY TO DO THAT.

>> Jeff: SPEAKING JUST AS A CONSUMER NOT A HUGE FAN OF THE INTRODUCTORY RATES.

OBVIOUSLY IT IS A GREAT DEAL, BUT WHAT'S HAPPENED TO ME WITH OTHER NATIONAL PUBLICATIONS IS YOU FORGET THAT AT SOME POINT IT'S GOING TO JUMP UP TO THE FULL STICKER PRICE AND YOU SEE IT ON YOUR CREDIT CARD BILL WAIT, WHAT HAPPENED THERE?

AND THEN YOU CALL UP AND EITHER NEGOTIATE OR CANCEL OR SOMETHING.

I MEAN THAT SEEMS TO BE THE MODEL THAT EVERYBODY'S DOING.

AND IF I WANTED IF A VIEWER OF OURS WANTED TO CALL UP TODAY AND GIVE YOU A CREDIT CARD, I WANT A ONE-YEAR SUBSCRIPTION I DON'T WANT TO DO THE $1 THING HOW MUCH WOULD THAT COST?

>> ANNUAL SUBSCRIPTION WE'RE ABOUT TO ROLL OUT A NEW ANNUAL OFFER BUT IT'S NOT A DISCOUNTED OFFER.

$225 A YEAR.

>> Jeff: THE OTHER THING I NOTICE IS THERE ARE SOME STRICT NEWS ORGANIZATION PAY WALLS OUT THERE.

THE PAY WALL IS THE THING THAT PRESERVES THE CONTENT FOR SUBSCRIBERS.

YOURS IS NOT A PARTICULARLY TALL PAY WALL AT THIS POINT WHICH I'M GUESSING YOU ARE AWARE OF AND THE PURPOSE OF THAT IS TO JUST EXPOSE MORE PEOPLE TO THE PRODUCT?

>> EXACTLY.

YOU GET A FIRST ARTICLE FREE WHEN YOU VISIT THE BANNER.

FOR THE SECOND ARTICLE YOU WANT TO READ IN ANY 45-DAY PERIOD WE ASK YOU TO REGISTER AND GIVE US YOUR E-MAIL ADDRESS AND SIGN UP FOR NEWSLETTERS.

AND THAT WAY WE KNOW WHO OUR READERS ARE AND THE THIRD ARTICLE YOU WOULD WANT TO ACCESS IN THAT SAME PERIOD, YOU WOULD HIT THE PAY WALL AND ASKED TO SUBSCRIBE.

>> Jeff: YOU PROBABLY DON'T REMEMBER THE DAYS OF PRINT NEWSPAPERS BACK AT THE NEWSROOM YOU WOULD GUESS WHAT THE LAYOUT WOULD BE THE MOST IMPORTANT STORIES OF THE DAY BUT YOU HAD NO FEEDBACK.

YOU DIDN'T KNOW WHO WAS READING WHAT.

NOW WITH THE DIGITAL NEWSROOM YOU KNOW HOW MANY CLICKS YOU MAY KNOW HOW MUCH TIME PEOPLE ARE SPENDING ON EACH ARTICLE AND I'M CURIOUS WHAT PEOPLE READ.

I SORT OF SUSPECT THAT THE LEAST SIGNIFICANT RAVENS NEWS GETS MORE CLICKS THAN THE MOST SIGNIFICANT CITY HALL NEWS.

AM I OVERSTATING THAT?

>> YEAH, I'VE BEEN PLEASANTLY SURPRISED AT OUR READERS.

THEY DEFINITELY ARE WILLING TO READ A HARD HITTING NEWS THIS PAST WEEK AFTER WE WON THE PULITZER PRIZE, WE ACTUALLY WERE PLEASANTLY SURPRISED BY THE BOOST OF READERS TO THE OVERDOSE SERIES.

SURE, YOU'RE RIGHT.

BREAKING NEWS PEOPLE READ THAT.

PEOPLE LOVE OUR FOOD COVERAGE.

BUT WE ARE ACTUALLY OUR SUBSCRIBERS ARE DISCERNING AND THEY READ ALL KINDS OF COVERAGE.

>> Jeff: I AM A FAN OF YOUR FOOD COVERAGE, TOO IT IS A GREAT NICHE WITH A GREAT WRITER.

THE IMPORTANCE OF THIS VENTURE, Mr. BANEHAM YOU ALL ARE NOT DOING THIS BECAUSE THE PRICE OF THE STOCK IS GOING TO GO UP.

THIS IS A PUBLIC SERVICE.

AND THE IMPORTANCE OF THAT OVERSIGHT OF LOCAL GOVERNMENT.

BOB I WILL START WITH YOU, I HEARD YOU TALK ABOUT THE DIFFERENCE BETWEEN LOCAL NEWS AND NATIONAL NEWS.

THERE IS PLENTY OF NATIONAL NEWS YOU SAID?

>> THAT'S RIGHT.

THE CRISIS ISN'T LOCAL NEWS BECAUSE THE REVENUE MODEL FELL APART.

AND NEWS IS ESSENTIAL TO THE FUNCTIONING OF OUR DEMOCRACY KEEPING THE CITIZENRY INFORMED.

THERE IS NO CRISIS IN NATIONAL NEWS UNLESS YOU WANT TO THINK ABOUT POLARIZED NEW SOURCES AND MISINFORMATION BUT THERE IS NO BIRTHTH OF NEWS ABOUT DONALD TRUMP ABOUT THE WAR IN UKRAINE AND THE ELECTION OF A POPE.

THERE'S PLENTY OF NATIONAL AND INTERNATIONAL NEWS AS GOOD OR BAD AS IT MAYBE.

BUT THERE IS NOT ENOUGH COVERAGE OF PEOPLE'S LOCAL COMMUNITIES.

>> Jeff: YOUR THOUGHTS ON THAT?

>> I TOTALLY AGREE WITH BOB.

PEOPLE KNOW MORE ABOUT WHAT DONALD TRUMP IS DOING THAN THEY KNOW MORE ABOUT WHAT BALTIMORE MAYOR BRANDON SCOTT IS DOING OR GOVERNOR WES MOORE.

WE ABSOLUTELY BELIEVE THAT THERE ARE NEWS DESERTS ACROSS MARYLAND THAT THERE HAS NOT BEEN ENOUGH COVERAGE OF THE LOCAL ISSUES AND WE'RE PLEASED THAT OUR SUBSCRIBERS AGREE AND THEY ARE WILLING TO PAY FOR A HIGH QUALITY NEWS SOURCE.

>> Jeff: KIMI YOSHINO IS THE EDITOR-IN-CHIEF OF THE PULITZER PRIZE WINNING BALTIMORE BANNER.

BOB COHN IS THE C.E.O.

WE APPRECIATE YOUR TIME.

THANK YOU VERY MUCH.

>> THANK YOU.

>> THANK YOU.

[♪♪] >> Jeff: AND JOINING US TO TALK ABOUT YOUR HEALTH IS TANYA NICHOLS, LICENSED PSYCHOLOGIST IN THE TRAUMA AND HEALING PROGRAM AT MT.

WASHINGTON PEDIATRIC HOSPITAL.

THANK YOU FOR JOINING US.

>> THANK YOU FOR HAVING ME.

>> Jeff: ONE OF THE THINGS YOU WORK ON INCLUDES CHILD AND FAMILY TRAUMATIC STRESS.

WHAT TYPES OF SITUATIONS ARE WE TALKING ABOUT?

>> SO WE'RE TALKING ABOUT WE MAY SEE ABUSE, PHYSICAL ABUSE, SEXUAL ABUSE, NEGLECT, KIDS WHO MIGHT HAVE BEEN THROUGH AN ACCIDENT, MEDICAL TRAUMA.

WE HAVE KIDS WHO HAVE EXPERIENCED TRAUMATIC GRIEF AND LOSS THOSE ARE THE THINGS WE OFTEN SEE.

>> Jeff: I CRINGE WHEN I HEAR THAT LIST AND THINK ABOUT THE THINGS THAT YOUNG PEOPLE HAVE TO ENDURE SOMETIMES.

BUT YOU SEE AN OPPORTUNITY TO HELP?

>> I DO.

I DO.

I THINK THAT IT'S SUCH A CRITICAL TIME IN A CHILD'S DEVELOPMENT AND WE HAVE A LOT OF EVIDENCE-BASED TREATMENTS THAT IS HELPFUL TO HELP REDUCE THEIR TRAUMATIC STRESS AND WORK WITH THE FAMILIES, HELP THE CHILDREN TO MAKE MEANING OF WHAT THEY'VE GONE THROUGH AND TO BE ABLE TO MOVE FORWARD IN THEIR LIVES.

AND NOT HAVE SOME OF THE CHALLENGES THAT THEY'VE HAD RELATED TO THE TRAUMA.

>> Jeff: HOW DOES THE PEDIATRIC WORLD DIFFER FROM ADULT CARE IN SIMILAR SITUATIONS?

AND HOW DOES IT DIFFER IF YOU ARE TALKING TO A FIVE-YEAR-OLD VERSUS A 15-YEAR-OLD?

>> SO WITH CHILDREN YOU'RE OFTEN WORKING WITH THEIR CAREGIVER YOU HAVE TO GET THE HISTORY AND THE BACKGROUND AND WHO IS GOING ON RELATED TO DEVELOPMENT, SOCIALLY WHAT IS GOING ON.

SOMETIMES WE COLLABORATE WITH OTHER PEOPLE ON THE TEAM.

IT COULD BE THEIR TEACHERS.

THEY MAY HAVE A WORKER, THEY MAY HAVE A WORKER THROUGH THE DSS.

SO WE COLLABORATE ACROSS THE TEAM.

WE DO BEHAVIORAL OBSERVATIONS.

WE MAY DO A CLINICAL INTERVIEW AND SOME PEOPLE COME IN FOR A PSYCHOLOGICAL ASSESSMENT WHERE WE GIVE MEASURES AND TESTS TO UNDERSTAND THEIR SOCIAL AND EMORE AGO -- EMOTIONABLE FUNCTIONING.

DEPENDING THE AGE WE ARE ENGAGING CHILDREN ON THEIR LEVEL.

WITH A FIVE-YEAR-OLD YOU WILL DO MORE PLAY BASED THINGS WITH A 15-YEAR-OLD YOU MAY DO GAMES THEY MAY JUST WANT TO TALK.

IT DEPENDS ON THE COGNITIVE LEVEL, THEIR CHRONOLOGICAL LEVELS A LOT OF FACTORS WE TAKE INTO ACCOUNT.

>> Jeff: WHAT IS THE INVOLVEMENT OF THE CAREGIVER A PARENT OR GUARDIAN AND OBVIOUSLY IT DEPENDS WHO THE NATURE OF THE TRAUMA WAS?

>> WITH THE CAREGIVER ONE OF THE THINGS WE WANT TO MAKE SURE THAT THE CAREGIVER CAN REGULATE THEMSELVES SO THEY CAN BE AVAILABLE TO HELP THE CHILD LEARN THE SKILLS WE ARE TEACHING THEM.

BE ABLE TO APPLY IT OUTSIDE OF THERAPY AND OTHER CONTEXT.

AND WE DO MODELING IN THE SESSIONS IN SOME CASES TO SHOW THEM SOME OF THE SKILLS IN REALTIME HOW THEY CAN APPLY IT.

AND I OFTEN THINK ABOUT PARENTS AND CAREGIVERS AS LIKE A CO-THERAPIST OR COACH WHERE I'M GIVING THE SKILLS AND WORKING WITH THE CHILD IN THE ONE HOUR I HAVE AND OUTSIDE OF THERAPY, THAT'S WHEN THEY ARE PRACTICING THEY ARE DOING THE PRACTICING AND NEED THEIR CAREGIVER TO REALLY PROMPT THEM TO USE THE SKILLS SOMETIMES UNTIL THE CHILD IS ABLE TO APPLY IT ON THEIR OWN.

>> Jeff: ARE THERE CASES WHERE THE OUTCOME IS FAVORABLE?

WHERE YOU'RE OPTIMISTIC THAT WE CAN REALLY HELP THIS PERSON AND ARE THERE OTHER TRAUMA MAYBE WHERE IT'S MUCH TOUGHER?

>> I THINK THERE'S A LOT OF CASES NOT A PARTICULAR TYPE OF CASE.

BUT IT DEPENDS ON THE ISSUE THE CHILD IT IS A LOT OF FACTORS AND WE HAVE GREAT TREATMENTS WHERE WE SEE PEOPLE GET BETTER WE SEE THE TRAUMATIC STRESS DECREASE.

AND THE CONSISTENCY COMING TO THERAPY HAVING AN INVOLVED CAREGIVER, CONNECTING WITH THE CHILD, AS A THERAPIST AND ALLOWING THEM TO SHARE AND REALLY PROCESS WHAT IS GOING ON ONCE THEY FEEL SAFE.

ONCE THEY KNOW THIS IS SOMETHING THAT THEY CAN GET BETTER WE SEE IMPROVEMENT.

SOME CASES DEPENDING ON THE TRAUMA IT CAN TAKE LONGER TO TREAT.

BUT WE SEE A LOT OF IMPROVEMENTS SOMETHING THAT IS ONE OF THE THINGS THAT MAKES ME EXCITED ABOUT THE WORK BECAUSE I SEE KIDS GETTING BETTER AND IT'S REWARDING.

>> Jeff: WHAT HAVE YOU LEARNED ABOUT APPROACHING KIDS?

I WOULD IMAGINE DEPENDING ON A NUMBER OF THINGS, THE CHILD MIGHT BE STAND OFFISH AT FIRST HOW DO YOU OVERCOME THAT?

>> YOU HAVE TO REALLY BUILD THE RAPPORT BUILD THE CONNECTION AND MEET THEM WHERE THEY ARE AT.

SOME KIDS ARE EXCITED ABOUT COMING TO THERAPY AND SOME ARE SCARED.

AND IT'S UNDERSTANDABLE ESPECIALLY COMING TO THE TALK ABOUT REALLY SCARY THINGS OR SOMETHING BAD THAT HAPPENED IN THEIR LIVES LIKE MANY KIDS I WORK WITH IN OUR TRAUMA AND HEALING PROGRAM AT MT.

WASHINGTON PEDIATRIC HOSPITAL IT TAKES TIME.

EACH CHILD IS DIFFERENT.

SO YOU REALLY HAVE TO MEET THEM WHERE THEY ARE AT AND TRY APPROACHES TO CONNECT.

AND WITH TIME USUALLY THEY OPEN UP.

>> Jeff: YOU MENTIONED THIS IS AN EVIDENCE-BASED FIELD.

WHAT HAS BEEN LEARNED OVER THE YEARS IN TERMS OF THINGS THAT YOU CAN APPLY IN YOUR PRACTICE?

>> SO IN TERMS OF TRAUMA TREATMENT ONE OF THE THINGS THAT WE KNOW WE HAVE TO REALLY TEACH CHILDREN AND THEIR CAREGIVERS DIFFERENT EMOTION REGULATION STRATEGIES.

HOW TO CALM THEMSELVES, HOW TO RELAX.

AND ALSO DIFFERENT COGNITIVE STRATEGIES TO HELP THEM REFRAME SOME THOUGHTS THAT IS MORE HELPFUL AND THEN THROUGHOUT THE WHOLE PROCESS WE ARE TALKING ABOUT THEIR TRAUMA WE ARE DOING THE GRADUAL TRAUMA PROCESSING AND WE SPEND ONCE THEY ARE MORE STABLE THEIR SYMPTOMS HAVE GONE DOWN WE CAN TALK ABOUT THE TRAUMA IN MORE DETAIL AND THAT IS A BIG PART OF THEIR TRAUMA PROCESSING AND WE DO WE CALL IT A TRAUMA NARRATIVE.

IT CAN TAKE ON FORMS WHETHER IT IS A POEM OR A STORY.

THAT IS ONE TREATMENT.

BUT ALL DIFFERENT TRAUMA THERAPIES INVOLVE THOSE COMPONENTS THEY MIGHT APPROACH IT DIFFERENTLY.

>> Jeff: HOW LONG DOES IT TAKE?

IF SOMEBODY AT A YOUNG AGE HAS HAD A LIFE ALTERING THING THEY ARE NOT GOING TO FORGET THEY ARE NEVER GOING TO GET BACK TO WHERE THEY SHOULD HAVE BEEN IS THAT FAIR?

I MEAN WHAT IS A REALISTIC GOAL FOR RECOVERY OF WHAT THEIR LIFE AND MENTAL HEALTH SHOULD HAVE BEEN BUT FOR THE TRAUMA?

>> SO IT REALLY DEPENDS ON THE TYPE OF TRAUMA, HOW LONG THE TRAUMA HAS BEEN GOING ON.

IF WE ARE TALKING ABOUT A SINGLE INCIDENT TRAUMATIC INCIDENT WHERE MAYBE THERE WAS AN ACCIDENT OR MAYBE THERE WAS SOMETHING RELATED TO COMMUNITY VIOLENCE THAT THEY WITNESSED OR SOMEONE CLOSE TO THEM WAS INVOLVED IN, WE MAY SEE -- WE MIGHT SEE SIX MONTHS TO LONGER BEING ABLE TO SEE THOSE SYMPTOMS COME DOWN.

AND THEN SOMETIMES PEOPLE HAVE RECURRENT TRAUMA THAT HAS BEEN GOING ON FOR A LONGTIME.

THOSE TYPES OF CASES TAKE LONGER.

BUT WE STILL SEE CHILDREN BEING ABLE TO MAKE TREMENDOUS STRIDES BEING ABLE TO ENGAGE AND DO THE THINGS THAT THEY WANT TO DO AND HAVING A LOT OF BEING ABLE TO CONNECT WITH PEERS IN A BETTER WAY.

DOING WELL IN SCHOOL.

SO I JUST THINK IN GENERAL ONCE YOU CONNECT TO THERAPY AND ACCESS TO GO ON A REGULAR BASIS YOU ARE BEING CONSISTENT THERE IS A LOT OF HOPE FOR KIDS AND FAMILIES.

>> Jeff: THAT IS GREAT.

YOU SPECIALIZE IN FOSTER CARE ADOPTION SITUATIONS.

HOW CAN YOU HELP THERE?

>> SO, MANY CHILDREN WHO HAVE HAD AN OUT OF HOME PLACEMENT, THEY MAY HAVE EXPERIENCED TRAUMA WHETHER IT'S SEPARATION FROM A CAREGIVER, MAYBE THE CAREGIVER HAS A MENTAL ILLNESS AND MAYBE THE CAREGIVER HAS A SUBSTANCE USE DISORDER.

SO FOR WHATEVER REASON, THEY MAY END UP IN THE FOSTER CARE SYSTEM.

SOME END UP GETTING ADOPTED SOME GET PLACED WITH KINSHIP PLACE MANY.

SO SIMILARLY, MANY OF THE SAME TREATMENTS WE USE WITH OTHER KIDS WE USE WITH CHILDREN WHO ARE IN THE FOSTER CARE SYSTEM OR WHO HAVE BEEN ADOPTED.

>> Jeff: TOUGH TIME TO BE A YOUNG PERSON.

THINK ABOUT ALL THE CHALLENGES OF GROWING UP NOW AMPLIFIED MAGNIFIED BY SOCIAL MEDIA AND PHONES AND OTHER THINGS.

WHAT BIG TRENDS DO YOU SEE IN THE OVERALL MENTAL HEALTH OF THE COMMUNITY OF YOUNG PEOPLE?

>> I DO THINK THAT WHILE SOCIAL MEDIA HAS A LOT OF PERKS A LOT OF PLUSES AND IT'S CHANGED HOW WE LIVE OUR LIVE IT IS CAN CREATE MORE ANXIETY WITH CHILDREN.

AND ADOLESCENTS.

THINGS CAN BE PUBLIC FACING.

THINGS THAT WOULD HAPPEN AT SCHOOL THAT WOULDN'T GO PUBLIC, IT CAN GET PUBLICIZED.

IT CREATES MORE ANXIETY.

BUT I THINK THAT'S WHY CAREGIVERS AND TEACHERS AND OTHER PEOPLE WHO ARE WORKING WITH KIDS ARE MONITOR THAT USAGE A LOT BECAUSE IT CAN GO IN A WRONG DIRECTION WHERE IT CAN IMPACT THEM.

>> Jeff: AS A SOCIETY, HOW CAN WE DO BETTER FOR OUR YOUNG PEOPLE?

AND I MEAN THAT IS SORT OF A BROAD QUESTION BUT SPECIFICALLY IN THE TRAUMATIC SITUATIONS THAT YOU DEAL WITH?

>> I THINK THAT YOU KNOW BEING AWARE NOTICING IF A CHILD THEIR BEHAVIOR HAS CHANGED IF THEIR EMOTIONS OR MOOD HAS CHANGED AND CHECKING IN AND BEING CURIOUS ABOUT THEM KNOW YOUR CHILDREN'S BASELINE OR TEACHERS.

YOU KNOW THE CHILD'S BASELINE OR ADOLESCENT'S BASELINE IF YOU ARE NOTICE THEY ARE WITHDRAWN OR IRRITABLE THEY ARE NOT ENGAGING AND INTERESTED IN THE THINGS THAT THEY WOULD NORMALLY ENGAGE IN, BE CURIOUS ABOUT WHAT IS GOING ON AND YOU MIGHT FIND OUT THAT SOMETHING MAY HAVE HAPPENED THAT WAS DIFFICULT OR TROUBLING OR SCARY FOR THE CHILD.

>> Jeff: CAN YOU TELL WHEN YOU ARE WORKING WITH A YOUNG PERSON THEY TALK ABOUT HOW KIDS ARE RESILIENT AND KIDS CAN CLAM UP, WE ALL CAN, AND MAYBE WANT TO HIDE WHAT IS GOING ON.

I'M GUESSING YOU CAN SEE THROUGH THAT SOMETIMES?

>> I THINK ONCE YOU ESTABLISH THAT CONNECTION WITH A CHILD AND THEY KNOW YOU ARE A SAFE PERSON, YOU ARE THEIR THERAPIST YOU WANT TO KNOW MORE CURIOUS HOW THEY ARE DOING, EVENTUALLY THAT SOME OF THE GUARD COMES DOWN AND THEN THEY ARE SHARING MORE HOW THEY FEEL AND WHAT THEIR THOUGHTS ARE WHAT IS BOTHERING THEM ON THEIR MIND.

>> Jeff: YOU SEEM TO LIKE WHAT YOU DO.

I'M CURIOUS HOW YOU GOT INTO A DIFFICULT, CHALLENGING FIELD?

>> I WENT INTO GRAD SCHOOL BEING OPEN ABOUT THE DIFFERENT POPULATIONS I COULD WORK WITH AND I FOUND THAT UNDERSTANDING TRAUMA HELPED ME UNDERSTAND HOW PEOPLE ARE TRYING TO DO THE BEST THEY CAN WITH WHAT THEY HAVE.

AND HOW SOME OF THE THINGS THAT THEY'VE BEEN THROUGH HOW IT'S SHAPED THEM AND SOME THINGS THEY HAD TO DO HELP THEM SURVIVE AND SOME AREAS IT MAY NOT BE SO HELPFUL.

IT HELPED ME UNDERSTAND BEHAVIORS IN A MORE COMPLEX WAY AND I LOVE WORKING ACROSS TEAMS.

WITH THE TRAUMA WORK YOU GET TO WORK WITH DIFFERENT PEOPLE AND TO REALLY HELP THE CHILD THRIVE.

THAT IS HOW I GOT INTO IT.

>> Jeff: MT.

WASHINGTON PEDIATRIC HOSPITAL AS A SPECIALIST PEDIATRIC SPECIALIST, YOU CAN HELP A YOUNG PERSON THROUGH WHAT AGE?

>> ACTUALLY, WE START AT INFANTS AND WE CAN WORK UP INTO OUR CLINIC AGE 19.

THE THERAPIES WE HAVE THAT INVOLVE INFANTS WE'RE DOING MOST OF THE WORK WITH THE CAREGIVER BUT THERE ARE THERAPIES THAT HELP CHILD AND PARENT OR CAREGIVERS WITH BABIES AS WELL.

>> Jeff: IN A SENTENCE OR SO, ANY OTHER SERVICES AT MT.

WASHINGTON PEDIATRIC HOSPITAL THAT YOU PROVIDE TO THE COMMUNITY THAT YOU WANT PEOPLE TO KNOW ABOUT?

>> THAT WE PROVIDE TO THE COMMUNITY.

>> Jeff: SPECIFICALLY IN THE MENTAL HEALTH FIELD?

>> SO THAT IS A GOOD QUESTION.

WE DO OUTREACH OUR TRAUMA TEAM AND TRAUMA AND HEALING PROGRAM WE DO OUTREACH AND PRESENT VACCINATIONS AND WE PROVIDE INFORMATION TO PEOPLE IN THE COMMUNITY TO LET THEM KNOW WE EXIST AND THERE ARE LOTS OF GREAT SERVICES THAT THEY CAN GET FOR THEIR KID IN OUR DEPARTMENT.

>> Jeff: TANYA NICHOLS WITH MT.

WASHINGTON PEDIATRIC HOSPITAL, THANK YOU.

>> THANK YOU SO MUCH FOR HAVING ME.

>> Jeff: AND THAT IS "DIRECT CONNECTION" FOR THIS WEEK.

THANK YOU FOR WATCHING.

AND HAVE A GOOD NIGHT.

[♪♪]