Violence Intervention Program

The Violence Intervention Program (VIP) at CHOP was established in 2012 by Joel Fein, MD, MPH, an Emergency Department (ED) Physician who had treated far too many assault injured youth. For most, the ED was able to heal their physical wounds, but for some, the patients were discharged back into the community only to be re-admitted with similar violent injuries. Dr. Fein realized that violence prevention required a public health approach, and trauma-informed care needed to be at the core of providing services to families.

CHOP VIP provides a direct and sustainable connection between the hospital and the community. Today, as part of CHOP’s comprehensive Center for Violence Prevention, this program promotes healing, and seeks to reduce re-injury and retaliation through a community- and family-focused model that works directly with patients between 8 and 18 years old who are treated at CHOP for an injury due to interpersonal violence.

Program Details

How VIP Works

A youth injured by assault is identified in the ED or Trauma Unit and referred to CHOP VIP. A Violence Prevention Specialist then connects with the patient and patient’s family, at the bedside when possible but often after discharge, to perform a comprehensive intake assessment and provide psycho-education regarding trauma symptoms, safety planning, and provides resources to support families through the post-injury period.

After discharge from the hospital, we provide trauma-informed case management, mental health services, and navigation to needed resources.  

The VIP Team helps the youth and his or her family navigate complex systems of care to meet their needs within the communities in which they live. The patient and family work together with VIP team members to establish goals with the aim of reducing the negative consequences of violent injuries.

The VIP serves as a bridge to long-term support for families and increases the likelihood that families successfully engage in services. In order to satisfy our patient's goals, the team builds relationships and partnerships with service providers and community agencies in the Philadelphia area. These relationships facilitate access to the services and programs that our patients require to achieve recovery and safety.

Through VIP directly, our youth and staff can participate in psycho-educational groups that help build their resilience. Read more about Building Resilience After A Violent Experience (BRAVE).

The multidisciplinary VIP team includes Licensed Social Workers, a Community Health Worker, an Emergency Department Physician, an Adolescent Medicine Physician, a Psychiatrist, a Clinical Psychologist, a Research Scientist, Research Coordinators, Peer Mentors, and Administrative staff.

The Community We Serve

We serve youth who reside in Philadelphia County and have sought care for assault-related injuries in the ED, Trauma Unit, or Concussion Clinic at CHOP. Here are a few facts about the community of youth that we serve.

  • The majority of program participants (70%) reside in neighborhoods within West and Southwest Philadelphia.
  • The average age at injury for our patients is 14 years, 82% are African-American, and we serve an equal numbers of male and female youth.
  • Overall, Philadelphia has a young population, with 25% younger than 20 years of age. 
  • Approximately 70% of our patients’ assaults occur in school or directly after school. Thus, we provide advocacy on the individual school and district level to ensure the safety needs of patients are being addressed.
  • Homicide remains the leading cause of death for our teens and young adults.  For Philadelphia youth ages 10 to 24 years, the homicide rate is 4.7 times greater than the national average.
  • One in eight high school students reported carrying a weapon in the past 30 days
  • More than 30% of elementary and middle school youth are involved in daily bullying and victimization.
  • In high school, 45% of youth report being in a physical fight in school. 
  • At CHOP, we have seen an increase in violently injured youth presenting for emergency care. Approximately 500 patients with assault-related injuries are treated each year in our ED and Trauma Unit. 
VIP Impact

VIP not only serves the assault-injured patient, but wraps services around the entire family, including caregivers and siblings, understanding that violence and trauma impact the entire family.

Most patients receive VIP services for 3 to 6 months but that time period could be longer as needs require. During that time we advocate to reduce barriers to successful goal resolution and coach youth and family members in how to successfully navigate complex service systems. CHOP VIP measures its impact by rigorous tracking of each patient’s needs, goals, and outcomes.

Through the support of the Hospital and donations/grants from funders, our intensive community-focused model is on pace to provide services to more than 100 youth and their families annually.

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Chedaya is a former VIP client and peer mentor to youth currently participating in VIP; she is pictured here with her mother. Watch a video about Chedaya’s recovery and resilience following an assault on the playground of her school.

Participating youth self-identify recovery goals in 15 domains of needs, ranging from post-injury medical needs to basic needs, including housing and food insecurity.  Additionally, many youth identify significant post-assault safety needs.  Through continued tracking, more than 800 discreet patient goals within these need domains have been identified. Patients who have completed our program have had an average of 5 self-identified goals, and almost 80% of these are resolved through referrals, resources, education, and advocacy provided by VIP.

To date, our youth are most in need of support in these critical areas:

  • Mental health (86% of youth):  Providing and/or referring youth/siblings/caregivers for therapy to; suicide safety planning; referring family to the Office of Intellectual Disabilities; care coordination with clinical professionals; and providing support to family in seeking emergency mental health care.
  • Education (64% of youth): Care coordination and advocacy; re-enrollment or school transfer (due to safety issues); assistance in 504 Accommodations; requests for an Individual Education Plan (IEP); assistance with homebound services requests; college preparation assistance; and referrals to the Education Law Center.
  • Legal (57% of youth): Accompanying patients and families to court hearings; assisting families in navigating the legal system; obtaining police reports; and care coordination and advocacy within legal system.

The emphasis on these needs was also observed in a study of male VIP clients from 2012-2016, as published in the Journal of Adolescent Health. Young men in the program self-identified mental health (89%), legal (60%), and education (58%) as their primary areas where additional support was needed. Learn more about the study.

Another VIP-led research study, published in the Journal of Interpersonal Violence, re-emphasized a priority on outcomes related to psychosocial health. In the study, 79 front-line staff members from 22 hospital-based violence intervention programs (HVIPs) were asked to identify and prioritize individual-level outcomes they believe are achieved among their clients by participating in such a program. The authors found that mental health and coping, social support, and well-being were important indicators of HVIP success. Learn more about the study.

Being able to assess our case management goals has been extremely beneficial in guiding both our research efforts and our clinical services. In addition to these successes, we see our clinical work (therapy and psycho-educational peer groups) as critical to improving outcomes in patients' self-esteem; sense of safety; ability to trust; sense of belonging; emotion regulation; coping and communication skills; and family relationships. We are currently designing outcome measures for these domains. 

Towards a Replicable Model

The VIP is one of more than 30 member programs in The Health Alliance for Violence Intervention (The HAVI) and we are increasingly recognized as a model in pediatric hospital-based violence prevention. Most recently, in early 2020, the VIP program was chosen by the Centers for Disease Control and Prevention’s (CDC) Division of Violence Prevention as one of nine programs to participate in the Evaluability Assessments of Promising Hospital-Based Violence Prevention Program.  Philadelphia is fortunate to have a number of these hospital-based programs and we are grateful for the assistance of and collaboration with the Healing Hurt People program at Drexel University. Through The HAVI, CHOP’s VIP collaborates on clinical best practices, while we undertake research opportunities to rigorously evaluate and inform enhancements to our program. The HAVI hosts an annual conference that brings more than 200 participants from member programs.

VIP Brochure

Download the VIP brochure to learn more.

Recommended Resources

CHOP Publications on Treating Assault Injured Youth
Relevant Publications 
Violence Intervention Program Blog Posts