The Italian Home for Children in Jamaica Plain, Mass., provides shelter and counseling to children who have been taken from their families because of abuse or neglect. The children are often explosive, and for years they were treated with the rewards and punishments typical of parent training. But when Simona Arcidiaco took over as chief operating officer a few years ago, she began to question whether the system was working. “Unfortunately, a lot of kids were coming back to us,” says Arcidiaco. “Even when behavioral interventions worked here, they didn’t last when the child was discharged into a new environment.”

Arcidiaco had already begun to move away from the standard system of rewards and consequences when she heard about CPS, which was being used successfully at another Boston-area institution, Cambridge Hospital. She went to a CPS workshop given by Greene and began implementing the model in the summer of 2006. Though it’s early yet, Arcidiaco has seen encouraging signs, including the case of a young girl with selective mutism who improved significantly. “When we admitted her, we didn’t demand that she talk,” says Arcidiaco. “That took away some anxiety, and gradually she began doing things such as raising her hand to go to the bathroom, which she had been afraid to do before. Our approach was to acknowledge what she could and couldn’t do at this time and to adjust our interventions accordingly.” Eventually, the girl began speaking to her roommate and one staff member.

Other institutions that have longer track records with CPS have also seen progress. At Cambridge Hospital’s locked, 13-bed inpatient child psychiatry unit, 95% of the kids are admitted for out-of-control behavior and 80% have a history of trauma. In the past, a patient could erupt at any time, punching a nurse or attacking a counselor, and children were being forcibly restrained, often compelled to take psychotropic medication or strapped to a bed. In the nine months before the team at Cambridge Hospital began implementing CPS, there were 281 episodes of restraint and an average of almost 11 staff and patient injuries each month. During the 15 months since implementing CPS, there has been just one episode of restraint and monthly injuries have dropped to 3.3.