# Enriching Relational Environments as a Critical Pathway for Healing from Trauma:  Helping Adults Use Purposeful Interactions and Build Developmental Relationships with Children in Out of Home Care

> **NIH NIH R01** · CORNELL UNIVERSITY · 2024 · $555,475

## Abstract

Most U.S. children living in out of home care (OOHC) have debilitating impairments regulating emotions and
behavior and the success of treatment efforts for these children depends principally on caregivers’ capacity to
provide developmentally enriching, therapeutic care. While living in OOHC, the adults who care for these
children during the critical hours outside of formal therapy play central roles in their treatment. Yet, OOHC
caregivers receive little education about how to meet the unique relational needs of the children they serve and
lack a clear understanding of their own therapeutic role in each child’s rehabilitation. In addition, the most
commonly-used training programs for caregivers in OOHC cover an eclectic range of topics without a specific
focus on relational skills, and few have empirical support. Ultimately, in order for OOHC services to optimize
children’s rehabilitation and mitigate the long-term sequelae of developmental trauma, it is imperative to
provide opportunities for caregivers to develop skills for eliciting developmentally enriching interactions (DIs)
during their ordinary care routines. Toward that goal, we propose two specific aims. Aim #1: Produce a video-
based Developmental Interaction Workshop Series (DIWS) that enables caregivers to repeatedly observe and
practice specific forms of DI and to create opportunities to increase their frequency during daily care routines.
The DIWS will include two 4-hour sessions for caregivers and supervisors, as well as two 90-minute sessions
for supervisors. A beta version will be implemented in one Residential Care (RC) agency, revised as needed,
and then fully implemented in three RC agencies. Aim #2: Evaluate the DIWS using mixed methods (staff and
child surveys, staff interviews, and ethnography) in four RC agencies to document preliminary evidence of its
impact, acceptability, and feasibility. We expect the DIWS to lead (1) caregivers to become more capable,
motivated, and purposeful about eliciting DIs in their caregiving role, and (2) caregivers and children to
perceive a greater prevalence of DIs during routine daily activities. We will also identify individual,
organizational, and implementation-related factors related to uptake. The DIWS will provide a
developmentally-informed framework for understanding and enhancing the child-adult relationships in
OOHC. Mixed-method evaluation results will provide the foundation for future RCTs of the program’s
efficacy, inform program improvements, and facilitate its wider dissemination.

## Key facts

- **NIH application ID:** 10895571
- **Project number:** 5R01HD109329-03
- **Recipient organization:** CORNELL UNIVERSITY
- **Principal Investigator:** Deborah E Sellers
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $555,475
- **Award type:** 5
- **Project period:** 2022-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10895571

## Citation

> US National Institutes of Health, RePORTER application 10895571, Enriching Relational Environments as a Critical Pathway for Healing from Trauma:  Helping Adults Use Purposeful Interactions and Build Developmental Relationships with Children in Out of Home Care (5R01HD109329-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10895571. Licensed CC0.

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