Metiv’s Children’s Emotion Regulation Clinic (CERC) enhances resilience and emotion regulation for traumatized and at risk children and parents. Exposure to multiple acts of political violence such as war and terrorism, along with the stresses of daily life in Israel, have proven adverse effects on children including impaired emotion regulation, leading to post-traumatic stress symptoms (PTS), impaired development and behavioral problems. CERC promotes a unique approach based on Metiv’s research showing that development of emotion regulation plays a key role in prevention of psychopathology resulting from traumatic events and stress.

Research and response:

During the past 15 years Metiv has developed a number of programs for promoting resilience among children of different ages. These programs have been scientifically tested in the field, and found beneficial for target audiences. CERC focuses on children due to the understanding that developing skills in emotion regulation plays a key role in the prevention of psychopathology resulting from traumatic events. Exposure to trauma at a young age can drastically disrupt a child’s capacity in three domains of self-regulation that are crucial for healthy functioning: sensory regulation, emotion regulation, and executive functioning.

Metiv research has found that a crucial factor in the development of young children is their parents’ sense of competence and ability to self-regulate during and after emergency. Stability and resilience in parents and caregivers helps in preventing psychopathology in children exposed to trauma. This knowledge, which we published in scientific articles and two books, forms the basis of the CERC model which incorporates the NAMAL program for mothers of toddlers and young children ages 2-4, and the PANDA program for children aged 7-12, both of which are structured evidence based programs with a specific protocol.

Intervention Programs:

NAMAL (an acronym in Hebrew for Let’s Make Room for Play) consists of 11 afternoon group meetings in which parents and children aged 2-4 participate. The goal of the program is to strengthen the parent-child bond and teach families the importance of playfulness for the development of the child. The meetings consist of playful and fun music, craft, drama and movement activities. The groups are facilitated by trained early childhood mental health professionals, and music and movement therapists.

Main themes of NAMAL program include: 1) the Parent-child bond as a secure, and protective base, 2) promotion of independence and self-esteem, 3) playfulness, humor and creativity, 4) expression and reflection of feelings (emphasis on fear and anger, as well as the shift between positive and negative feelings), and 5) play for working through trauma and stress.

The eight session PANDA intervention, geared for children who have been exposed to traumatic events or display difficulties in emotion regulation, incorporates the latest development in the field of building resilience including mindfulness techniques, cognitive behavioral strategies and narrative interventions – all used in a creative and playful manner. The intervention is conducted in small groups of 6-8 children and its efficacy was described in our study (Pat-Horenczyk, Sim Wei, Schramm, et al., 2015).

CERC creates a comprehensive care model by implementing the NAMAL and PANDA programs together with clinical treatment, with the purpose of strengthening pre and post trauma coping skills and techniques in at risk populations. This therapy may include psychotherapy, play therapy, CBT, dyadic therapy, biofeedback and possibly psychiatry. Based on clinical assessment, children in group therapy programs may then receive clinical therapy, and vice-versa.

Benefit for the Community:

CERC further includes extensive training and supervision for facilitators and caregivers where they learn the basic principles of the PANDA and NAMAL programs which allows them to implement the group interventions within their own communities. Parallel to the group sessions, facilitators receive ongoing supervision and consultation in order to better implement the “PANDA and NAMAL Language” in the children’s daily experiences and to create an environment which promotes regulation and coping. Both programs are accompanied by ongoing evaluation.

Our Vision Moving Forward:

The components of CERC, including the PANDA and NAMAL programs, the direct clinical care provided, and the trainings provided to community professionals will instill a new language of emotion regulation which will help children and families to cope with the multiple sources of stress and trauma in Israel, thus enhacing emotional stability and wellbeing.

For more information please contact CERC Director Sarit Schramm Yavin