In 2003, COAF provided financial and technical support to the Psychiatric Outreach Program established by the Armenian Relief Society, Western Region, USA. Immediately following the earthquake in December 1988, the ARS, with support from a USAID, provided mental health services to children and their families in the earthquake zone. In 1991, the ARS established two mental health clinics in Gyumri and Spitak to provide mental health services to survivors of the earthquake. Psychiatrists from the United States provide continuing medical education to both clinics that host psychiatrists, psychologists, and speech therapists. Psychiatric Outreach Program staff has conducted a significant body of research on trauma that has been recognized worldwide as a major contributions in the field.