Between 2010 and 2013, Hallmark Youthcare began the organizational role out of the Sanctuary Model, an international Trauma Theory and certification program. Hallmark Youthcare worked to implement vast changes in treatment, training, staff support, and family engagement as part of the trauma-informed program. In 2013 Hallmark Youthcare received a three- year certification as a Sanctuary Certified Program through the Sanctuary Institute after three years of implementation and a multi-day audit of services, client and family reports, observation of treatment, and completion of multi-year development requirements. To this day, Hallmark Youthcare is the only Sanctuary Certified Program in the state of Virginia.