A statewide introduction of trauma-informed care in a child welfare system

Barriers and facilitators for access to mental health services by traumatized youth

“…Some participants reported an increased likelihood of referrals as a result of interacting and networking with providers from other agencies that have the resources to adequately address the needs of traumatized youth. This is consistent with the only two prior quantitative studies to our knowledge that have examined organizational and provider factors associated with referrals, which also found that participants endorsed improved organizational and provider readiness to refer traumatized youth after participating in a TIC training (Kerns et al, 2016; Kramer et al, 2013). Moreover, some participants in this study described how the training improved their agencies’ recognition of the importance of linking youth with a history of trauma to appropriate services, thus influencing these organizations and providers to make referrals a higher priority.…”

“…Several quantitative and mixed methods studies have found TIC trainings to be an effective starting point for screening and identifying traumatized youth and making referrals to appropriate trauma treatment and services (e.g. Fraser et al, 2014; Kramer, Sigel, Conners-Burrow, Savary, & Tempel, 2013; Lang, Campbell, Shanley, Crusto, & Connell, 2016). There has been a variety of TIC trainings that have been implemented, including one-day didactic trainings on basic TIC principles (Conners-Burrow et al, 2013; Fraser et al, 2014; Kramer et al, 2013), small group discussions over several months on TIC as it pertains to working with individuals with mental/behavioral health challenges (Kerns et al, 2016), and a two-year hybrid training comprised of didactic sessions and small group discussions among social service workers (Lang et al, 2016).…”

“…For example, some studies only focused on organizational and provider level barriers to referrals (Conners-Burrow et al, 2013; Fraser et al, 2014; Lang et al, 2016), without taking into consideration barriers at the level of youth and families. In addition, several studies only included participants from rural, predominantly white settings (Conners-Burrow et al, 2013; Henry et al, 2011; Kramer et al, 2013) and others did not report the sociodemographic characteristics of their target populations (Fraser et al, 2014; Kerns et al, 2016; Lang et al, 2016). As a result, perspectives on TIC trainings in urban communities of color are not well represented in the literature.…”

“…As a result, perspectives on TIC trainings in urban communities of color are not well represented in the literature. Some studies were also limited by the design of their training interventions, which only included participants from the mental health and/or child welfare systems, many of whom already have prior exposure to trauma-related concepts (Conners-Burrow et al, 2013; Fraser et al, 2014; Kerns et al, 2016; Kramer et al, 2013; Lang et al, 2016). Moreover, with the exception of one mixed methods study conducted by Fraser et al (2014), prior studies have primarily relied on pre-post quantitative surveys to assess barriers and facilitators to TIC referrals.…”

An Association Between Implementing Trauma-Informed Care and Staff Satisfaction

“…The outcomes of the Kramer et al study were limited to knowledge on TIC and supervisory behaviors (measured through self-report on survey items) which were assessed at baseline, immediately following the final training, and a three-month follow-up. The post-test and three-month follow-up displayed significant increases in TIC knowledge and supervisory behaviors supporting its implementation (Kramer et al, 2013). Kusmaul et al (2015) explored differences in staff perceptions of the service environment following the implementation of TIC based on the principles of Harris and Fallot (2001).…”