Effectiveness of a Trauma-Informed Care Initiative in a State Child Welfare System: A Randomized Study

Abstract

Trauma-informed care (TIC) initiatives in state child welfare agencies are receiving more attention, but little empirical evidence exists as to their efficacy. The purpose of this study was to assess changes in self-reported practices and perceptions of child welfare staff involved in a multifaceted, statewide TIC intervention. Ten child welfare offices were matched and randomized to an early or delayed cohort. Staff were surveyed at Time 1 prior to any intervention, Time 2 postintervention for Cohort 1, and Time 3 postintervention for Cohort 2. The survey covered six domains: trauma screening, case planning, mental health and family involvement, progress monitoring, collaboration, and perceptions of the state's overall system performance. Linear mixed modeling assessed the effect of the intervention. Cohort by time interaction was significant for three intervention targets. We demonstrate, using a rigorous study design, the mixed results of a multimodal intervention to improve trauma-informed attitudes, practices, and system performance. TIC initiatives must account for complex, dynamic contextual factors.

Revisiting Relational Coordination: A Systematic Review

“…While the above studies reported positive results of team training, a few reported null results (e.g., Raghav, 2018;Trojan et al, 2009). Beyond health care, studies in banking (Siddique et al, 2019) and pharmaceuticals (Koulikoff-Souviron & Harrison, 2010) found positive effects of team training on relational coordination, while a study of team training in the youth service sector found no effect (Jankowski et al, 2019).…”

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

“…110 In a multifaceted, statewide program spanning child welfare, mental health, and juvenile justice in New Hampshire, the Partners for Change Project implemented case planning for youth who had been screened for trauma, multisystem collaboration, and evidence-based trauma treatments across systems, resulting in improvements in case planning, trauma screening, mental health referrals, and overall system performance. 116 Because the child and family population in child welfare and juvenile justice system is known to have much higher healthcare needs, including physical, mental health and preventive care, implementing TIC in these systems could eventually have a significant impact on health care needs and outcomes of this vulnerable population. 79,99,104,117 Healthcare and educational systems also interact frequently.…”

Developing a clinical pathway for traumatic stress in prisons

“…21 However, there is currently a lack of evidence about the impact of whole-system trauma-informed approaches on outcomes for service-users, along with a lack of consistency when defining its components. 23 Exploration of these is likely to be an important element of clinical pathway development in this area, using learning from other areas – such as the offender personality disorder pathway - in which whole-system approaches have been introduced and evaluated. 24…”