Reshaping Child Welfare’s Response to Trauma

Abstract

Growing evidence has linked early trauma with severe psychiatric consequences. Posttraumatic stress disorder (PTSD) is a potentially debilitating mental health condition found among some youth in foster care and foster care alumni. However, the current child welfare practice response has not met the demands in both assessment and intervention. This critical review aims to use the evidence to reshape the child welfare response to trauma in children and adolescents. We begin with research on the psychiatric consequences of child maltreatment and issues related to diagnostic assessment for PTSD. Next, we compare major foster care/alumni studies showing considerably higher rates of PTSD among young foster care recipients and alumni than among nationally comparable groups. To inform practice on childhood trauma, we then summarize current evidence-based interventions showing effectiveness with PTSD. Finally, we address new dimensions, such as gene-environment research, posttraumatic growth, and implications for reshaping child welfare practice and foster care.

Predictors of empirically-supported interventions following structured functional assessment.

“…Note that this is a much smaller proportion of the total sample than that which was assessed to have a history of trauma exposure (~55%) or problems with trauma-related symptoms (~45%). The implication of these figures is clear: there is a sizeable portion of the OOHC population with identified trauma-related needs who are not currently receiving an evidence-based, trauma-focused treatment; this finding is consistent with prior research suggesting that traumatized youth in OOHC are undertreated (Ai, Foster, Pecora, Delaney, & Rodriguez, 2013).…”

Supporting youth involved in domestic minor sex trafficking: Divergent perspectives on youth agency

“…A third approach to street youth, the protective model, depicts these youth as victims whose basic rights have been violated, and for whom interventions focus on solving immediate problems rather than addressing structural causes (Thomas de Benitez, 2003). Historically, the predominance of a protective model in child welfare services in the United States has positioned children and youth as passive recipients of services and not active decision-makers in their own lives (Ai, Foster, Pecora, Delaney, & Rodriguez, 2013;Watt, Norton, & Jones, 2013). The challenge for adults charged with the care and protection of these youth is to find a workable balance between adolescents' right to protection from sexual exploitation and their right to participation in decisions affecting them (Ruck, Keating, Saewyc, Earls, & Ben-Arieh, 2014).…”

Title IV-E Child Welfare Training and University Partnerships: Transforming State Child Protection Services into a Trauma-Informed System

“…The Centers for Disease Control and Prevention has conducted decades of research investigating the public health repercussions of Adverse Childhood Experiences (Feletti & Anda, 2014). A multitude of studies reveals the effects of trauma upon long term outcomes, including an array of emotional, behavioral, cognitive, and social, cognitive, emotional and behavioral impairments (Ai et al, 2013;Feletti & Anda, 2014;Felitti et al, 1998).…”

“…There is a significant body of research indicating the importance of using a Traumainformed approach in working with maltreated children, yet not all states and jurisdictions have fully engaged in the process of identifying or adapting a model or framework by which they will approach trauma-informed practice (Ai, Foster, Pecora, Delaney, & Rodriguez, 2013;Hanson & Lang, 2016;Klain & White, 2013). As states transition to a trauma-informed approach, there is a need for high caliber evidence based curricula.…”