Trauma-Informed Care in the Massachusetts Child Trauma Project

Abstract

Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC.

Characteristics of Australian adolescent females in residential treatment who report using methamphetamines

“…The staff discussed changes in practice implemented in response to growing methamphetamine use in their clients, such as allowing detox time within the program and increased education, training and upskilling of program staff. There is growing evidence demonstrating that trauma‐informed models of care can meet the multifaceted needs of vulnerable adolescents and help build resilience and positive coping strategies . Further, given the strong perception among the staff that methamphetamines can help adolescents to cope and reduce hypervigilance, strategies to promote self‐reflection without the use of AOD is likely to be an important part of models of care designed to build resilience.…”

Linking Kids with Trauma to Evidence-Based Treatment: Implementation of a Centralized Referral System at the Child Trauma Training Center at the University of Massachusetts Medical School

“…13 Regional data from the Core Dataset of participating Massachusetts National Child Traumatic Stress Network sites (n=532) shows that 97% of traumatized children have experienced multiple traumas with most experiencing 4 or more traumas in their childhood. 14 Data from the Central MA Child Trauma Center (CMCTC) (n=147) shows that youth in central MA had baseline average scores exceeding clinical levels in overall behavior problems as measured using the Child Behavior Checklist -CBCL. 15 Analysis of this data shows that children in this sample experienced a mean of 3 traumatic events (range 0 to 9), with the most common traumas being domestic violence (54%), traumatic loss (35%), physical abuse (30%), sexual abuse (26%) and community violence (23%).…”

Trauma-Informed Social Work Practice with Children and Youth

“…The Children's Bureau issued policies and provided funding to support statewide initiatives to develop TI-CW systems (Berliner and Kolko 2016). ACF designated TI-CW system development a child welfare funding priority and supported approximately 20 state and tribal TI-CW initiatives (e.g., Akin et al 2017;Bartlett et al 2016;Kerns et al 2016).…”

“…Professionals across the different systems lack clarity on how to operationalize TI care (Branson et al 2017;Donisch et al 2016). Systems experience high staff turnover (Bartlett et al 2016), heavy caseloads, limited resources (Kramer et al 2013), and insufficient evaluation of TI initiatives (Hanson and Lang, 2016). Workers hesitate to conduct trauma-impact assessments with children (Kerns et al 2016), receive insufficient training in implementing TI practices (Donisch et al 2016), lack access to trauma assessment tools and evidence-based treatments (Donisch et al 2016;Kramer et al 2013), and, when trained, are no more likely to refer children to evidence-based treatments than untrained workers (Dorsey et al 2012).…”