In recent years, the field of child welfare has witnessed a significant shift towards trauma-informed care (TIC), recognizing the profound impact of adverse experiences on children and families. This approach is revolutionizing how we support families in healing and thriving after facing adversity. As our understanding of trauma and its effects deepens, so does our ability to provide more effective, compassionate care to those who need it most.
Trauma-informed care is an organizational model designed to address the emotional needs of system-involved children who have experienced trauma (Bartlett & Rushovich, 2018). It’s not just about treating trauma; it’s about creating an environment that promotes healing and prevents re-traumatization. This approach recognizes that trauma affects not only individuals but entire families and communities.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma-informed care as a program, organization, or system that:
- Realizes the widespread impact of trauma and understands potential paths for recovery
- Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system
- Responds by fully integrating knowledge about trauma into policies, procedures, and practices
- Seeks to actively resist re-traumatization (SAMHSA, 2014)
Research has shown that TIC can significantly improve outcomes for children and families. A study by Murray et al. (2019) found that caregivers who received trauma-informed parenting training showed increased knowledge of trauma-informed practices, greater tolerance for misbehavior, and improved self-efficacy in caring for children with trauma histories. This highlights the importance of educating and supporting caregivers as part of a comprehensive trauma-informed approach.
The Impact of Adverse Childhood Experiences
The groundbreaking Adverse Childhood Experiences (ACE) study conducted by Felitti et al. (1998) highlighted the prevalence and long-term effects of childhood trauma. Even in predominantly white, middle-class populations, childhood trauma was found to be surprisingly common. This research underscores the importance of addressing trauma early and effectively.
The ACE study revealed a strong correlation between adverse childhood experiences and negative health outcomes in adulthood, including increased risk for chronic diseases, mental health issues, and substance abuse (Felitti et al., 1998). This connection between childhood trauma and adult health emphasizes the critical need for early intervention and support for families experiencing adversity.
Implementing Trauma-Informed Care in Child Welfare
Implementing TIC in child welfare systems is a complex process but one with promising results. Jankowski et al. (2019) evaluated a statewide trauma-informed care intervention and found improvements in trauma screening, initial case planning, and perceptions of system performance. This study demonstrates that systemic changes can lead to tangible improvements in care delivery and outcomes for families involved in child welfare.
Key components of implementing trauma-informed care in child welfare systems include:
- Training staff at all levels on trauma and its impacts
- Incorporating trauma screening and assessment into standard procedures
- Developing trauma-specific interventions and evidence-based treatments
- Creating a safe and supportive organizational culture
- Collaborating with other agencies and community partners to provide comprehensive care
While understanding trauma is crucial, the concept of resilience is equally important. Resilience occurs when positive experiences outweigh adverse ones. Masten (2014) defines resilience as “the capacity of a dynamic system to adapt successfully to disturbances that threaten system function, viability, or development” (p. 6). The single most significant protective factor in preventing both childhood trauma and its adverse outcomes is the presence of a safe, stable, nurturing adult caregiver consistently present in a child’s life (National Scientific Council on the Developing Child, 2015). This underscores the importance of supporting parents and caregivers in developing strong, positive relationships with their children.
Trauma-informed care recognizes that healing happens in relationships. It emphasizes the importance of involving the entire family in the healing process. By supporting parents and caregivers, we can help break the intergenerational transmission of trauma (Kimberg & Wheeler, 2019).
Family-centered approaches to trauma-informed care include:
- Providing psychoeducation to families about trauma and its effects
- Offering family therapy and support groups
- Teaching parenting skills that promote attachment and emotional regulation
- Connecting families with community resources and support networks
- Addressing parents’ own trauma histories and mental health needs
The Future of Trauma-Informed Care
As we move forward, the focus is shifting towards creating trauma-informed systems that not only support children and families but also care for the well-being of providers and staff. This holistic approach recognizes that everyone in the system plays a role in healing and resilience.
Emerging areas of research and practice in trauma-informed care include:
- Cultural adaptations of trauma-informed practices to better serve diverse populations
- Integration of trauma-informed care principles into educational settings
- Exploration of the intersections between trauma-informed care and social justice initiatives
- Development of technology-based interventions to increase access to trauma-informed support
In conclusion, trauma-informed care offers a powerful framework for supporting families in healing from adversity. By understanding the impact of trauma, fostering resilience, and working together, we can create a future where families not only survive trauma but thrive in its aftermath. As we continue to refine and expand our approaches to trauma-informed care, we move closer to a world where every family has the support and resources they need to heal and grow stronger together.
Shanika Lavi Wilson, DSW, LCAS, LCSW (She/Her) is the Interim MSW Program Director and an Associate Professor in the Department of Social Work at North Carolina Central University. She can be reached at 919-423-7952 or via email at swils108@nccu.edu.
References
Bartlett, J. D., & Rushovich, B. (2018). Implementation of trauma systems therapy-foster care in child welfare. Children and Youth Services Review, 91, 30-38.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258.
Jankowski, M. K., Schifferdecker, K. E., Butcher, R. L., Foster-Johnson, L., & Barnett, E. R. (2019). Effectiveness of a trauma-informed care initiative in a state child welfare system: A randomized study. Child Maltreatment, 24(1), 86-97.
Kimberg, L., & Wheeler, M. (2019). Trauma and trauma-informed care. In M. R. Gerber (Ed.), Trauma-Informed Healthcare Approaches (pp. 25-56). Springer.
Masten, A. S. (2014). Global perspectives on resilience in children and youth. Child Development, 85(1), 6-20.
Murray, K. J., Liang, A., Barnack-Tavlaris, J. L., Navarro, A. M., Flett, G. L., & Zautra, A. J. (2019). The role of social support in the relationship between childhood trauma and depression among survivors of childhood trauma. Journal of Interpersonal Violence, 34(21-22), 4601-4623.
National Scientific Council on the Developing Child. (2015). Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience: Working Paper No. 13. Retrieved from https://developingchild.harvard.edu/resources/supportive-relationships-and-active-skill-building-strengthen-the-foundations-of-resilience/
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
