Trauma-Informed Care in Child and Family Serving Programs
Lisa Conradi, Psy.D, and Charles Wilson, MSW
The findings from the ACE Study clearly demonstrated that the effects of adverse childhood experiences, including traumatic events, are among the most emotionally devastating and have been linked to a host of negative outcomes in childhood, from emotional and behavioral problems to impaired school performance.1 In order to better address these adverse childhood experiences, it is imperative to adopt a strategic and systemic approach—a trauma-informed approach—to care for children and families who have experienced significant stresses such as those included in the ACEs.2 The National Child Traumatic Stress Network (NCTSN) developed the following definition of a trauma-informed child- and family-serving system:3
A trauma-informed child- and family-service system is one in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child, using the best available science, to facilitate and support the recovery and resiliency of the child and family.
While the actual words vary considerably across definitions and perspectives on trauma-informed care, organizations, and systems, some common themes emerge as the essential elements of a trauma-informed system.4 These include:
(1) Maximize physical and psychological safety for children and families. The term psychological safety means a “sense of safety, or the ability to feel safe, within one’s self and safe from external harm.”5 At its most fundamental level, recovery from trauma requires a sense of safety, and providers must recognize safety is both physical and psychological.
(2) Identify trauma-related needs of children and families. Where possible, a trauma-informed approach suggests the use of a reliable and valid screening tool for identifying the client’s trauma history and traumatic stress responses, and to direct referrals for assessment and treatment when indicated.6
(3) Enhance child well-being and resilience. Trauma-informed care seeks to support positive relationships in the client’s life and minimize disruptions to familiar and positive figures. It seeks to do so, while also supporting referral to specially trained mental health professionals who are schooled in evidence-based treatment models.
(4) Enhance family well-being and resilience. Families may find it difficult to be protective if they have been affected by trauma, and they may need help and support in order to draw on their natural strengths.
(5) Enhance the well-being and resilience of those working in the system. Trauma-informed organizations must consider their staff’s physical and psychological safety and actively work to promote effective interventions for secondary traumatic stress.
(6) Partner with youth and families. Consumers being served—and often their family members who have been involved in the service system—have a unique perspective and can provide valuable feedback on how the system can better address trauma among those served.
(7) Partner with agencies and systems that interact with children and families. It is important that those aspiring to provide trauma-informed care partner with others in parallel service systems in identifying and addressing trauma. Working with allied professionals who know the clients and family can help in developing an appropriate service plan and prevent potentially competing priorities.
Taken together, these essential elements provide a helpful framework to conceptualize the components of a trauma-informed system for children and families.
References and Resources
1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, et al. 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. 1998;14:245-258.
2. Conradi, L. Wilson, C. Managing traumatized children: A trauma systems perspective. Current Opinion in Pediatrics. 2010;22:621-625.
3. National Child Traumatic Stress Network. Creating trauma-informed systems.
4. Child Welfare Committee, National Child Traumatic Stress Network. Essential elements of a trauma-informed child welfare system.
5. Chadwick Center for Children and Families. Chadwick Trauma-Informed Systems Project. Creating trauma-informed child welfare systems: A guide for administrators.
6. Conradi, L., Wherry, J., & Kisiel, C. Linking child welfare and mental health using trauma-informed screening and assessment practices. Child Welfare. 2011;90(6):129-148.
© 2015 by Academy on Violence and Abuse