December 27, 2016 – Building In Trauma-Informed Care

Teresa HuizarGood morning and happy Tuesday. I hope this finds everyone well. In just a few days, it will be 2017. With each new year comes growth and change, not the least of which for us in the CAC world is the implementation of the new Standards for Accredited Members

One of the most important and exciting aspects of the new Standards is the focus on trauma-informed care. The Standards emphasize the need for a focus on trauma-informed care (referred to as TIC in the study) in every aspect of the work that we do, from the moment a child steps through our doors and throughout the life of the case. But what, exactly, does this mean and how can CACs incorporate this focus into the fabric of their existence? These are the questions that researchers examined in a recent study published in the Children and Youth Services Review, titled “Implementation and program evaluation of trauma-informed care training across state child advocacy centers: an exploratory study.” 

The focus on trauma-informed care is hardly new. Indeed, it has been the case for some time now that CACs and MDTs provide victims and their caregivers access to evidence-based, trauma-focused mental health services such as TF-CBT. But the current Standards take that idea one step further, to ensure that CACs and MDTs promote trauma-informed awareness in all practices, not just in the provision of therapeutic services. But, as the researchers in the current study note, “[w]hile CACs provide safe and child-sensitive environments, the extent to which all CAC staff are trained in the effects of trauma on child victims or TIC is unknown.” Id., p. 16. 

To examine this, researchers looked to the CACs in Florida, where “[a] total of 203 employees of 5 different CACs … participated in the trainings offered between August 2013 and October 2014.” Id., p. 17. The trainings used a modified version of NCTSN’s Child Welfare Trauma Training Toolkit. For the purposes of this study, participants were grouped into two categories: “Clinical Staff/Direct Contact (e.g., case manager, therapist, intake worker, and advocate) and Administrative (e.g., receptionist, support staff, transportation driver, law enforcement, and state attorney’s office staff).” Id

The training itself focused on “the seven Essential Elements of care, including enhancing child and family well-being and resilience, maximizing psychological safety for children and families, and partnering with agencies and systems.” Id., p. 19. Participants were given pre- and post-tests, and were surveyed on their satisfaction with the training. The researchers also followed up with the participants one year after the training to determine the maintenance of TIC knowledge. 

The researchers noted that “[s]cores on the pretest evaluation demonstrate a need for implementing the training with all CAC workers.” Id., p. 19. Interestingly, “[p]rior training on TIC did not affect participants’ pretest knowledge, emphasizing a need for continued awareness of TIC practices.”  Id., pp. 19-20. Also surprising was the fact that those with a longer history of employment with a CAC actually showed less knowledge than newer employees, perhaps indicating the recent “growth in the field of traumatology over the last decade….” Id., p. 20. And “[w]hile there was some drop in TIC knowledge scores over time, follow-up scores were still significantly higher than pretest scores.”  Id

The results also show the need for repeated training for CAC workers. Indeed, the researchers recommend “continued supervision for trauma-informed practice. This allows for staff to have a place to discuss the complexity of their work and help emphasize the need for self-care.” Id. And while prior knowledge of TIC did not affect participants’ scores, “those who had more professional development (>2 times per year) showed greater TIC knowledge, which may indicated training in general leads to greater awareness of the importance of being trauma-informed.” Id

So how does a CAC build TIC knowledge? NCTSN is the logical starting point, with abundant resources for teams and organizations to use to create a culture of trauma-informed care, beginning with the Child Welfare Trauma Training Toolkit. With these resources, CACs can build strong, resilient, trauma-informed staff who can, in turn, imbue these same strengths in the children and families we serve.

As always, I thank you for all your hard work and dedication and for all that you do on behalf of children and families.

Warm regards,  
Teresa | 516 C Street, NE, Washington, DC 20002 US

Copyright © 2016 National Children's Alliance, All rights reserved.

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