Trauma-Informed Practice

The National Family Preservation Network (NFPN) has received a number of inquiries regarding trauma-informed practice. One of the most frequent comments is, “We don’t want to introduce the subject of trauma to our practitioners because we don’t know where to find resources.”

This is an urgent need because all of the ACF federally funded projects and many state funded projects now require that trauma be addressed. So, let’s see what we can learn about trauma-informed practice.

How is trauma defined?

Traumas are events involving threat or danger according to Lucy Berliner, Director of Harborview Center for Sexual Assault and Traumatic Stress at the University of Washington. Traumas may be directly experienced or witnessed. Exposure to trauma is common, with 60% of children experiencing at least one trauma each year. Trauma exposure is almost universal among children in the child welfare system.

What are the effects of trauma?

The reaction to trauma, referred to as post-traumatic stress (PST), includes unwanted and upsetting memories of the trauma and physical reactions that may include irritability, sleeplessness, anxiety, depression, etc. Over time, the PST may subside without treatment (CW360° Trauma-Informed Child Welfare Practice, Winter 2013. PDF file)

Multiple traumatic events, referred to as chronic trauma, can have long-term effects including brain abnormalities, attachment disorders, arrested development, difficulty in regulating emotions, detachment, behavioral problems, and learning difficulties. Chronic trauma may result in a diagnosis of Post-Traumatic Stress Disorder (PTSD). Key symptoms of PTSD include intrusive memories, avoidance or numbing reactions, with symptoms interfering with functioning for a period of at least 30 days in duration. About one-fifth of young adults aging out of foster care were diagnosed with PTSD in a recent national study. The rate is higher than that of American veterans of war. Chronic trauma and PTSD require treatment.

How do we address trauma?

The effects of chronic trauma paint a grim picture, so agencies have a valid point in not wanting to introduce the subject of trauma without knowing what to do about it. On the brighter side, knowledge and resources for trauma-informed practice are growing rapidly.

One resource, designed to train child welfare workers, is available through the New Jersey Child Welfare Training Academy. The Director, Robert Ring, has graciously granted permission to NFPN to distribute the manuals for practitioners and trainers.

To access the training materials, visit:
http://nfpn.org/trauma

Trauma and IFPS

NFPN promotes Intensive Family Preservation Services (IFPS) and the origin of the Homebuilders® model of IFPS was in the mental health system. In fact, the model was developed to “prevent the psychiatric hospitalization of mentally ill and severely behaviorally disturbed children and youth” (Fraser, Pecora, and Haapala, 1991).

In one of the earliest unpublished studies of the use of Homebuilders® IFPS as an alternative to psychiatric hospitalization, 19 of the 25 children (76%) were at home six months following the services while 100% of the comparison group were placed in a psychiatric or correctional facility. A complete report on studies of the use of IFPS in the mental health system will be released soon by the Institute for Family Development.

There is an excellent overview of trauma resources available from the state of Virginia. The Virginia Child Protection Newsletter (Fall, 2012) provides information on a half-dozen evidence-based treatments for childhood trauma. To download the newsletter, go to http://psychweb.cisat.jmu.edu/graysojh/pdfs/Volume95.pdf

Trauma Assessment

NFPN wants to contribute to trauma-informed practice by adding a trauma screening domain to the NCFAS assessment tools.

If your agency is currently using one of the NCFAS assessment tools, you are interested in a family-focused trauma screening tool, and your agency can contribute to the cost of developing and testing the trauma screening domain, please contact Priscilla Martens, Executive Director, director@nfpn.org, 888-498-9047.

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