Content area
Full Text
Children in the child welfare system frequently experience trauma within the caregiving relationship. These traumatic experiences may be compounded by system trauma and place these children at high risk of emotional disorders and placement in out-of-home (OOH) mental health treatment programs. This article reviews the literature on trauma and children in the child welfare system and discusses a study of trauma-informed practices in OOH treatment programs and the curriculum Creating Trauma-Informed Care Environments, which resulted from study findings.
Childhood traumatic stress refers to both physical and emotional responses of children to life-threatening events that cause or threaten injury, such as child sexual abuse, physical abuse, or family violence (Child Welfare Collaborative Group, National Child Traumatic Stress Network [NCTSN], and California Social Work Education Center, 2008). The types of trauma prevalent among children and families in child welfare include abuse and neglect, exposure to violence, and exposure to parental substance abuse. Child maltreatment also co-occurs with risk factors within disadvantaged environments, such as neighborhood violence and inadequate community resources (Edleson, 1999; Rudo, Powell, èc Dunlap, 1998).
As children move through the child welfare and juvenile court systems, they often encounter additional stressful, frightening, and emotionally overwhelming experiences through "system-generated trauma" (Ryan, Bashant, èc Brooks, 2006), such as multiple placements and frequent changes in schools and peer groups (Ko, Ford, Kassam- Adams, Berkowitz, Wilson, Wong, Brymer, èc Layne, 2008). Because of the increased risk for emotional and behavioral challenges experienced by children in child welfare (Landsverk, Burns, Stambaugh, èc Rolls Reutz, 2009), these placement changes often include out-of-home (OOH) mental health treatment programs, including residential treatment programs. Consequently, there are high rates of trauma exposure in the histories of youth in OOH settings (LeBeI èc Stromberg, 2004).
The high rate of dependent children and youth in OOH mental health treatment programs, combined with the recognition of the need for trauma-related training and resources from Florida's service provider community, provided the impetus for evaluating the degree to which trauma-informed care was being implemented in Florida's OOH mental health treatment programs. The findings from the eight nominated residential mental health settings in Florida who participated in the assessment were used to develop a comprehensive curriculum that highlights successful implementation and sustainability of cultural change within organizations that are...