title: Trauma-Informed Care in the Massachusetts Child Trauma Project.
abstract: Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC.
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, MA, USA jessica.bartlett@umassmed.edu.
authors.forename: Jessica Dym
authors.initials: JD
authors.lastname: Bartlett
authors.affiliation: LUK Inc., Fitchburg, MA, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Barto
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Griffin
authors.affiliation: Child Witness to Violence Project, Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston, MA, USA.
authors.forename: Jenifer Goldman
authors.initials: JG
authors.lastname: Fraser
authors.affiliation: The Trauma Center at Justice Resource Institute, Brookline, MA, USA.
authors.forename: Hilary
authors.initials: H
authors.lastname: Hodgdon
authors.affiliation: Massachusetts Department of Children & Families, Boston, MA, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Bodian
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000628:therapy*; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare; D002675:Child, Preschool; D006801:Humans; D008404:Massachusetts; D012017:Referral and Consultation / Q000458:organization & administration; D012947:Social Work / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000523:psychology* / Q000628:therapy*
keywords: child PTSD/trauma; child maltreatment; child trauma; child welfare; evidence-based practice; evidence-based treatment