title: Building Capacity for Trauma-Informed Care in the Child Welfare System: Initial Results of a Statewide Implementation.
abstract: Exposure to childhood trauma is a major public health concern and is especially prevalent among children in the child welfare system (CWS). State and tribal CWSs are increasingly focusing efforts on identifying and serving children exposed to trauma through the creation of trauma-informed systems. This evaluation of a statewide initiative in Connecticut describes the strategies used to create a trauma-informed CWS, including workforce development, trauma screening, policy change, and improved access to evidence-based trauma-focused treatments during the initial 2-year implementation period. Changes in system readiness and capacity to deliver trauma-informed care were evaluated using stratified random samples of child welfare staff who completed a comprehensive assessment prior to (N = 223) and 2 years following implementation (N = 231). Results indicated significant improvements in trauma-informed knowledge, practice, and collaboration across nearly all child welfare domains assessed, suggesting system-wide improvements in readiness and capacity to provide trauma-informed care. Variability across domains was observed, and frontline staff reported greater improvements than supervisors/managers in some domains. Lessons learned and recommendations for implementation and evaluation of trauma-informed care in child welfare and other child-serving systems are discussed.
authors.affiliation: Child Health and Development Institute, Farmington, CT, USA Department of Psychiatry, UCONN Health, Farmington, CT, USA Child Study Center, Yale School of Medicine, New Haven, CT, USA jalang@uchc.edu.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lang
authors.affiliation: Child Health and Development Institute, Farmington, CT, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Campbell
authors.affiliation: Connecticut Department of Children and Families, Hartford, CT, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Shanley
authors.affiliation: Division of Prevention & Community Research and The Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Crusto
authors.affiliation: Division of Prevention & Community Research and The Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Connell
mesh_terms: D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000628:therapy*; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare; D003237:Connecticut; D006284:Health Plan Implementation; D006801:Humans; D012947:Social Work / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000523:psychology* / Q000628:therapy*
keywords: child welfare; implementation; system; trauma; trauma-informed