Visual inspiration today is taken from the Brisbane Powerhouse in New Farm Park.
Bartlett, Barto, Griffin, Goldman Fraser, Hodgdon & Bodian (2016) Trauma-informed Care in the Massachusetts Child Trauma Project. Child Maltreatment, Vol 21(2), p 101-112
The background details
Trauma-informed care includes awareness and identification of trauma, evidence-based interventions and avoidance of re-traumatisation.
Variations in the definition and operationalisation of trauma-informed care makes evaluation and generalisability of programs difficult.
The Massachusettes Child Trauma Project sought to implement and sustain trauma-informed care across mental health and child protection networks in the state. This article evaluated the Project and attempted to answer two research questions.
Were there improvements in practice and the system?
What were the outcomes for children and young people impacted by trauma?
1) Training for child protection staff and foster parents in trauma-informed screening, assessment and treatment.
2) Statewide dissemination of three evidence-based treatments: Attachment, self-Regulation and Competency (ARC); Child-parent psychotherapy; Trauma-focused CBT. With support of Learning Collaboratives.
3) Development of trauma-informed leadership teams to focus on installing and support trauma-informed systems.
- Collected data from Leaders of trauma-informed leadership teams, senior leaders of learning collaboratives, clinicians, children, young people and parents.
- Assessed functioning of cross-sector teams, implementation of trauma-informed care in organisations, referral processes, trauma-informed care priorities and PTSD symptoms.
- Analysis was quantitative and qualitative, with multivariate modelling of PTSD outcomes.
Improvements across the system were identified, including an increase in the use of evidence-based practice and interventions - which demonstrated a reduction in PTSD symptoms for children and young people.
Tell me more ...
- Trauma-informed Leadership Teams: A key success of the trauma-informed leadership teams was increased connections between child protection and mental health workers. At the beginning, teams established a common language with a shared understanding of trauma. The teams also built a greater awareness of the importance of evidence-based interventions, which facilitated appropriate referrals to these programs. Some of the activities undertaken included developing training and resources to educate other professionals in the community, as well as creating approaches to reduce secondary trauma such as through wellness classes, support groups and a self-committee. Challenges included recruiting individuals with a lived-experience and maintaining teams with a high-turn over rate in the profession.
- Learning Collaborative: These collaboratives identified training and education and trauma-focused treatment as their key priorities. They also reported that referral issues reduced with stronger relationships, better communication and shared language, stemming from the work of the leadership teams. Trauma screening also appeared to increase in organisations connected with the collaborative.
- Evidence-based Treatment: After 6 months of treatment, there was a significant reduction in the experience of PTSD related symptoms, with a stronger effect for older children. Although 8-18 year olds reported themselves as less symptomatic than did their caregivers.
Righto ... what does this mean for my practice?
For child protection practitioners, it is important to ensure clients are receiving evidence-based interventions. Child Safety Officers should ensure that services they refer to provide treatment that has demonstrated evidence in reducing symptoms of trauma (such as ARC or TF-CBT). Similarly, for mental health practitioners, it is important that treatment interventions are support by sound evidence for PSTD reduction in children and young people.
For team leaders and managers, this research demonstrates the importance of building networks with other trauma-informed practitioners in order to facilitate referrals and a shared understanding of the impact of trauma on children and young people.
If you are in Brisbane - you can join the Mental Health Practitioners Network (MHPN) Brisbane Youth Complex Trauma Network. Email: firstname.lastname@example.org to be included in the distribution list.