Improving Outcomes with Effective Trauma-Informed

Interventions

Charles Wilson, MSSWSenior Director

Sam and Rose Stein Endowed Chair in Child Protection

Centers for Developmental and Behavioral Sciences

Chadwick Center for Children and FamiliesRady Children’s Hospital-San Diego

Why is This Relevant to Management of Psychotropic

MedicationTrauma is all too common for children and youth served in

foster care

The link between traumatic

experience, behavior,

and how the system

responds

The link between our behavior in the system

and the child’s

response to our efforts

Definition of a Trauma-Informed System

A trauma-informed child welfare system is one in which all parties involved recognize and respond

to the varying impact of traumatic stress on children, caregivers and those who have contact

with the system.  Programs and organizations within the system infuse this knowledge,

awareness and skills into their organizational cultures, policies, and practices.  They act in

collaboration, using the best available science, to facilitate and support resiliency and recovery. 

- CTISP National Advisory Committee

Seeing Through a Trauma Lens

When we can see the opportunity to minimize trauma

reminders/triggers and reduce the need to control

mood and behavior with psychotropic

medications…

…we stop making it worse!

Seeing Through a Trauma Lens

The better we can differentiate

maladaptive behavior that

will respond to psychosocial interventions

from pathology that requires psychotropic intervention

In Fact, Many Children in Foster Care Do Receive Mental Health Services

•  

Stambaugh, L.F., Leslie, L.K., Ringeisen, H., Smith, K., & Hodgkin, D. (2012). NSCAW Child Well-Being Spotlight: Children in Out-of-Home Placements Receive More Psychotropic Medication and Other Mental Health Services than Children Who Remain In-Home Following a Maltreatment Investigation. OPRE Report #2012-XX, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Find this report and those on similar topics online at: http://www.acf.hhs.gov/programs/opre/ abuse_neglect/nscaw/

Seeing Through a Trauma LensThe better we can

see the opportunity to deploy evidence based or informed

psychosocial interventions that

can produce positive result - with

minimal side effects….

…we will also see the value to strategically combining

psychotropic and psychosocial

interventions in some cases.

Essential Elements of a Trauma-Informed Child-Serving System

Maximize Physical and Psychological Safety for the Child, Family

and CW Workforce

Identifying Trauma-

related Needs of the Child, and Family

Enhancing Child Well-Being and Resiliency

Enhancing Family Well-being and Resiliency

Enhancing the Well-Being and Resiliency of

those Working in the System

Partnering with Youth

and Families

Partnering with System

Agencies

Screening, AssessmentEvidence Based Treatments

Role of Caregivers with Trauma History

The Keys to Change Are in This Room

•for a move to a trauma informed environment - from the receptionist at the front desk to caseworkers and therapistsExpectation from the top leadership

•to support the transformationPolicy framework

•to retool to an evidence based approachCapacity of

the workforce

•that supports learning and delivering new evidence based practicesFinancing

approach