improving outcomes with effective trauma- informed interventions

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Improving Outcomes with Effective Trauma-Informed Interventions

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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 Lens

The 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, Assessment

Evidence 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 therapists

Expectation from the top leadership

•to support the transformation

Policy framework

•to retool to an evidence based approach

Capacity of the workforce

•that supports learning and delivering new evidence based practices

Financing approach