improving outcomes with effective trauma- informed interventions
TRANSCRIPT
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