The Child Welfare
Trauma Training
Toolkit: An Overview
Alison Hendricks, LCSW
Chadwick Trauma-Informed Systems Project
Chadwick Center for Children and Families
Rady Children’s Hospital – San Diego
Objectives
Participants will be able to:
• Define a trauma-informed child welfare system
• Learn about the Child Welfare Trauma Training
Toolkit, training activities, and resources
• Identify the 9 Essential Elements of TraumaInformed Child Welfare Practice
• Describe practical applications of the Essential
Elements in casework practice
What is a Trauma-Informed
Child Welfare System?
A Trauma-Informed Child Welfare System (TICW)
understands:
1)
The potential impact of childhood traumatic stress on the
children served by the system
2)
How the system can either help mitigate the impact of
trauma or inadvertently add new traumatic experiences
3)
How to promote factors related to child and family
resiliency after trauma
Rule 1 of a Trauma-Informed System:
Don’t Make It Worse
What is a Trauma-Informed
Child Welfare System?
4)
The potential impact of the current and past trauma on the
families with whom we interact
5)
How adult trauma may interfere with adult caregivers’ ability
to care for and support their child
6)
The impact of vicarious trauma on the child-serving
workforce
7)
That exposure to trauma is part of the job of protecting kids
About the Child Welfare
Trauma Training Toolkit
• A product of the Child Welfare Committee of the
National Child Traumatic Stress Network
• Toolkit includes a Trainer’s Guide and a
Comprehensive Guide as well as training slides,
handouts, and activities with a CD-Rom
• Goal of training is to educate child welfare
professionals about childhood trauma and its
impact and how to intervene in a trauma-responsive
manner
Toolkit Training Modules
• Module 1: Introduction to the Essential Elements (1 hour)
• Module 2: What is Child Traumatic Stress? (2.5 hours)
• Module 3: The Impact of Trauma on Children’s Behavior,
Development, and Relationships (2 hours)
• Module 4: Assessment of a Child’s Trauma Experiences (2
hours)
• Module 5: Providing Support to the Child, Family, and
Caregivers (1.5 hours)
• Module 6: Managing Professional and Personal Stress (1
hour)
• Module 7: Summary (1 hour)
Essential Elements of
Trauma-Informed Child Welfare
Practice
1. Maximize the child’s sense of safety
• Traumatic stress overwhelms a child’s sense of safety and
can lead to a variety of survival strategies for coping
• Safety implies both physical safety and psychological safety
• A sense of safety is critical for functioning as well as physical
and emotional growth
• While inquiring about emotionally painful and difficult
experiences and symptoms, workers must ensure that
children are provided a psychologically safe setting
What a Child Welfare
Worker Can Do
• When facilitating the placement of children, ask specifically
about any worries that they have about being safe, and
reassure them with information about how they are being
kept safe
• Help children who have trauma histories identify ways in
which adults in their life protect them and review these
points in each meeting with the children
• Prepare children in advance for placement changes and
legal proceedings by describing what will happen and
addressing any questions or concerns they may have
2. Assist children in reducing
overwhelming emotion
• Trauma can elicit such intense fear, anger, shame, and
helplessness that the child feels overwhelmed
• Overwhelming emotion may delay the development of ageappropriate self-regulation
• Emotions experienced prior to language development maybe
be very real for the child but difficult to express or
communicate verbally
• Trauma may be “stored” in the body in the form of physical
tension or health complaints
What a Child Welfare
Worker Can Do
• Teach children and caregivers strategies for coping with strong
emotions, such as relaxation techniques, meditation, dance, art,
music, yoga, and physical exercise
• Inform all prospective foster parents of any applicable trauma
history of potential foster children, while simultaneously
respecting the children’s confidentiality
• Provide information to resource parents about the links between
trauma reminders and the overwhelming emotions children may
experience and help them identify trauma reminders for the
children in their care
3: Help children make new
meaning of their trauma history and
current experiences
• Trauma can lead to serious disruptions in a child’s sense of
safety, personal responsibility, and identity
• Distorted connections between thoughts, feelings, and
behaviors can disrupt encoding and processing of memory
• Difficulties in communicating about the event may undermine
a child’s confidence and social support
• Child welfare workers must help the child feel safe, so he or
she can develop a coherent understanding of traumatic
experiences
What a Child Welfare
Worker Can Do
• Help a child with a trauma history create a Life Book
• If removal of children from their home of origin is necessary,
review with the children and families the true reasons for
removal and correct any misconceptions
4. Address any impact of trauma and
subsequent changes in child’s behavior,
development, and relationships
• Traumatic events affect many aspects of the child’s life and
can lead to secondary problems (e.g., difficulties in school and
relationships, or health-related problems)
• These “secondary adversities” may mask symptoms of the
underlying traumatic stress and interfere with a child’s recovery
from the initial trauma
• Secondary adversities can also lead to changes in the family
system and must be addressed prior to or along with traumafocused interventions
What a Child Welfare
Worker Can Do
• Ask the child and caregiver at each point of contact whether the
child has been experiencing signs of trauma such as nightmares,
bedwetting, emotional outbursts, or changes in behavior or
apparent developmental level at home or at school
• When a caregiver expresses concern with a child’s behavior that
appears related to a trauma history, help the caregiver to
understand the child’s conduct in a non-judgmental way and
provide ideas for coping strategies
• When children show behavioral indicators of trauma, assess the
issue and make referrals to other professionals as needed
5. Coordinate services with
other agencies
• Traumatized children and their families are often involved with
multiple service systems, and child welfare workers are
uniquely able to promote cross-system collaboration
• Service providers should try to develop common protocols and
frameworks for documenting trauma history, exchanging
information, coordinating assessments, and planning and
delivering care
• Collaboration enables all helping professionals to view the child
as a whole person, thus preventing potentially competing
priorities
What a Child Welfare
Worker Can Do
• Organize quarterly meetings with other service providers, to
discuss common cases (while respecting confidentiality) and
to develop a trauma-informed “common language” and
shared framework regarding child traumatic stress
• Promote continuity in helping relationships for the child and
family by making calls to other service providers involved
with the family and checking in about the child’s progress
6. Utilize comprehensive assessment of
the child’s trauma experiences and their
impact on the child’s development and
behavior to guide services
• Thorough assessment can identify a child’s reactions and how
his or her behaviors are connected to the traumatic experience
• Thorough assessment can also predict potential risk behaviors
and identify interventions that will ultimately reduce risk
• Child welfare workers can use assessment results to determine
the need for referral to appropriate trauma-specific mental
health care or further comprehensive trauma assessment
What a Child Welfare
Worker Can Do
• Refer children who have experienced trauma and show or report
trauma-related symptoms to a trauma-informed mental health provider
who is knowledgeable about assessment instruments appropriate for
assessing trauma
• Develop a list of available social supports within the community,
including friends, family and community agencies with experience
treating trauma
• Use the Child Welfare Trauma Referral Tool or other screening tool to
identify any urgent trauma-related concerns and to determine if they
need a mental health referral (including a possible referral to traumaspecific mental health assessment)
7. Support and promote positive
and stable relationships in the life
of the child
• Separation from an attachment figure, particularly under
traumatic and uncertain circumstances, is highly stressful for
children
• Familiar and positive figures—teachers, neighbors, siblings,
relatives—play an important role in supporting children who
have been exposed to trauma
• Minimizing disruptions in relationships and placements and
establishing permanency are critical for helping children form
and maintain positive attachments
What a Child Welfare
Worker Can Do
• For traumatized children who are struggling in their foster
placements, help their foster parents understand the child’s
needs and reactions and provide support and coping skills to the
foster parents to increase the likelihood of successful placement
• For children removed from their homes, help to maintain existing
positive relationships in the child’s life (i.e., teachers, friends,
siblings) by making efforts to keep children in their schools and
communities and facilitating meetings with those individuals as
much as possible
8. Provide support and guidance
to child’s family and caregivers
• Resource families have some of the most challenging roles in
the child welfare system
• Resource families must be nurtured and supported so they, in
turn, can foster safety and well-being
• Relatives serving as resource families may themselves be
dealing with trauma related to the crisis that precipitated child
welfare involvement and placement
What a Child Welfare
Worker Can Do
• Assist children and families with getting concrete needs met,
including shelter, food, medical care, transportation, respite
care, etc.
• Identify parents or other caregivers who are struggling with
their own traumatic experiences or secondary adversities.
Provide them with support and referrals to trauma-informed
providers and link them with other families for mutual
support.
9. Manage professional and
personal stress
• Child welfare is a high-risk profession, and workers may be
confronted with danger, threats, or violence
• Child welfare workers may empathize with victims; feelings of
helplessness, anger, and fear are common
• Child welfare workers who are parents, or who have histories of
childhood trauma, might be at particular risk for experiencing
such reactions
What a Child Welfare
Worker Can Do
• Practice using stress management techniques such as
meditation, prayer, conscious relaxation, deep breathing,
journaling, and/or exercise
• Meet with supervisor for regularly scheduled consultation on
cases and meet with a peer to seek support on difficult
cases
Case Vignette - Tommy
• 4-year-old boy
• Recently witnessed an episode of domestic
violence between his parents
• Neighbors called the police
• Police arrested his father
• Ambulance had come to take his mother
(bleeding and unconscious) to the
emergency room
• Police called Child Welfare
Tommy in Foster Care
• Placed in foster care 8 weeks ago
• Initially quite withdrawn and resisted soothing
or nurturance
• Wakes up twice a night with or without
nightmares, but falls back asleep fairly easily
• Irritable and fatigued
• Wets the bed 2-3 times a week
Tommy in Foster Care (continued)
• Attends daycare three times per week
• At high risk to be excluded - intense episodes of aggression towards
peers, especially girls
• Can also be very helpful to others, appears sensitive
when they are upset, and attempts to comfort them
• Typically ignores verbal limits and desperately fights
physical restraint, to the point of exhaustion
• Following visits with his mother, he tends to isolate
himself
• Does not visit with his father who is incarcerated
Activity: How can we help
Tommy during each phase?
• Investigation
• Risk and needs
assessment
• Removal
• Placement
• Mental health services
• Support and training for
foster parent
• Visitation
• Collaboration with
other systems
• Child welfare worker
training and support
How Can we Create a More
Trauma-Informed Child
Welfare System?
• Materials and resources
• Child Welfare Trauma Training Toolkit
• Caring for Children who Have Experienced Trauma: A
Workshop for Resource Parents
• Bridging the gap between child welfare and mental
health
• CW Breakthrough Series Collaborative
• Chadwick Trauma-Informed Systems Project
• State and National Initiatives
Resources
• www.cebc4cw.org - Online evidence-based
practice resource designed for child welfare
professionals - with support from California
Department of Social Services
• www.nctsn.org and http://learn.nctsn.org - National
Child Traumatic Stress Network, includes NCTSN
Learning Center for Child and Adolescent Trauma
• www.ChadwickCenter.org - Chadwick Center
Contact Information
Alison Hendricks, LCSW
Operations Manager
Chadwick Trauma-Informed Systems Project
www.chadwickcenter.org
ahendricks@rchsd.org
(858)576-1700x2736