The impact of a statewide trauma-informed child welfare initiative on children’s permanency and maltreatment outcomes

Barto, Beth; Bartlett, Jessica Dym; Ende, Adam Von; Bodian, Ruth; Noroña, Carmen Rosa; Griffin, Jessica L.; Fraser, Jenifer Goldman; Kinniburgh, Kristine M.; Spinazzola, Joseph; Montagna, Crystaltina; Todd, Marybeth

doi:10.1016/j.chiabu.2018.04.023

Cited by 26 publications

(23 citation statements)

References 40 publications

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“…103 The Massachusetts Child Trauma Project (MCTP), another multisystem, statewide project, aimed to improve the safety, permanency, and well-being of maltreated children by training child welfare workers and mental health providers on TIC, disseminating information on evidence-based treatment, and integrating the systems of care in their State. Barto et al 104 examined provider and family outcomes at pre-and post-intervention. They found that not only the child protection capacity among providers increased, but also recidivism for substantiated maltreatment decreased by 12% for physical abuse, 14% for neglect and 15% for any maltreatment among children.…”

Section: Impact Of Trauma-informed Care Interventions On Child and Famentioning

confidence: 99%

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Oral¹,

Coohey²,

Zarei³

et al. 2020

Turk J Pediatr

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There is building evidence that Adverse Childhood Experiences without early and proper intervention leads to subsequent short- and long-term behavioral, social, physical and mental health problems. Practitioners, researchers, and healthcare systems have been implementing trauma-informed care (TIC) in a variety of health and human services settings, resulting in improvements in clinical care and prevention of illness by identifying high risk populations. This has led to positive health outcomes including improved compliance, better access to mental health services and reduced health care costs. A systematic review was conducted of studies that focused on TIC implementation in healthcare settings, statewide TIC implementation, impact of adverse childhood experiences on health outcomes, impact of TIC on health outcomes, and evaluation of TIC implementation. A search was conducted in March 2019 to identify studies in PubMed, Medline, and other online literature. We limited our search to articles published in English after 2000. This article aims to review the components of TIC phases of implementation in healthcare settings, success stories across the nation to help the readers understand the importance of a paradigm shift to improve healthcare delivery and health outcomes and to prevent illness starting from childhood with a family centered care perspective.

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Section: Impact Of Trauma-informed Care Interventions On Child and Famentioning

confidence: 99%

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Oral¹,

Coohey²,

Zarei³

et al. 2020

Turk J Pediatr

View full text Add to dashboard Cite

show abstract

“…Only eight projects reported specifically on outcomes for children and/or their families (see Table 3). The state-wide Massachusetts Child Trauma Project (MCTP) was the largest and the most comprehensively evaluated of these, reporting that the 55,145 children who received MCTP interventions had significantly lower substantiated maltreatment reports when compared to the 36,108 children who had not received the intervention [17]. However, children in the intervention group had more maltreatment reports overall (both substantiated and unsubstantiated) and total out-of-home placements than did their counterparts in the comparison group.…”

Section: Resultsmentioning

confidence: 99%

“…With the exception of the MCTP outcome evaluation [17], most studies lacked a control or comparison group and were based on small sample sizes. As such, while positive trends were observed, the effectiveness of large scale, system wide initiatives remain an area requiring significant further evaluation.…”

Section: Resultsmentioning

confidence: 99%

“…As noted in the service user outcomes section, service evaluation showed improvements in child mental and emotional well-being [19,20,21,22,23], decreased caregiver stress [21,22] and improved placement stability [22,24]. Likewise, although not linked to specific elements of service provision, participation in the Massachusetts Child Trauma Project [17] resulted in significantly lower substantiated maltreatment reports, while contact with trauma-informed mental health services improved foster parents’ satisfaction and commitment [18].…”

Section: Resultsmentioning

confidence: 99%

“…These include a relative dearth of outcome focused evaluations, particularly in relation to large-scale TIC efforts, a lack of experimental designs, small sample sizes, high attrition rates and short follow-up periods in longitudinal designs [10,11,12]. In reviewing the child welfare TIC implementation literature, it is clear that while many of these difficulties remain, there has been a drive in recent years to develop the TIC outcomes evidence base with multi-component evaluations of large scale child welfare initiatives beginning to emerge [17,18,23,25,27]. These multi-method evaluations have drawn on administrative data, clinical assessments, staff surveys and interviews and focus groups with managers, staff, community stakeholders and service users in an effort to elucidate the impact of different TIC components.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Trauma Informed Child Welfare Systems—A Rapid Evidence Review

Bunting

Montgomery

Mooney

et al. 2019

IJERPH

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Trauma informed care (TIC) is a whole system organisational change process which emerged from the seminal Adverse Childhood Experiences (ACE) study, establishing a strong graded relationship between the number of childhood adversities experienced and a range of negative outcomes across multiple domains over the life course. To date, there has been no systematic review of organisation-wide implementation initiatives in the child welfare system. As part of a wider cross-system rapid evidence review of the trauma-informed implementation literature using systematic search, screening and review procedures, twenty-one papers reporting on trauma-informed implementation in the child welfare system at state/regional and organisational/agency levels were identified. This paper presents a narrative synthesis of the various implementation strategies and components used across child welfare initiatives, with associated evidence of effectiveness. Training was the TIC implementation component most frequently evaluated with all studies reporting positive impact on staff knowledge, skills and/or confidence. The development of trauma-informed screening processes, and evidence-based treatments/trauma focused services, where evaluated, all produced positive results. Whilst weaknesses in study design often limited generalisability, there was preliminary evidence for the efficacy of trauma-informed approaches in improving the mental and emotional well-being of children served by community-based child welfare services, as well as their potential for reducing caregiver stress and improving placement stability.

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PEGASE Program: Identification of babies in the child protection system at risk of developmental delays or disorders and the implementation of a ‘supra‐optimal’ care pathway

Toussaint¹,

Rousseau²

2022

Child Abuse Review

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The importance of the first three years of life for children's development and the consequences for their general health in adulthood have been widely documented in the international literature, including the benefits of early identification and intervention programs. Additionally, convergent research has highlighted wide‐ranging negative trajectories attributable to both the short and long‐term consequences of abuse and neglect and their neurobiological impact on health and development. However, formal identification processes and the use of standardised screening tools in child protection remain relatively rare despite the potential societal impact of child maltreatment in terms of public and economic health. Moreover, delays between the initial identification of mental health problems and health and developmental disorders, and the introduction of appropriate interventions persist. Abused and neglected infants risk an exacerbation of the consequences of early maltreatment due to insufficient access to prompt assessment and treatment, including appropriate responses to their health needs. The aim of this article is to present the PEGASE program, an innovative French program for very young children in care, which is modelled on the care of premature babies. By setting up an early care pathway, it aims to ensure adequate medical follow‐up – both somatic and psychiatric – through standardised examination and tailored interventions in order to limit the adverse health and developmental consequences of abuse. The presentation of the PEGASE program is supplemented by a case study.

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The impact of a statewide trauma-informed child welfare initiative on children’s permanency and maltreatment outcomes

Cited by 26 publications

References 40 publications

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Trauma Informed Child Welfare Systems—A Rapid Evidence Review

PEGASE Program: Identification of babies in the child protection system at risk of developmental delays or disorders and the implementation of a ‘supra‐optimal’ care pathway

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