Trauma-informed care for children involved with the child welfare system: A meta-analysis

Zhang, Saijun; Conner, Austin; Lim, Younghee; Lefmann, Tess

doi:10.1016/j.chiabu.2021.105296

Cited by 22 publications

(11 citation statements)

References 41 publications

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“…The results of our study extended initial findings that EBP and TS symptoms are not only cross-sectionally related, but also interact in their development over time. The predictors and interactions studied imply that strengthening social and interpersonal skills is crucial to promote adaptive responses after trauma exposure, while reducing psychopathology 56. Taken together, the results argue for viewing emotional and behavioural problems of high-risk children in the context of a TIC approach.…”

Section: Discussionmentioning

confidence: 79%

“…Second, due to unforeseen appointments, illness or leaving the care facility, the participation rate of the children fluctuated over time. Unfortunately, a high attrition rate is a well-known problem of longitudinal studies and can hardly be avoided, especially in the field of research with children in care 56. Due to the achieved sample size and the design of the current work, it was nevertheless possible to reliably estimate LGCMs 42…”

Section: Discussionmentioning

confidence: 96%

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Co-development of traumatic stress symptoms and externalising behaviour problems among foster children and the effect of complex trauma: a latent growth curve model

et al. 2023

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ObjectivesFoster children are disproportionately exposed to complex trauma, which may lead to multifaceted impairments that manifest in comorbid emotional and behavioural problems. As little is known about the interactions between comorbid disorders over time, the present study aims to explore the co-development of traumatic stress (TS) symptoms and externalising behaviour problems (EBP), as well as the influence of complex trauma operationalised as cumulative child maltreatment (CM).SettingAs part of a 3-year longitudinal study, children from six foster care facilities in Lower Austria were interviewed at three measurement points.ParticipantsOf, in total, 263 participating children, the data of 124 children aged 10–18 years (M=13.5, 28% female) could be analysed.Primary and secondary outcome measuresLatent growth curve models were used to examine the co-development of TS symptoms (International Trauma Questionnaire) and EBP (Child Behaviour Checklist) over time; gender, age and cumulative CM (Childhood Trauma Questionnaire) acted as time-invariant covariates.ResultsWhile average TS symptoms decreased over time, EBP remained stable. Findings revealed that the initial severity of EBP was both related to the initial severity of TS symptoms and predictive of their rate of change. Cumulative CM was a significant predictor of initial TS symptoms and EBP even after controlling for age and gender, but not for the rates of change.ConclusionsTaken together, our results indicate that EBP and TS symptoms are not only cross-sectionally associated but interact with each other over time. Furthermore, an underlying complex trauma could at least partly determine the severity of the two symptom groups. In accordance with a trauma-informed care approach, our study highlights the importance of trauma-specific screening of high-risk children with complex or diffuse symptoms and argues for the benefits of treatments that focus on improving emotion regulation and social skills in addition to addressing trauma.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 96%

Co-development of traumatic stress symptoms and externalising behaviour problems among foster children and the effect of complex trauma: a latent growth curve model

et al. 2023

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“…Considering where these interventions are being carried out, one would expect most of them to be in a mental health facility, as trauma has traditionally been linked to posttraumatic stress and other mental disorders and that is where the historical roots of the TIC movement can be traced (NCTIC, 2012). Furthermore, given the substantial body of literature on ACE, it is neither odd that it has been conveniently implemented in CWS as well (Zhang et al, 2021). Yet, we also see that other areas such as juvenile justice, education, and community partnerships are represented, while in a smaller percentage, and that other settings that work with vulnerable populations are yet to benefit from this approach (Piotrowski, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, systematic reviews have focused more on the domains of workforce development or trauma-focused services (Han et al, 2021; Purtle, 2020), on specific settings (Bailey et al, 2019; Zhang et al, 2021), or on the operationalization of the TIC framework itself (Bargeman et al, 2021; Champine et al, 2019). These reviews also contribute to highlight the potential benefits of TIC, while alerting of the poor methodology that questions the evidence.…”

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confidence: 99%

Effectiveness of trauma-informed care interventions at the organizational level: A systematic review.

Fernández¹,

Gausereide-Corral²,

Valiente³

et al. 2023

Psychological Services

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Due to the recognition of the high prevalence and widespread effects of trauma, trauma-informed care (TIC) framework has emerged to address its impact and prevent retraumatization in the systems of care. Since organizational support has been identified as crucial in TIC implementation and sustainability, this systematic review assessed the status quo of TIC interventions which explicitly incorporate an organizational component. Our search yielded 880 articles, and 15 met the inclusion criteria. All the studies were carried out in the United States, more than half in mental health and Child Welfare Services, through longitudinal designs with no randomization or control group. All the studies utilized one to six organizational components, the most frequent related to presence of a defined leadership, procedures against retraumatization and provision of strength-based services. A wide variety of measures were used to assess the effectiveness of TIC interventions, with staff perceptions and safety management indicators being the most frequently used. In summary, the review indicates a positive trend in relation to the effectiveness of the interventions included in the study, with an improved functioning of beneficiaries, enhanced accessibility, and quality of services. However, the low quality and high heterogeneity of the studies make it difficult to draw conclusions with certainty. Therefore, the primary endeavor in TIC research is to provide more solid evidence. Partnerships between academic and community stakeholders will be of high value in this process. Impact StatementTrauma-informed care (TIC) literature advocates for organizational interventions as necessary conditions to implement and sustain change. This article represents a first attempt to systematically review the characteristics and effectiveness of TIC studies which incorporate at least one organizational component. Studies display positive results in beneficiaries' functioning and quality of care, yet their significant disparity and methodological limitations make comparison difficult.

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“…Previous studies have revealed that interpersonal stressors including bullying victimization can easily stress people out, which may raise their risk of cognitive vulnerability and NSSI (Guerry & Prinstein, 2010). For LBC, the absence of one or both parents is a challenge that increases their vulnerability to peer victimization and abuse (Zhang, Conner, et al, 2021; Zhang, Zhou, et al, 2021), which may result in more negative cognition and a variety of harmful behaviors. Therefore, child maltreatment and bullying victimization can lead to NSSI among LBCs.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal relationship between child maltreatment, bullying victimization, depression, and nonsuicidal self‐injury among left‐behind children in China: 2‐year follow‐up

Yan,

Ding,

Wang

et al. 2023

J Clin Psychol

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BackgroundLeft‐behind childre (LBC) in China are deeply concerned by society because of their high risk of emotional and behavioral problems. Depression and nonsuicidal self‐injury are the most harmful and worrying negative emotional and behavioral problems in LBC. Unfortunately, LBCs are in unfavorable environments for a long time and are prone to negative interpersonal interactions. Child maltreatment and bullying victimization, as the two most typical negative interpersonal interactions in family and school environments, maybe the key risk factors for depression and nonsuicidal self‐injury among LBCs. However, we are less known of the longitudinal effects of child maltreatment and bullying victimization on LBC's depression and nonsuicidal self‐injury and their underlying mechanisms.AimsThis study used a two‐year longitudinal design with three‐time points to investigate the longitudinal effects of child maltreatment and bullying victimization on depression, nonsuicidal self‐injury, and the mediating role of negative thoughts and self‐compassion.Materials & MethodsA sample of 592 LBC (390 were males, Mage at time 1 = 9.56, SDage = 0.65; 202 were females, Mage at time 1 = 9.43, SDage = 0.63) completed a set of questionnaires at three‐time points. This study used SPSS software (version 25.0) and MPLUS software (version 8.3) for all analyses.Results(1) Child maltreatment not only affects depression and nonsuicidal self‐injury but also affects depression and nonsuicidal self‐injury through negative thoughts. Child maltreatment affects depression through self‐compassion and does not affect nonsuicidal self‐injury. (2) Bullying victimization affects depression and nonsuicidal self‐injury through negative thoughts and bullying victimization further affects depression through self‐compassion but does not affect nonsuicidal self‐injury.ConclusionThis study revealed the effects of negative interpersonal interactions (child maltreatment, bullying victimization) on LBC's adverse emotions and behaviors, and their underlying mechanisms, which helps to provide parents, schools, and psychoeducational workers with a new perspective on intervention.

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Trauma-informed care for children involved with the child welfare system: A meta-analysis

Cited by 22 publications

References 41 publications

Co-development of traumatic stress symptoms and externalising behaviour problems among foster children and the effect of complex trauma: a latent growth curve model

Co-development of traumatic stress symptoms and externalising behaviour problems among foster children and the effect of complex trauma: a latent growth curve model

Effectiveness of trauma-informed care interventions at the organizational level: A systematic review.

Longitudinal relationship between child maltreatment, bullying victimization, depression, and nonsuicidal self‐injury among left‐behind children in China: 2‐year follow‐up

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