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Module 2 Resources: Trauma-Informed Child-Serving Systems

Websites and Online Materials

  1. ACEs articles by category Oct 18, 2016 – Wisconsin Dept of Health Services, ACEsConnection.com – Scott Web, from the Wisconsin Department of Health Services, has provided a comprehensive list of articles about ACEs covering Adversity Impact; Brain and Biology; Bullying; Courts, Juvenile Justice, Corrections, and Probation; Post-Traumatic Stress Disorder; Resilience; Schools; Substance Use Disorder; and Trauma-Informed Care. To access this resource copy and paste the following link into your browser http://www.acesconnection.com/blog/a-month-of-aces-articles-by-category-wisconsin-dept-of-health-services
  2. ‘Ambassadors of Hope’ Trauma-sensitive schools understand the whole child, DerbyInformer.com. Teachers that understand the brain and the way that trauma effects the brain can better regulate child behaviors in the classroom. Students are less likely to change their behavior when teachers employ punitive punishment, especially when it is public. New strategies have been proven to improve behaviors and enhance the education environment.
  3. Assessing the effects of foster care: Early results from the Casey National Alumni Study. This online document presents data collected from case records and interview about the life experiences, educational achievement, and current functioning of more than a thousand Casey Family Program foster care alumni who were served in 23 communities across the country between 1966 and 1998. The report also documents the incidence and cost of child maltreatment.
  4. Balancing science with justice for violent teens, TheTennessean.com. Expansion of the juvenile justice system may be necessary to address the scientific proof that a young person’s brain is not fully developed until the age of 25. An adolescent who has been exposed to trauma likely has not developed the parts of the brain responsible for impulse control and decision making, but there is evidence that with support these young people can develop into fully functional adults.
  5. Chicago Teens and Combat Veterans Join Forces to Process Trauma. For children in some Chicago neighborhoods, walking up and down the same street where there was a beating or a shooting or a body is just part of life — one that isn't always talked about. That's something the Urban Warriors program is trying to change. The YMCA of Metro Chicago project connects these children, who live in high-violence neighborhoods, with veterans who have served in Iraq or Afghanistan and who might understand what they're going through.
  6. The Child and Family Policy Forum, May 14, 2013. The forum discusses findings from a Chapin Hall report in which researchers identified a subset of parents involved with the child welfare system who have experienced extensive childhood trauma and face multiple challenges or service needs. These findings have implications for caseworker engagement and service interventions, and they also raise fundamental questions about our obligation and approaches to working with parents, protecting children, and promoting well-being. The forum also discusses changes to policies and practices in the child welfare, legal, and human services fields that may be necessary to improve the well-being of this group of children and their families.
  7. Child Welfare 360° (CW360°) is an annual publication that provides communities, child welfare professionals, and other human service professionals, comprehensive information on the latest research, policies and practices in a key area affecting child well-being today. The publication uses a multidisciplinary approach for its robust examination of an important issue in child welfare practice and invites articles from key stakeholders, including families, caregivers, service providers, a broad array of child welfare professionals (including educators, legal professionals, medical professionals and others), and researchers.
  8. Community Matters. Community Matters (CM) is recognized as an innovative and thought-leading organization committed to improving the social-emotional climate of our nation’s schools and communities. Founded in 1996, CM has evolved from its earliest focus on youth development and bullying prevention to become a widely respected consulting, training and presenting organization. CM provides programs and services for educational, youth-serving and governmental entities.
  9. Correctional Staff Must Pay Attention to Needs of Girls in Adult Facilities, Researchers Say. Girls who end up in the adult system share many of the characteristics of girls in the juvenile justice system, according to the report. They are likely to have experienced disproportionately high rates of physical or sexual abuse or trauma, more likely to be pregnant or parenting and to need services including mental health counseling and substance use treatment.
  10. Creating a 21st Century Child Well-Being System, HuffingtonPost.com. An article by Matthew Melmed, Executive Director of Zero to Three, with recommendations for protecting young children through strategies that help build strong communities that strengthen the ability of parents to cope with their own needs as well as meet the needs of their children.
  11. Creating Cultures of Trauma-Informed Care (CCIT) model. Creating Cultures of Trauma Informed Care (CCTIC) developed over the last ten years by Community Connections, draws substantially on Using Trauma Theory to Design Service Systems, a book edited by Maxine Harris, Ph.D., and Roger Fallot, Ph.D. (2001). Used by state service systems and provider organizations, this work presents a step-by-step model for state mental health, substance abuse, and other public human service systems, public and private provider agencies, and individual services and programs to become “trauma-informed.” The model provides guidelines for evaluating and modifying all system and service components in light of a basic understanding of the role that violence plays in the lives of people seeking mental health and addictions services, most of whom have been traumatically impacted by unaddressed histories of sexual and physical abuse and other violence.
  12. Documentary highlights the struggles of dealing with trauma. Grand Valley State University held a free screening of the new film for students. The documentary, directed by James Redford, delves into trauma-informed education and the Adverse Childhood Experience Study (ACES). The film follows students at Lincoln High School, an alternative high school in Walla Walla, Washington, for a year. Many of the students at the school struggle with ACES. The film follows Lincoln’s staff as they try a different approach to how they discipline students. The new approach is based in understanding and treatment, rather than traditional punishment with detention or suspension.
  13. Elementary school launches in-house therapy for at-risk students, MLive.com – Washington Elementary School in Bay City, MI is one of the first in the state to start an in-house health center to address the medical and behavioral issues for its large population of at-risk students. The original aim of the initiative was to decrease suspensions due to behavioral issues.
  14. Fighting Trauma. Research shows that building resilience in children through creating environments that are stable, as well as emotionally and physically safe, can help counteract the effects of their previous adverse experiences. However, it can be hard for even well-meaning caregivers who don't fully understand the effects of trauma to respond effectively to kids' needs. The Spokane Regional Health District has developed a user-friendly toolkit for teachers, parents and daycare providers, which helps all the caretakers to respond to trauma with sensitivity.
  15. How Grief Goes Unnoticed in Foster Children: And the Underlying Trauma that it Causes. If a small girl is pulled from her mother’s home, only to be placed in the safety of strangers, and she attends school later that week, only to throw something at another student or even the teacher, is she grieving or a troublemaker? Foster children have often suffered a tremendous loss — a deep sadness and grief that often goes unrecognized, and often leads to deeper traumas. When we learn to recognize that a child may be grieving, it may be easier to throw our arms around them and tell them everything is going to be OK, instead of issuing a punishment.
  16. IMPACT – Experts have concluded that adverse experiences in childhood can have physiological effects on the body and brain. This affects the long-term decision making skills, sense of safety, and ability to regulate emotions in young people. This webinar provides effective strategies for youth programs to implement to better serve the needs of youth.
  17. Integrating Trauma-Responsive Services into Programs for Youth, AECF.org. The Fall/Winter Edition of IMPACT, the quarterly newsletter of the National Child Traumatic Stress Network (NCTSN), describes Oklahoma’s journey in creating a trauma-informed state. It also showcases how one foster youth continues to make her voice heard, focuses on outstanding Centers in New York, Illinois, and Colorado, and explores racial disparities in the Juvenile Justice System in our Spotlight on Culture.
  18. Interventional Policies and Practices Needed to Prevent Bullying and its Harm, ScienceDaily.com . A post reprinted from materials provided by National Academy of Sciences suggests that bullying is a serious public health problem, with significant short- and long-term psychological consequences for both the targets and perpetrators of such behavior, and requires a commitment to developing preventive and interventional policies and practices that could make a tangible difference in the lives of many children.
  19. Kindergartners with Traumatic Life Experiences Struggle More in School. A study of more than 1,000 urban children showed those with difficult experiences up until age 5 had math and reading difficulties and difficulty focusing in kindergarten, and were also more likely to have social problems and to be aggressive toward others.
  20. LA Unified cities rising suicidal behavior and devises tools to address it – Los Angeles Unified schools use the Incident System Tracking Accountability Report (iStar) to keep track of the number of troubling incidents that occur in district schools during the school year. The tracking system is drawing attention to the growing number of behaviors among youth that suggest a pathway towards suicide.
  21. Mississippi: The Future of Restraint and Seclusion in Schools. Mississippi could be the next state to pass regulations determining how the harsh punishment tactics are used on "out-of-control" kids.
  22. Momentum Grows for Trauma-Informed Movement in Tennessee. Leaders in Tennessee are poised to take what they have started in Memphis statewide, demonstrating that ACES research has the power to galvanize communities and even whole states to make fundamental changes to benefit children, adults, and families. An analysis of the cost of ACES in the state has been persuasive in convincing policy makers to invest in the reduction of ACES.
  23. Multiplying Connections seeks to create more and higher quality connections between young children and caring adults. Multiplying Connections works with and through the people in public organizations that regularly serve children and families. Through their Cross Systems Training Institute they train professionals in trauma-informed techniques that build resilience and reduce harm. They collaborate with administrators and managers to change practices and policies in organizations and systems.
  24. Nationally Recognized West Virginia Program Helps Children Deal with Trauma. In 2013, the West Virginia Center for Children’s Justice launched a program called “Handle with Care”. The collaborative program is meant to help children who’ve experienced abuse, neglect or other types of trauma succeed in school. The program that started on the West Side of Charleston is now expanding across the state and in other communities across the nation.
  25. NCTSN: Juvenile Justice System. Children who come to the attention of the juvenile justice system are a challenging and underserved population. The National Child Traumatic Stress Network has developed resources to help juvenile justice professionals understand and provide trauma-focused services to these youth.
  26. NEAR@Home Toolkit: A Guided Process to Talk about Trauma and Resilience in Home Visiting. Home visitors are interested in bringing information about ACEs to families but worry about causing harm. The NEAR@Home toolkit addresses these concerns. This training manual created by Thrive Washington provides guided processes to help you learn and practice language and strategies to safely and effectively talk about the trauma of ACEs. The toolkit emphasizes safety and reflective support for the home visitor as a critical element in this process. Using this process, home visitors will build skills in the therapeutic use of self and discover increased compassion, patience, and stamina in their work with families.
  27. NRCCPS Webinar Domestic Violence and Child Protective Services Summer Series (2013) is a series of monthly webinars focusing on domestic violence and child protection. The series is entitled Safety Organized, Trauma-informed, Solution-focused Approaches to Domestic Violence in Child Protection.
  28. The Office for Victims of Crime (OVC) is one of seven components within the Office of Justice Programs, U.S. Department of Justice. The OVC is committed to enhancing the Nation’s capacity to assist crime victims and to providing leadership in changing attitudes, policies, and practices to promote justice and healing for all victims of crime. It is charged by Congress with administering the Crime Victims Fund (the Fund), which supports a broad array of programs and services that focus on helping victims in the immediate aftermath of crime and continuing to support them as they rebuild their lives. More details about OVC’s mission and services are available in the What is OVC? fact sheet.
  29. Pennsylvania Recovery and Resilience – Trauma-Informed Care for Children. The website provides details and resources for Pennsylvania’s statewide trauma-informed care initiative. It details the models and treatments they implemented to provide trauma-informed care and illustrates collaboration efforts.
  30. The Pongo Teen Writing Project is a volunteer, nonprofit program for teens who are on the streets, in jail, or in other ways leading difficult lives. The program helps young people express themselves through poetry, especially youth who have never written before. They also share teaching techniques with caring adults. Among other information on the website is a video about an Emmy-winning story from KING5-TV that represents the emotional power and joy in Pongo’s poetry program inside juvenile detention.
  31. Restraints Persist at "Psychoeducational' Programs Despite State Regulations. Although Georgia’s Board of Education adopted regulations that addressed the use of seclusion and restraints in schools, it is still used in schools. The Atlanta Journal-Constitution writes how the use of this practice is being addressed by the Georgia Board of Education.
  32. The Road to Recovery: Supporting Children with Intellectual and Developmental Disabilities Who Have Experienced Trauma.This Toolkit developed by the National Child Traumatic Stress Network consists of a Facilitator Guide and a Participant Manual. Together, they are designed to teach basic knowledge, skills, and values about working with children with IDD who have had traumatic experiences, and how to use this knowledge to support children’s safety, well-being, happiness, and recov­ery through trauma-informed practice.  The Toolkit, in its entirety, is available for download from the Trauma & IDD Toolkit webpage on the NCTSN Learning Center. This page includes the PowerPoint files of the Slidekit; NCTSN videos (i.e., NCTSN PSA & an excerpt from The Promise); Pre-Training and Follow-Up Evaluations (PDF versions & links to online Qualtrics versions); and, all activity files (i.e., a Board Game).
  33. The Safe Start Initiative is funded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP), Office of Justice Programs, U.S. Department of Justice. The goal of the Safe Start Initiative is to broaden the knowledge of and promote community investment in evidence-based strategies for reducing the impact of children's exposure to violence. Safe Start’s website provides research studies and reports, evidence-based practices websites and resources.
  34. SAMHSA's National Center for Trauma-Informed Care (NCTIC) is a technical assistance center dedicated to building awareness of trauma-informed care and promoting the implementation of trauma-informed practices in programs and services.
  35. Standards of Practice for Trauma-Informed Care in Oregon. The following standards of practice for trauma-informed care in Oregon are based on nationally recognized principles of trauma informed care and are in alignment with SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. The Standards are intended to provide benchmarks for planning and monitoring progress and means to highlight accomplishments.
  36. Suicide and Depression Awareness for Students. Depression and suicidal thoughts are two of the most frightening things a person can face in their lifetime. Unfortunately, acting on those suicidal thoughts is a far too common scenario for many across the world, including students. In fact, suicide is the second-leading cause of death for those between the ages of 15 and 24. This guide is dedicated to helping those who are suffering or have suffered from depression, suicidal thoughts or suicide attempts. It is also designed for concerned friends and family members who might be worried that someone they love will experience death by suicide. Finally, it is meant for students, so that they might spot the warning signs of suicide in others – or in themselves – and find the proper resources.
  37. Teens Teach Trauma Care to Camden schools [CourierPostOnline.com]. In September, more than 1,000 teachers in the Camden School district will learn about trauma-informed care from Hopeworks ‘N Camden, a nonprofit offering job training and experience for Camden's youth. Teams of young people will teach school workers why traumatized people act out and how to manage negative emotions and stress in healthy ways.
  38. Therapy dogs bring comfort to troubled youth, TheGazette.com – Youth at the Linn County Juvenile Detention Center find connection with therapy dogs that visit the center. The dogs are able to target the students who need the most interaction
  39. Three Years after Newtown, Schools Broaden Their Definition of Safety. It's been three years since a gunman forced his way into a Newtown, Conn., elementary school and killed 20 young children and six staff members before turning the gun on himself and taking his own life as police responded to the scene. The shootings were a catalyst for discussions that continue today about schools' responsibility to keep students safe. For many educators, those discussions have led to a broader understanding of what safety means for students—both physically and emotionally.
  40. To Manage the Stress of Trauma, Schools are Teaching Students How to Relax, WashingtonPost.com: An article in the Washington Post describes a practice that is growing in schools nationwide, in Houston Elementary in Northeast Washington where they are using mindfulness and other therapies to help children manage the stress they encounter in their daily lives.
  41. Transforming School Climate Through Trauma Informed Practices. This 90-minute Webinar presented by the U.S. Departments of Justice, Education, and Health and Human Services, is the seventh in a series from the Supportive School Discipline Initiative. It examined the impact of exposure to trauma on student behavior, discussed how some discipline responses can traumatize or re-traumatize youth, and provided some trauma-informed alternatives. In addition, the behavioral impact of trauma on youth with disabilities was explained.
  42. Trauma Center at Justice Resource Institute. Dr. Bessel van der Kolk and his colleagues have published a number of articles on traumatic stress. Versions of these articles are available for download from the web. In addition, they have developed several products for clinicians, trauma survivors and their family and friends to help aid in the recovery process.
  43. Trauma-Informed Approaches for Caring for Every Child’s Mental Health. This webisode by SAMHSA’s KSOC-TV (Knowledge Network for Systems of Care) explores the principles of a trauma-informed approach and trauma-specific interventions designed to address the consequences of trauma among children, youth and families. Panelists featured include: Larke Huang, PhD, Director, Office of Behavioral Health Equity at SAMHSA; Kay Connors, LCSW-C, Program Director, Taghi Modarressi Center for Infant Study, FITT Center Department of Psychiatry, University of Maryland, Baltimore; and Che Bullock, young adult trauma survivor.
  44. Trauma Training - SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation. Although prevalence estimates vary, there is consensus that high percentages of justice-involved women and men have experienced serious trauma throughout their lifetime. The reverberating effects of trauma experiences can challenge a person’s capacity for recovery and pose significant barriers to accessing services, often resulting in an increased risk of coming into contact with the criminal justice system. To raise awareness about trauma and its effects among criminal justice professionals, SAMHSA’s GAINS Center developed a half-day training curriculum for criminal justice professionals: How Being Trauma-Informed Improves Criminal Justice System Responses.
  45. Trauma Training for Educators. This free training resource developed by Communities in Schools in Central Texas, is designed to give anyone who works with children important trauma-focused information about how student learning and behavior is impacted by trauma and how educators and support staff can help students develop a greater sense of safety at school and begin to build new emotional regulation skills. There is a 43 minute video containing school based scenarios along with information about complex trauma and the skills to respond to children / youth.  Also included is a facilitator’s discussion guide and handouts. The information, scenarios and skills are relevant for any child serving agency staff.
  46. UCSF Healthy Environments and Response to Trauma in Schools (HEARTS). This project is a comprehensive, multilevel school-based prevention and intervention program for children who have experienced trauma. The goal of UCSF HEARTS is to create school environments that are more trauma-sensitive and supportive of the needs of traumatized children. A main objective of this project is to work collaboratively with the San Francisco Unified School District (SFUSD) to promote school success by decreasing trauma-related difficulties and increasing healthy functioning in students within the SFUSD who have experienced complex trauma.
  47. Vermont State Legislature. House Health Care Bill H. 762. Bill H. 762, The Adverse Childhood Experience Questionnaire, is the first bill in any state in the nation that calls for integrating screening for adverse childhood experiences in health services, and for integrating the science of adverse childhood experiences into medical and health school curricula and continuing education. Additional information, including amendments, summaries and status can be obtained from the Vermont State Legislature website.
  48. Washington State Study Shows Promise for Community Network-Driven Approach to ACEs. Community networks in the state of Washington have been effective in reducing the effects of adverse childhood experiences (ACEs), according to a study released this month by respected policy research firm Mathematica.
  49. What Is a "Trauma-Informed" Juvenile Justice System? A TARGETed Approach (JJIE.org): This article in the Juvenile Justice Information Exchange by Dr. Julian Ford describes the use of TARGET (Trauma Affect Regulation: Guide for Education and Therapy). TARGET is a multisession gender-specific ethno-culturally adapted intervention for traumatized youth (and adults) that can be done as a one-to-one, group, family or milieu therapy, and/or as a training on emotion regulation skills for juvenile justice staff to use on a 24-hour, seven-day-a-week basis in community or congregate justice programs.
  50. What Mindfulness Does for Urban Kids, CityLab.com – With the help of the Holistic Life Foundation in Baltimore City, participating schools have seen a decrease in suspensions through the use of mindfulness instruction for disruptive students. Youth develop positive coping skills to deal with toxic stress.
  51. Why school climate matters with a President Trump, PsychologyToday.com – Students who experience high levels of in-school victimization are likely to have lower educational aspirations, higher rates of school discipline, and higher rates of missed school. With the increase in overt harassment following the election, it is important that educators make the classroom a safe space where students can feel free to perform.
  52. Why Social and Emotional Skill Building in Early Childhood Matters. Research shows that a firm foundation of social and emotional skills sets the stage for academic and even career achievement. But in one national survey of 3,600 kindergarten teachers, 20 percent reported that at least half of the class did not have the social skills necessary for school success.
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Downloadable Documents

  1. Alaska & Boston: Recovery-Oriented and Trauma-Informed Care in Health Care Settings, Including Medical/Health Home Settings (PDF, 3.7MB). The slides provided at the webinar organized by SAMHSA in January 7, 2016 show how the recovery-oriented and trauma-informed care works in health care settings, including medical and health home settings in Alaska and Boston.
  2. Assessing Exposure to Psychological Trauma and Posttraumatic Stress Symptoms in the Juvenile Justice Population (295KB). This document by the NCTSN highlights the prevalence of trauma among justice-involved youth and the negative consequences. It provides guidance for addressing trauma in this population, including guidance on screening, assessment, disclosures and clinical considerations.
  3. Attorney General’s Task Force on Children Exposed to Violence Executive Summary. (PDF, 189KB). This summary contains a brief of the recommendations made by the Task Force on Children Exposed to Violence. The recommendations focus on six main areas: 1) ending the epidemic of children exposed to violence, 2) identifying children exposed to violence, 3) treatment and healing of exposure to violence, 4) creating safe and nurturing homes, 5) communities rising up out of violence, and 6) rethinking our juvenile justice system.
  4. Attorney General’s Task Force on Children Exposed to Violence Full Report. (PDF, 3MB). This 2012 full report provides detailed recommendations from the Task Force on Children Exposed to Violence. Recommendations focus on six topics: 1) ending the epidemic of children exposed to violence, 2) identifying children exposed to violence, 3) treatment and healing of exposure to violence, 4) creating safe and nurturing homes, 5) communities rising up out of violence, and 6) rethinking our juvenile justice system. Within each topic area, details about how violence impacts the child and recommendations are provided.
  5. Becoming Trauma-Informed: What Does this Mean for Non-Clinical Staff? (PDF, 2MB). In this webinar, the Director of Trauma-Informed Services at National Council for Behavioral Health, Karen Johnson, discusses how addressing trauma is now the expectation, not the exception, in behavioral health and community organizations. Furthermore, there is an urgency to spread the understanding of trauma far beyond the scope of the clinical and peer workforce to ensure everyone in an organization is becoming trauma-informed.
  6. Building a Statewide Trauma-Informed System of Care. (PDF, 700KB). Issue Brief No. 27, December 5, 2013. The issue brief published by the Child Health and Development Institute of Connecticut stresses the importance of understanding child traumatic stress, building a statewide trauma-informed system of care, screening and identifying child trauma, promoting access to trauma-focused treatment, and creating systems to serve children and families.
  7. Bridging Silos, Improving Systems. (PDF, 2MB). Johnson, D., Chung, P., Schroeder, J. & Myers, J. The Foundation Review. 2012;4(2); 84-97. This article discusses the importance of human services agencies working together to better serve their target population. Examples of systems building from Colorado and Connecticut are given along with lessons learned.
  8. Child Trauma Toolkit for Educators. NCTSN. The Child Trauma Toolkit for Educators was developed to provide school administrators, teachers, staff, and concerned parents with basic information about working with traumatized children in the school system. The toolkit includes facts, suggestions, and information on the psychological and behavioral impact of trauma by grade level, and self-care.
  9. Child Traumatic Stress: What Every Policymaker Should Know. (PDF, 2MB). Gerrity, E. & Folcarelli, C. (2008). Durham, NC and Los Angeles, CA: National Center for Child Traumatic Stress. This guide was written to educate policymakers about the scope and impact of childhood trauma, to offer effective solutions that can be implemented with the support of informed public policy and to provide information about additional resources. The National Child Traumatic Stress Network (NCTSN) offers this resource for all those who work to develop and implement policies for child and family-serving systems, including federal, state, and local policymakers, agency and center staff, mental health clinicians, researchers, and service providers, child advocates, and families and consumers affected by trauma.
  10. Children in Foster Care with Parents in Federal Prison: A Toolkit for Child Welfare Agencies, Federal Prisons, and Residential Reentry Centers. (PDF, 3MB). Federal Interagency Working Group for Children of Incarcerated Parents. June 2013. This toolkit is geared towards workers that may interact with inmates and their families. The toolkit contains answers to FAQ that social workers, Residential Re-entry Center staff, and child welfare staff may pose.
  11. Children With Traumatic Separation: Information for Professionals (PDF, 516.78KB). This 5 page fact sheet developed by the National Child Traumatic Stress Network provides helpful information for those working with children who experience loss.  The relationship with a parent or primary caregiver is critical to a child’s sense of self, safety, and trust. However, many children experience the loss of a caregiver—either permanently or for varying amounts of time—due to death due to other circumstances. For example, chronic separations may result from military deployment, parental incarceration, immi­gration, parental deportation, or termination of parental rights. When sep­arated from their caregiver, children may develop posttraumatic respons­es. The fact sheet gives information on traumatic separation, chal­lenges children may face, posttraumatic responses children may have, and suggestions for helping children who experience traumatic separa­tion from a caregiver.
  12. Concept of Trauma and Guidance for a Trauma-Informed Approach. This document from SAMHSA introduces a concept of trauma and offers a framework for how an organization, system, service sector can become trauma-informed. Includes a definition of trauma (the three "E's"), a definition of a trauma-informed approach (the four "R's"), 6 key principles, and 10 implementation domains.
  13. Consumers and Carers perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups (PDF, 972KB). Seclusion and restraint are interventions currently permitted for use in mental health services to control or manage a person’s behavior. In Australia, serious concerns about the use of such seclusion and restraint have been raised at least since 1993. Consumers and their supporters have also expressed strong views about the harm of these practices. This paper presents the results of ten focus group discussions with people with lived experience of mental health issues and also careers, family members and support persons in relation to the use of seclusion and restraint.
  14. Creating Trauma-Informed Child-Serving Systems. (PDF, 159KB). NCTSN. 2007 This service systems brief highlights the need for child-serving systems to provide a safe environment for the children they serve. In order to create a safe and healthy environment in which to serve children, the NCTSN provides information about creating a trauma-informed system within child welfare, schools, health care, juvenile justice, law enforcement, and mental health.
  15. Creating Trauma-Informed Child- and Family-Serving Systems. (PDF, 1MB). PowerPoint. Lisa Conradi. Chadwick Trauma-Informed Systems Project. This presentation gives the reader insight on how to integrate mental health into the child welfare system. This presentation also discusses the essential elements of a trauma-informed child welfare system.
  16. Creating Trauma-Informed Child Welfare Systems: A Guide for Administrators. (PDF, 5MB). Chadwick Trauma-Informed Systems Project, June 2012. This guide is a tool for administrators across child welfare and other child-serving systems who are interested in having a more trauma-informed system that is responsive to the needs of children who have experienced trauma.
  17. CW360˚: Trauma-Informed Child Welfare Practice. (PDF, 1MB). Center for Advanced Studies in Child Welfare. School of Social Work, University of Minnesota. Winter 2013. This issue of CW360 focuses on the practices of a trauma-informed child welfare system. Topics include, among others, the impact of trauma on the parent and child, cultural adaptation, and trauma screening.
  18. Educational and employment outcomes of adults formerly places in foster care: Results from the Northwest Foster Care Alumni Study. (PDF, 350KB). Pecora PJ, Kessler RC, O’Brien K, et al. Children and Youth Services Review. 2006;28:1459-1481. This study evaluated the intermediate and long-term effects of family foster care on adult functioning using a sample of 659 young adults from two public and one private child welfare agencies, case record reviews, structured interviews, and a survey response rate of 76%. Two foster care experience areas were estimated to significantly reduce the number of undesirable outcomes in the Education outcome domain: positive placement history (e.g., high placement stability, few failed reunifications), and having broad independent living preparation (as exemplified by having concrete resources upon leaving care).
  19. Evidence-Informed Interventions for Posttraumatic Stress Problems with Youth Involved in the Juvenile Justice System (142KB). This report highlights the importance of effective therapeutic interventions ─ provided on a timely basis and matched to the specific needs and life circumstances of each traumatized youth ─ to help restore responsible social citizenship and healthy development for troubled youths, and enhance the safety and health of their families, communities, schools, peer-groups, and workplaces. It provides guidance for what to consider before providing a therapeutic intervention to traumatized youth in the juvenile justice system and lists interventions with an evidence base for traumatized youth Involved in Juvenile Justice.
  20. Guidance letter on trauma-focused care in child-serving settings. (PDF, 136KB). US Department of Health and Human Services. July 2013. This letter is a result of a collaborative effort from the Administration for Children and Families (ACF), Substance Abuse and Mental Health Services Administration (SAMHSA), and Centers for Medicare & Medicaid Services (CMS). In this letter, the agencies provide State Directors with information about federal resources that can help address the impact of trauma.
  21. Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense. (PDF, 197KB). Justice Policy Institute. Published July 2010. This brief gives the reader information on why trauma-informed care should be a common practice in the juvenile justice system. This brief argues that interaction with the juvenile justice system in itself is a traumatizing experience and that trauma-informed practices should be implemented within this system.
  22. Implementing Trauma-Informed Practices in Child Welfare. (PDF, 276KB). State Policy Advocacy and Reform Center. ABA Center on Children and the Law. November 2013. This brief highlights the effects of trauma on child wellbeing and provides practice recommendations and examples of specific initiatives to guide transformation of the child welfare system. Topics include the effects of trauma on children in foster care, the benefits of trauma-informed practices, models of trauma-informed practices, and trauma-informed practice recommendations.
  23. Long-term Socioeconomic Impact of Child Abuse and Neglect: Implications for Policy. (PDF, 114KB). Zielinski DS. Center for Child and Family Policy. Duke University. July 2005. This brief provides an overview of how child abuse and neglect affects victim’s later socioeconomic status. The author also provided strategies for addressing this problem.
  24. Making Medicaid Work for Children in Child Welfare: Examples from the Field. Pires SA, Stroul BA, Hendricks T. Center for Health Care Strategies. June 2013. This document discusses Medicaid strategies that emerged as most important for effectively serving children in child welfare and presents case studies highlighting the experiences of Arizona, Massachusetts, Michigan, and New Jersey. The document concludes with a discussion of cross-state observations and lessons learned.
  25. Managing traumatized children: a trauma systems perspective. (PDF, 88KB). Current Opinion in Pediatrics, 22:621-625. Conradi L, Wilson C (2010). This article reviews current research on trauma-informed child-serving systems. Topics discussed in this review include the prevalence of trauma, the current state of trauma-informed child-serving systems, and components of a trauma-informed child-serving system.
  26. Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services. (PDF, 821KB). National Center for Trauma-Informed Care. 2008 Update. This report is an update of the 2004 technical report describing trauma-informed and trauma-specific service models identified by state behavioral health service systems and organizations. All models in this report are designed and used specifically to address trauma in the lives of children, their parents or caregivers, and adults.
  27. Monroe County Research to Practice Council White paper – Creating a Trauma Informed System of Care. (PDF, 263KB). This white paper discusses the impact of child trauma in Monroe County, New York. The document was developed to provide information concerning the role trauma plays and identifies steps to be taken in order to transform a community’s child serving culture to one that is authentically trauma informed.
  28. Moving Toward Trauma-Informed Child Welfare: Examples from the field. Julie Collins. Children’s Voice. July/August 2011. This article discusses the growing shift towards creating trauma-informed child welfare agencies.
  29. NCCTS Leadership: Trauma-Informed Systems. (PDF, 100KB). NCTSN. 2009. This article highlights the need for trauma-informed systems and discusses initiatives and publications to transform systems into trauma-informed child-serving systems.
  30. New Directions in Child Abuse and Neglect Research. (PDF, 795KB). Institute of Medicine of the National Academies. Report Brief. September 2013. This report is an update to the 1993 publication “Understanding Child Abuse and Neglect.” In this report, an argument is made for a coordinated, national research study with high-level federal support due to the uniqueness of trauma experiences.
  31. Parenting a Child Who Has Experienced Trauma. (495 KB) This factsheet discusses the nature of trauma, especially abuse or neglect, the effects of trauma on children and youth, and ways to help a child who has experienced trauma. Parents or foster parents who do not understand the effects of trauma may misinterpret their child’s behavior, and attempts to address troubling behavior may be ineffective or, in some cases, even harmful. By understanding trauma, parents and foster parents can help support a child’s healing, the parent-child relationship, and their family as a whole.
  32. Post-Traumatic Stress Disorder and Children in Foster Care. Information Packet. (PDF, 585KB). Hieger, J, Ariyakulkan L, Serdjenian, T. National Resource Center for Permanency and Family Connections. December 2012. Federal legislation can support diagnosis and treatment of PTSD among children in foster care. A provision of The Fostering Connections to Success and Increasing Adoptions Act of 2008 requires all states to increase their oversight of the health and mental health of foster care children, including initial and follow up health assessments to determine whether a child needs additional help. This document highlights states that have amended their policies and implemented programs to meet these legislative mandates.
  33. Promoting Recovery and Resilience for Children and Youth Involved in Juvenile Justice and Child Welfare Systems. SAMHSA May 9, 2012. This publication from SAMHSA is in support of National Children’s Mental Health Awareness Day. Topics in this publication include the need for trauma-informed services in child welfare and juvenile justice, SAMHSA initiatives providing trauma-informed services, and the experiences of children in child welfare and juvenile justice.
  34. Responding to Childhood Trauma: The Promise and Practice of Trauma Informed Care. (PDF, 369KB). Pennsylvania Office of Mental Health and Substance Abuse Services. February 2006. The goal of this paper is to build on comprehensive efforts by the National Technical Assistance Center for Mental Health Planning (NTAC), the National Association of State Mental Health Program Directors (NASMHPD) and others, to increase appreciation of the relevance of trauma in understanding children and in planning to meet their needs.
  35. Restraint/Seclusion Bill Introduced in U.S. House of Representatives. (PDF, 34KB). May 6, 2013. Congressman George Miller (D-CA), ranking member of the House Education & Workforce Committee and Congressman Gregg Harper (R-MS) introduced the Keeping All Students Safe Act, HR 1893, a bill to protect all students nationwide from restraint and seclusion.
  36. San Francisco’s El Dorado Elementary uses trauma-informed & restorative practices; suspensions drop 89%. Social Justice Solutions. Posted 1/29/2014. This article discusses El Dorado Elementary School’s experience in implementing UCSF Healthy Environments and Response to Trauma in Schools (HEARTS), a comprehensive, multilevel school-based prevention and intervention program for children who have experienced trauma.
  37. Strengthening Policies to Support Children, Youth, and Families Who Experience Trauma. (PDF, 1MB). Unclaimed Children Revisited. Working Paper No. 2. National Center for Children in Poverty. Columbia University. July 2007. This paper focuses on policies to address child trauma. This paper discusses trauma and its effects, inadequacies of current service and policy responses, emerging best practices, and recommendations.
  38. The System of Care Trauma-Informed Agency Assessment (TIAA) (1 MB). is an in-depth, validated data-collection tool designed by dedicated family, youth and agency staff to identify areas of strength and pinpoint areas for improving trauma-informed service. It is designed to meet agencies and communities where they are at, and to build on established successes. TIAA data guides change according to each organization’s unique strengths and needs. The assessment can be adapted for single or multi-agency use and its language modified to suit agency norms. Programs can be added to it that reflect a full service array, e.g., multi‐systemic therapy, substance abuse, co‐occurring, or day treatment services. Where data already exists on an environment’s physical and emotional safety, youth and family empowerment, trustworthiness, trauma competence or cultural competence, components of the TIAA can be used to enhance existing data collection.
  39. Testifying in Court about Trauma: The Court Hearing. Tip Sheet for Clinicians. NCTSN. “Testifying in court can be a difficult and stressful experience for clinicians. But judges and lawyers are not experts in child development or the impact of trauma on children. The knowledge clinicians bring to bear is essential if the legal system is to have any hope of making sound decisions that will serve children’s interests. By educating the court through testifying, clinicians provide an invaluable service to the legal system and, most importantly, to children.” This tip sheet provides essential information for what to expect when testifying in court about trauma.
  40. THRIVE - Maine’s Trauma-Informed System of Care: Final Evaluation Report. (PDF, 2MB). Maine Department of Health and Human Services. August 2012. This report discusses the outcomes of Maine’s THRIVE Initiative, a system of care for children, youth, and families with a focus on trauma-informed practices.
  41. Trauma among Girls in the Juvenile Justice Systems (141KB). This report by the NCTSN explains why there are increasing numbers of girls in the juvenile justice system, the prevalence of trauma among this population, the impact of the juvenile justice system on traumatized girls, and gender-responsive programming.
  42. Trauma and Resilience: A New Look at Legal Advocacy for Youth in the Juvenile Justice and Child Welfare Systems. (PDF, 394KB). This report from the Juvenile Law Center provides a vital look at how system involvement – in the juvenile justice or child welfare system – can cause trauma, or exacerbate underlying trauma caused by sexual abuse, violence, the death of a loved one, witnessing violence, and other experiences. The report emphasizes the opportunity to support resilience in youth, and also recognizes the risk of lifelong damage from unaddressed trauma. The publication sets forth key risks and opportunities related to the use of trauma research in advocacy on behalf of youth in the juvenile justice and child welfare systems, and includes both strategies for individual advocates and policy recommendations for changing the system.
  43. Trauma histories among justice-involved youth: findings from the National Child Traumatic Stress Network. (PDF, 360KB). Dierkhising CB et al. European Journal of Psychotraumatology. 2013;4:1-12. This study describes detailed trauma histories, mental health problems, and associated risk factors (i.e., academic problems, substance/alcohol use, and concurrent child welfare involvement) among adolescents with recent involvement in the juvenile justice system. The results indicate that justice-involved youth report high rates of trauma exposure and that this trauma typically begins early in life, is often in multiple contexts, and persists over time. Findings provide support for establishing trauma-informed juvenile justice systems that can respond to the needs of traumatized youth.
  44. Trauma-Informed Care: Opportunities for High-Need, High-Cost Medicaid Populations (262 KB). March 2015. This brief developed by the Center for Health Care Strategies, provides an introduction to trauma‐informed care and describes how it can be adopted to better serve high‐need, high‐cost Medicaid populations, including examples from three innovative programs across the country. The brief draws from the experiences of organizations in the Center for Health Care Strategies’ Complex Care Innovation Lab, made possible by Kaiser Permanente Community Benefit to uncover new ways to improve care for individuals with complex medical and social needs.
  45. Trauma-Informed Care in Behavioral Health Services. (PDF, 5MB)Treatment Improvement Protocol (TIP) Series 57. Substance Abuse and Mental Health Services Administration. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014. This treatment improvement protocol targeted towards behavioral health service providers and administrators provides a trauma-informed care framework for behavioral health services. This TIP is divided into three parts: (1) A Practical Guide for the Provision of Behavioral Health Services, (2) An Implementation Guide for Behavioral Health Program Administrators, and (3) A Review of the Literature.
  46. Trauma Sensitive Schools. The Trauma and Learning Policy Initiative’s (TLPI) mission is to ensure that children traumatized by exposure to family violence and other adverse childhood experiences succeed in school. As part of this effort TLPI published Helping Traumatized Children Learn (HTCL), which introduces the Flexible Framework, a tool organized according to six core operational functions of schools that can help any school create a trauma sensitive learning environment for all children. The publication consists of two volumes, Volume 1) A Report and Policy Agenda and Volume 2) Creating and Advocating for Trauma-Sensitive Schools.

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Additional References

  1. A statewide introduction of trauma-informed care in a child welfare system. Kramer TL, Sigel BA, Conners-Burrow NA, Savar PE, Tempel A. Children and Youth Services Review. 2013;35:19-24. The purpose of this paper is to show results from an evaluation for the first phase of a trauma-informed training program for the Arkansas Division of Child and Family Services (DFCS). The initial phase consisted of DFCS area directors and supervisors participating in 10 regional, 2-day workshops modeled after the NCTSN trauma informed training for child welfare.
  2. Addressing the Impact of Trauma Before Diagnosing Mental Illness in Child Welfare. Griffin G, McClelland G, Holzberg M, Stolbach B, Mai N, Kisiel C. Child Welfare. 2011;90(6),69-89. Congress now requires child welfare systems to respond to emotional trauma that stems from child maltreatment and removal from home. In this study, 14,000 clinical assessments from Child Welfare in Illinois were analyzed. Based on the results, three recommendations are made-1) trauma screening and assessments are conducted of all youth in child welfare, 2) evidence-based, trauma-focused treatment begin when a child demonstrates a trauma-related symptom, and 3) clinicians should not diagnose a child with a mental illness without first addressing the impact of trauma.
  3. Creating Trauma-Informed Systems: Child Welfare, Education, First Responders, Health Care, Juvenile Justice. Ko SJ, et al. Professional Psychology: Research and Practice. 2008;39(4):396-404. This article reviews how traumatic stress impacts children and adolescents' daily functioning and how various service systems approach trauma services differently. It also provides recommendations for how to make each of these service systems more trauma informed and an appendix detailing resources in the National Child Traumatic Stress Network that have been produced to meet this objective.
  4. Linking Child Welfare and Mental Health Using Trauma-Informed Screening and Assessment Practices. Conradi L, Wherry J, Kisiel C. CH. Child Welfare, 2011;90(6):129-147. This paper provides a concrete definition of trauma-focused screening and highlights how that differs from a more comprehensive trauma-focused assessment process and a psychological evaluation. The authors also highlight existing trauma-focused screening and assessment tools that are used widely within child welfare system and the challenges related to integrating trauma-focused screening practices into child welfare. The authors provide recommendations for ways in which child welfare jurisdictions can integrate trauma-focused screening practices into their daily practice.
  5. Mandated Reporting of Child Abuse and Neglect. A Practical Guide for Social Workers. Lau K, Krase K, Morse RH. December 2008. This book provides clear definitions of different types of child abuse, including physical, sexual, and emotional, and delineates guidelines on how to identify risk factors and signs of child maltreatment. The authors also clarify difficult ethical issues, including client confidentiality and privileged communication, and present numerous case studies and theoretical vignettes culled from their own experiences as social workers.
  6. Trauma-informed care training in a child welfare system: Moving it to the front line. Conners-Burrow NA, Kramer TL, Sigel BA, Helpenstill K, Sievers C, McKelvey L. Children and Youth Services Review. 2013;35:1830-1835. This study evaluates an initiative in Arkansas to train child welfare front-line staff members in trauma-informed care practices. This study evaluated the impact of training on knowledge and use of trauma-informed care practices among case workers, program assistants, and other front life staff. Results showed that the training process was highly successful in improving knowledge of trauma-informed care practices, especially among staff members with the least formal education and training.

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