Reducing the Harms of Childhood Trauma

Repeated traumatic experiences in childhood can have a strong, lasting impact on a person’s future health, behavior, and success. As the number of these experiences increases, the risk of harm related to physical and mental health, academic and professional performance, and early substance use in adulthood can also increase. Forms of trauma include child abuse, neglect, grief, loss, separation from family, and placement in welfare, among other stressors. Complex trauma occurs when these experiences start early in childhood and accumulate. Within child welfare systems, the likelihood of anxiety and depression is higher among children with complex trauma.

In April of 2018, two fatal cases of child abuse in Maine brought attention to how things can go incredibly wrong when a state’s welfare system fails to identify dangerous maltreatment situations. Approaching child welfare with a practice that helps monitor, address, and overcome trauma has potential to improve how child abuse and neglect are tackled on a system and state level. Trauma-informed initiatives also equip case-workers with tools to manage responses to their own trauma that might result from being exposed to their clients’ experiences.

The Massachusetts Child Trauma Project ran from 2011 to 2016, with a goal of using trauma-informed practice to help children with complex trauma under the care of the state’s welfare program. It emphasized increased training for caseworkers to employ protocols and guidelines for trauma-informed approaches so that clients can be more actively referred to evidence-based treatment options.

Physical abuse was 12% less likely in the intervention group of children who received care from programs using trauma-informed practice, compared to children who did not receive trauma-informed care.

Beth Barto and colleagues conducted a study to assess the impact of the Massachusetts project on cases of child maltreatment, as well as successful placement of foster children in stable and permanent families. The researchers compared experiences of children served by welfare offices that did not employ the project’s protocols to children served by offices that did, with the expectation that trauma-informed care would result in better outcomes.

The study’s results aligned with the researchers’ hypothesis that children whose caseworkers followed the Massachusetts Child Trauma Project’s protocol saw better outcomes overall. Physical abuse was 12% less likely in the intervention group of children who received care from programs using trauma-informed practice, compared to children who did not receive trauma-informed care. Neglect was 14% less likely among children in the intervention group. In terms of permanency of placement of children in the welfare system, those who received trauma-informed care were 21% more likely to be adopted than those served by programs without trauma-informed protocol. Compared to long-term foster care, children who are successfully adopted experience more stability and have improved mental health.

The researchers emphasize that policy makers consider investing in trauma-sensitivity training for state welfare programs. They also suggest that collaborations between mental health and child welfare services, as well as changes in their practices to incorporate more trauma-informed approaches, may lead to improved coordination of care for children and better health, academic performance, and life success.

Feature image: tom_t.photography, Lost Teddy? used under CC BY-NC-ND 2.0