Bartlett Jessica Dym, Barto Beth, Griffin Jessica L, Fraser Jenifer Goldman, Hodgdon Hilary, Bodian Ruth
Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, MA, USA
LUK Inc., Fitchburg, MA, USA.
Child Maltreat. 2016 May;21(2):101-12. doi: 10.1177/1077559515615700. Epub 2015 Nov 12.
Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC.
儿童虐待是一个严重的公共卫生问题，与儿童福利（CW）系统相关的创伤经历会使其有害影响更加复杂。创伤知情护理（TIC）是满足受创伤儿童需求的一种有前景的策略，但关于TIC在儿童福利系统中的影响的研究有限。本研究考察了马萨诸塞州儿童创伤项目的初步结果，该项目是儿童福利系统和心理健康网络中的一项全州范围的TIC倡议。实施1年后，儿童福利办公室的创伤知情领导团队成为TIC系统整合的关键架构，心理健康提供者参与基于证据的治疗（EBT）学习协作与创伤知情的个人及机构实践的改善相关联。经过大约6个月的EBT治疗，与基线相比，儿童的创伤后症状和行为问题有所减少。出现的TIC障碍包括儿童福利机构中与创伤相关工作的资源稀缺，以及很少有心理健康提供者为幼儿提供EBT。未来的研究可能会探索TIC在服务系统各组成部分中的差异，以及通过TIC传播的不同EBT模式产生不同效果的可能性。
