Academic journal article Child Welfare

Creating More Trauma-Informed Services for Children Using Assessment-Focused Tools

Academic journal article Child Welfare

Creating More Trauma-Informed Services for Children Using Assessment-Focused Tools

Article excerpt

This article promotes integrating assessment and evidence-based practice in the treatment of traumatized children through a review of two newly developed trauma assessment tools: (1) the Child Welfare Trauma Referral Tool (CWT), and (2) Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP). These tools use pathways and algorithms to increase understanding of individual child trauma victims, and assist professionals working with children to make appropriate referral and treatment decisions within both child welfare and mental health contexts.

This article presents two tools to assist professionals in the fields of child welfare and mental health working with child trauma victims: The Child Welfare Trauma Referral Tool (CWT) and Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP). The CWT can be used to guide caseworkers in making appropriate referrals for mental health treatment. The TAP model can be used to guide therapists' decisions about treatment models that will most benefit the child. These tools use pathways and algorithms to link children with the most appropriate treatment interventions. They may be used alone, or in sequence. When used sequentially, they increase the probability that child trauma victims will receive the most appropriate mental health services. Both tools were developed from the collaborative efforts of the Chadwick Center for Children and Families, Rady Children's Hospital and Health Center in San Diego, California, and the National Child Traumatic Stress Network (NCTSN).

This paper will explore the impact of trauma on children and explain the importance of conducting a thorough assessment of the child's trauma history and current psychological and behavioral problems. We will introduce the first pathway, the Child Welfare Trauma Referral Tool (CWT), and using a case example, discuss how this tool has helped caseworkers within San Diego County make appropriate mental health referrals for children involved in the Child Welfare System. We will then review the second pathway, Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP). TAP provides a framework for clinicians interested in using evidence-based assessment and treatment practices. It uses standardized measures to augment customary assessment methods (i.e., clinical interviews and observation), helps clinicians to better understand child clients, and informs clinical decisions regarding appropriate treatment models and interventions. We will share a case in which the TAP model helped a clinician to more clearly conceptualize a client and identify the most appropriate form of treatment.

Impact of Trauma

Children exposed to trauma often experience both immediate and long-term difficulties. Common short-term psychological reactions to childhood trauma include depression, anxiety, anger, conduct problems, learning impairments, dissociation, posttraumatic stress symptoms, and proximal and distal developmental disturbances (Cahill, Kaminer, & Johnson, 1999; Kendall-Tackett, Williams, & Finkelhor, 1993; Lanktree, Briere, & Zaidi, 1991; Putnam, 2003; Pynoos, Steinberg, & Wraith, 1995). Evidence also exists in children with neurological impairments resulting from extreme exposure to child abuse and neglect (Perry, 2006). Research on the long-term consequences of childhood trauma shows that an increase in lifethreatening diseases like cancer, alcoholism, diabetes, and obesity, as well as a greater likelihood of depression and suicide attempts (Felitti et al., 1998) can be correlated to such trauma. Because childhood trauma can have such a far-reaching impact, it is important to focus on identifying at-risk children in need of trauma-informed therapy early and connect them with appropriate therapeutic resources.

Importance of Assessment in Trauma Treatment

Gaining an adequate understanding of the client is important for making appropriate clinical decisions about treatment. …

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