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October 2019Vol. 20, No. 8Preventing Adverse Experiences in Child Welfare

Written by Jerry Milner and David Kelly

As a field, when we most commonly think about and discuss trauma-informed care, we usually think in terms of adverse experiences that have already occurred. We are trained on how to recognize trauma and how to provide clinical interventions to parents and children who have experienced trauma at some point in their lives. This approach of looking back to understand how to move forward has helped us to become more conscientious and effective in working with individuals who have experienced trauma so that we are less likely to compound it. Such efforts have helped us make some progress in developing more effective ways to serve and support people who have experienced adversities and the trauma that so often follows.

All of this is helpful, and all such efforts are clearly relevant to our work in child welfare.

However, we should be equally, if not more, committed to thinking about how we can be proactive in going after the sources of trauma and adversity to prevent them from happening in the first place. We can apply our knowledge about prevalent causes of adversity and trauma that lead children and families to the child welfare system and organize ourselves with strength of purpose to address those causes.

A truly trauma-informed system should be one that looks forward to preventing trauma as well as looks backward at trauma that has already occurred.

Screening and scoring adverse childhood experiences (ACEs) is an area that receives considerable energy in the field. We know that the ACEs scores for many, if not most, of the parents and children that make contact with child welfare are likely to be high. While some ACEs are beyond the scope of child welfare and may be unavoidable (e.g., the death of a parent), many are brought about by the lack of protective capacities of parents in caring for their children.

When we, as a broad child and family serving system—not only the child welfare agencies—work together to create environments and conditions where families can thrive and children are free from harm, we work in support of building and strengthening protective capacities. And when we strengthen the protective capacities of parents, we create the potential for fewer ACEs in the lives of children that require "fixing" through clinical interventions.

For example, when we universally link parents and newborn infants with home visiting programs from the beginning, we have incredible opportunities to help those children avoid traumatic experiences and enable parents to not be unduly affected by their own adversity. When we make community-based family resource centers available to all families in a community, we have opportunities to support them before avoidable traumatic events overtake them. But when we remove children from their families—even when necessary for safety reasons—we often create additional adversity that is compounded when children move from home to home and remain in care for extended periods of time. Inadequate parent-child contact while a child is in out-of-home placement is an additional source of adversity and trauma, as is emancipating after years of foster care without the connections, relationships, and skills to make it in the world. These things may not be officially on the list of ACEs, but they comprise sources of avoidable trauma for so many in the child welfare system. We have to go on the offensive against the sources of adversity and trauma if we expect to have a true trauma-informed or trauma-oriented system.

Over the past 2 years, we have visited family resource centers, family enrichment centers, and family support centers in multiple states and have seen the range of supports they provide families. We have heard directly from families that speak to how these community resources have helped them in times of need to remain healthy, enhance their skills, and decrease their social isolation. 

We have also had the pleasure to go on home visits with visiting programs and watched as young mothers asked questions and received support in their own homes. We have witnessed the strength of relationships between visitors, like Summer in Albany and Faith in South Carolina, and young parents trying to raise their children safely.

Until we organize around and commit to strengthening families—all families—to gain resiliency and the protective capacity needed to care for their children safely as well as provide families with the supports they need to make it through difficult times, adversity, trauma, and ACEs scores will continue to be high.  If we are serious about being trauma informed, we have to be serious about reducing adversity in the first place not just scoring and trying to fix it after it has happened.