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October 2019Vol. 20, No. 8Study on the Effectiveness of a Trauma-Informed Care Initiative

An article in the journal Child Maltreatment discusses a study conducted as part of New Hampshire's Partners for Change project, a trauma-informed 5-year initiative funded by the Children's Bureau from 2012 to 2017 to improve the social-emotional well-being and developmentally appropriate functioning of children and families served by the New Hampshire Division for Children, Youth and Families (DCYF). New Hampshire was also one of 20 grantees tasked with implementing trauma-informed care in their state or tribal child welfare systems.

The project's objectives included the following:

  • To implement universal screening for trauma exposure, posttraumatic symptoms, and well-being needs of all children and youth involved with child protective services and the juvenile justice system
  • To use data-driven case planning informed by trauma-screening results
  • To enhance progress monitoring through rescreening and increased coordination between child welfare and mental health providers
  • To increase trauma-focused competencies among child welfare staff
  • To increase collaboration between child welfare and community-based behavioral health services
  • To monitor the use of psychotropic medication
  • To assist mental health providers in using evidence-based trauma treatments
  • To realign service array strategies

The study focused on DCYF child protective services and juvenile justice staff and supervisors in 10 district offices. Participants in each district office were randomly assigned to either the early intervention group or the late intervention group. The survey covered the domains of trauma screening, case planning, mental health and family involvement, progress monitoring, collaboration, and perceptions of the state's overall system performance.

The following are some key findings of the study:

  • Prior to the intervention, most of the domains were moderately intercorrelated, suggesting that the behaviors and attitudes associated with trauma-informed care are part of a broader grouping of trauma-informed skills and knowledge.
  • Case-planning practices were positively related, although only modestly, to frequency of progress monitoring and trauma screening.
  • Trauma-screening practices were modestly associated with more positive attitudes toward system performance and higher mental health referral/family involvement practices.

The article also discusses future directions and study limitations.

"Effectiveness of a trauma-informed care initiative in a state child welfare system: A randomized study," by M. Kay Jankowski, Karen E. Schifferdecker, Rebecca L. Butcher, Lynn Foster-Johnson, and Erin R. Barnett (Child Maltreatment24), is available at