March 2023Vol. 24, No. 2Healing-Centered and Trauma-Responsive Care Across Child Welfare for Better Youth Engagement

Written by the Capacity Building for States (including contributions by young adult consultants Brandy Hudson and Julia Mueller)

Trauma results from events that are experienced by individuals as physically or emotionally harmful and that have lasting adverse effects on functioning and well-being (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). Research shows that children exposed to maltreatment often experience traumatic stress with profound long-term consequences for their futures (Child Welfare Information Gateway, 2020). Young people in foster care have particularly high rates of trauma exposure (Casey Family Programs, 2018). Similar to the families and young people they partner with, child welfare caseworkers also are more likely than the general population to experience secondary traumatic stress, which is the emotional duress that occurs when an individual hears about the firsthand trauma experiences of others on a regular basis (National Child Traumatic Stress Network, 2011).

Combined with other workforce challenges, secondary stress can lead to burnout, which is a progressive process characterized by emotional exhaustion, depersonalization, and reduced sense of personal accomplishment that, in a workplace setting, is often attributed to organizational characteristics or stressors (Rienks, 2020). This may lead to reduced levels of engagement. Young people who work with child welfare systems can also experience burnout as a result of their time in care, in addition to their efforts to transform child welfare systems.

Finally, both staff and young people in the child welfare system (especially individuals identifying as Black, Indigenous, or people of color) may experience feelings of moral injury (the psychological damage caused when individuals are put in a position of representing policies and taking actions that conflict with their moral code), which may lead to additional traumatic stress (Seymour, 2021).

The following challenges and sample solutions can help agencies consider how to improve engagement at their agencies by focusing on access to trauma-responsive and healing-centered care.

Challenge: Burnout Among Caseworkers and Young People

Sample Solution: Access to Trauma-Responsive Care

Trauma and burnout are common problems for both caseworkers and young people involved with child welfare. This is partly a result of experiencing (firsthand or secondhand) the challenges, emotions, and stresses related to the work of ensuring that children and young people are safe and able to have experiences that are similar to those of their peers not in foster care (i.e., normalcy).

Traumatic stress also can significantly affect engagement between caseworkers and young people by changing the way people process, retain, or understand information. For example, caseworkers with burnout may not be able to empathetically listen to the young people with whom they work or offer them the highest level of individualized care (SAMHSA, 2005). On the other hand, young people experiencing trauma may be less likely to provide meaningful input into their own case plans or engage fully with their caseworkers.

To address this challenge, it is critical for child welfare agencies to provide access to trauma-responsive care for both staff and the young people they serve. It’s important to note that trauma treatment exists on a continuum that begins with recognizing the presence of trauma and acknowledging the role trauma may play in an individual’s life and continues on to integrating knowledge about trauma into policies, procedures, and practices and building an organizational culture and climate that incorporates the needs of individuals with trauma (including caregivers) in every aspect (Buffalo Center for Social Research, n.d.; SAMHSA, 2014).

Examples of trauma-responsive care that highlights healing and resilience may include the following:

• Training staff on the principles of trauma-responsive care and how they can apply it to their work with young people, including looking for simulation training or other opportunities for staff to practice using trauma-responsive principles
• Ensuring that young people and child welfare staff can access trauma treatment and resources (e.g., access to therapists, group therapy, published or digital resources on trauma and self-care) on a regular basis, including the participation of young people in group therapy or wellness activities together with caseworkers to build a shared understanding of trauma and find communal ways to address it
• Building the capacity of trauma treatment providers to support young people and staff in the child welfare system
• Training staff on burnout and self-care to address it, including incentives and paid leave for participation in self-care (National Child Welfare Workforce Institute, 2021)

Challenge: Feelings of Depersonalization Due to Trauma Response

Sample Solution: Focusing on Healing-Centered Engagement and Individualized Service Provision

Traumatic stress and burnout can lead to feelings of detachment that may interfere with meaningful engagement and partnership. This may result in both caseworkers and young people feeling “detached” or “tuned out” from each other and not being able to actively listen and process information or their own emotions.

An important part of addressing this challenge involves a focus on healing-centered engagement. This approach is strengths based and emphasizes culture, spirituality, civic action, and collective healing. A healing-centered approach emphasizes that a person is much more than their trauma and highlights the ways in which trauma and healing are experienced collectively (Ginwright, 2018). This type of holistic engagement is the foundation for any organizational trauma-informed or trauma-responsive approach.

The following are additional ways child welfare agencies can address feelings of depersonalization among both young people and child welfare staff:

• Creating a welcoming environment at the agency that facilitates conversation (e.g., comfortable chairs and couches, access to water or warm drinks) rather than a sterile, siloed one (e.g., cubicles)
• Encouraging young people and staff to maintain strong connections to their cultural identity since there is evidence that it contributes to mental health resilience, higher levels of social well-being, improved coping skills, and other benefits (Stafanson, 2019)
• Hiring staff with lived experience who can better understand what young people are experiencing because they have also been there
• Providing time for caseworkers to process their emotions as they go from case to case to make it possible for them to fully focus on each one

By implementing the principles of trauma-responsive care and healing-centered engagement, agencies can improve communication between caseworkers and young people, which can lead to a better understanding of young people’s needs and better outcomes going forward.

References

Buffalo Center for Social Research. (n.d.). What is trauma-informed care? University at Buffalo. https://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html

Casey Family Programs. (2018). Why should child protection agencies become trauma-informed? https://www.casey.org/media/SComm_Trauma-informed-1.pdf

Child Welfare Information Gateway. (2020). The importance of a trauma-informed child welfare system. https://www.childwelfare.gov/pubs/issue-briefs/trauma-informed/ 

Ginwright, S. (2018, May 31). The future of healing: Shifting from trauma informed care to healing centered engagement. Medium. https://ginwright.medium.com/the-future-of-healing-shifting-from-trauma-informed-care-to-healing-centered-engagement-634f557ce69c

National Child Traumatic Stress Network. (2011). Secondary traumatic stress: A fact sheet for child-serving professionals. https://www.nctsn.org/resources/secondary-traumatic-stress-fact-sheet-child-serving-professionals

National Child Welfare Workforce Institute. (2021). Building a resilient workforce to address trauma and enhance well-being: Supporting self-care at the system level. https://ncwwi-dms.org/resourcemenu/resource-library/organizational-culture-and-climate/1657-key-takeaways-from-building-a-resilient-workforce-to-address-trauma-and-enhance-well-being-connecting-to-cultural-ways/file

Rienks, S. L. (2020). An exploration of child welfare caseworkers’ experience of secondary trauma and strategies for coping. Child Abuse & Neglect, 110, 104355. https://doi.org/10.1016/j.chiabu.2020.104355

Seymour, M. (2021, August 25). Moral injury [Video]. University of Minnesota. https://mediaspace.umn.edu/media/t/1_sgb2el4e/170899212

Stafanson, A. H. (2019, November 20). Supporting cultural identity for children in foster care. Child Law Practice Today. https://www.americanbar.org/groups/public_interest/child_law/resources/child_law_practiceonline/january---december-2019/supporting-cultural-identity-for-children-in-foster-care/

Substance Abuse and Mental Health Services Administration. (2005). Addressing burnout in the behavioral health workforce through organizational strategies. U.S. Department of Health and Human Services. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/pep22-06-02-005.pdf

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. U.S. Department of Health and Human Services. https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884