Trauma-informed care in child/family welfare services

Trauma-informed care in child/family welfare services

Summary

This paper aims to define and clarify what trauma-informed service delivery means in the context of delivering child/family welfare services in Australia. Exposure to traumatic life events such as child abuse, neglect and domestic violence is a driver of service need. Policies and service providers must respond appropriately to people who are dealing with trauma and its effects in order to ensure best outcomes for individuals and families using these services. In addition to evidence-based programs or clinical interventions that are specific to addressing trauma symptoms, such as trauma-focused cognitive behaviour therapy, there is a need for broader organisational- or service-level systems of care that respond to the needs of clients with a lived experience of trauma that go beyond a clinical response. Some of the challenges identified in implementing and embedding trauma-informed care across services and systems are discussed.

Key messages

  • Traumatic experiences are common, with people often having multiple adverse experiences across their life. There are many serious and deleterious outcomes associated with exposure to them.

  • Clients often present to child/family welfare services with a complex range of symptoms and behaviours related to prior and/or past trauma, which neither they nor those working with them have linked to this previous trauma exposure. As a result they may face an uninformed and fragmented response that is potentially re-traumatising.

  • There are a small number of trauma-specific interventions that have been evaluated using a rigorous scientific standard and been shown to be effective - however, the research is often based on populations who have experienced a single traumatic event rather than complex trauma.

  • Trauma-informed care is a framework for human service delivery that is based on knowledge and understanding of how trauma affects people's lives, their service needs and service usage.

  • With the lack of an overarching framework in Australia, there is a danger of inconsistent or piecemeal development of trauma-informed models and practices that do not share a consistent language or framework for implementing trauma-informed systems of care in child/family services.

  • As trauma affects a large proportion of the population, survivors are clients in a broad range of human services, and organisations across all settings should consider how a trauma-informed approach could benefit stakeholders, regardless of whether or not the organisation also provides evidence-based trauma-specific interventions.

  • Challenges to implementing a trauma-informed approach to care include: a lack of clearly articulated definitions (e.g. of trauma-specific interventions vs the concept and principles of trauma-informed care); translating trauma-informed care to specific practice and service settings; consistency across service settings and systems; care-coordination; a lack of guidance for facilitating complex system change; and a lack of evaluation of models of trauma-informed care.

  • Research is needed to explore whether different trauma-informed approaches are required for different population groups, including children, adolescents and adults, or for males and females.
Key messages: 

Traumatic experiences are common, with people often having multiple adverse experiences across their life. There are many serious and deleterious outcomes associated with exposure to them.

Clients often present to child/family welfare services with a complex range of symptoms and behaviours related to prior and/or past trauma, which neither they nor those working with them have linked to this previous trauma exposure. As a result they may face an uninformed and fragmented response that is potentially re-traumatising.

There are a small number of trauma-specific interventions that have been evaluated using a rigorous scientific standard and been shown to be effective - however, the research is often based on populations who have experienced a single traumatic event rather than complex trauma.

Trauma-informed care is a framework for human service delivery that is based on knowledge and understanding of how trauma affects people's lives, their service needs and service usage.

With the lack of an overarching framework in Australia, there is a danger of inconsistent or piecemeal development of trauma-informed models and practices that do not share a consistent language or framework for implementing trauma-informed systems of care in child/family services.

As trauma affects a large proportion of the population, survivors are clients in a broad range of human services, and organisations across all settings should consider how a trauma-informed approach could benefit stakeholders, regardless of whether or not the organisation also provides evidence-based trauma-specific interventions.

Challenges to implementing a trauma-informed approach to care include: a lack of clearly articulated definitions (e.g. of trauma-specific interventions vs the concept and principles of trauma-informed care); translating trauma-informed care to specific practice and service settings; consistency across service settings and systems; care-coordination; a lack of guidance for facilitating complex system change; and a lack of evaluation of models of trauma-informed care.

Research is needed to explore whether different trauma-informed approaches are required for different population groups, including children, adolescents and adults, or for males and females.

At the time of writing Liz Wall was a Senior Research Officer at the Australian Institute of Family Studies, Daryl Higgins was Deputy Director (Research) and Cathryn Hunter was a Senior Research Officer with the Child Family Community Australia information exchange at the Australian Institute of Family Studies.


The authors wish to acknowledge the valuable feedback of Cathy Kezelman, President, Adults Surviving Child Abuse and contribution of Antonia Quadara, Research Fellow, Australian Institute of Family Studies.


Cover image: © istock/ KatarzynaBialasiewicz

CFCA Paper
37
19 pp.
ISSN: 
2200-4106
ISBN: 
978-1-76016-068-5