The impact of a statewide trauma-informed care initiative in child welfare on the well-being of children and youth with complex trauma

The current study examined the effectiveness of three trauma treatments in the context of a statewide, trauma-informed child welfare initiative to improve outcomes for children with complex trauma. Clinicians enrolled 842 children (birth-18 years) involved in the child welfare system within the past year and administered measures at up to three time points (baseline, 6 months, 12 months) to assess children's behavior problems, symptoms of posttraumatic stress disorder (PTSD), and strengths and needs using parent/caregiver, youth, and clinician report measures. The results of four-level regression models specified to account for non-independence of observations within children, and among clinicians and within agencies, indicated that trauma treatment was associated with significant improvements in child behavior problems, PTSD symptoms, strengths, and needs. However, results differed by treatment model, with optimal outcomes for children receiving Attachment, Self-Regulation and Competency (ARC) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Positive findings across multiple child outcomes suggest that trauma treatment is an effective means of improving the developmental trajectories of children with complex trauma, but that each model has specific strengths and weaknesses that should be taken into account when selecting a treatment model for this population.