Trauma Systems Therapy Effective
A pair of longitudinal studies published in 2017 demonstrate both the complexity of implementing trauma systems therapy (TST) in child welfare, and the substantially improved outcomes for foster children when a child welfare system implements it. The studies show that no single provider in the system is key to its success, but rather that it is important to include all the providers in training on trauma informed care, Including, therapist, case managers, supervisors, and foster parents.
The outcomes for the children were remarkable. “Results indicate that, as children's care teams implement TST, children demonstrate greater improvements in functioning, emotional regulation, and behavioral regulation and they experience increased placement stability. Moreover, results demonstrate that positive effects of implementation of TST are produced by both those who work closely with the child (caregivers, case managers, and therapists) and those who work more distally with the child (case manager supervisors and family service coordinators), suggesting that no one staff member or caregiver is central to providing trauma-informed care; rather it may be the confluence of the TST skills of the child's entire care team that produces better outcomes.” (Murphy, Anderson Moore, Redd, Malm, 2017, p. 23) It is particularly important to note that there was a dose effect. The longer a child received TST the higher their level of placement stability. In addition, non-clinical staff and foster parents can effectively implement TST.
The implementation of TST demonstrated that this sort of transformation is difficult, but ultimately worth the effort. “We found the process of implementing and expanding TST demanding, iterative and complex, yet ultimately TST was implemented across levels. The majority of staff and foster parents completed training in TST, and fidelity measures showed progress in TST use over time. KVC's implementation of TST provided both the knowledge and the tools necessary for foster parents to better care for the children in their homes. KVC's efforts show it is possible to infuse trauma-informed care into a large child welfare organization across all levels of care.” (Redd, Z., Malm, K, Moore, K., Murphy, K. Beltz, M., 2017, p. 170) In addition, “While similar too public child welfare systems in the numbers of children and families served and the numbers of staff employed, the long tenure and commitment of KVC administrators who were responsible for implementation of TST is rare. The effort to infuse trauma-informed care into their overall system of care was not viewed as a “one-time” initiative or one that would get subsumed by new priorities.”( Murphy, Anderson Moore, Redd, Malm, 2017, p. 32)