Angelique Day

Foster Care Youth Share Stories of Trauma Before, During, and After Placement: Youth Voices for Building Trauma-Informed Systems of Care

Many research studies address child trauma experiences that take place before foster care placement. However, few studies focus on the types and patterns of trauma experiences that reportedly take place during and after foster care placement; that is, after entry into adult living. This study examined the testimony of 43 foster care youth who spoke to a listening panel comprised of state legislators, child welfare professionals, and university educators. Qualitative analyses of transcribed text data revealed 3 main themes. First, the youth reported experiencing trauma before, during, and after placement. Second, the youth described trauma events and situations that were chronic (i.e., intense, composite, or cumulative). Third, youth offered suggestions for reducing traumatic experiences for foster care youth. They recommended earlier family interventions, access to people who listen and care, improved parenting skills for foster parents, continuity of relationships, and opportunities for leadership for foster youth. Foster youth voices offer important suggestions for building, strengthening, and evaluating trauma-informed systems of care.

School Staff Perspectives on the Challenges and Solutions to Working With Court‐Involved Students

BACKGROUND Court-involved students, such as those in foster care and the juvenile justice system, generally experience high incidences of both acute and chronic trauma, adversely impacting their educational well-being and overall academic trajectory. Utilizing perceptions of teachers and other school staff, this study explores the challenges and needs of school personnel working with this student population. METHODS Participants were school personnel employed at a Midwest, urban, public charter school during the 2012-2013 academic year. Focus groups explored the perceptions of school staff members working with court-involved students to develop a staff training curriculum. Focus groups also were conducted after the training intervention to get feedback from participants and identify remaining challenges. Focus group data were analyzed and results were member-checked with study participants. RESULTS Findings included 7 major themes (14 subthemes) regarding student behaviors that were challenging for school staff to manage. Themes included trauma-related behaviors, attachment-related behaviors, staff preintervention needs, intervention feedback, and staff postintervention needs. CONCLUSIONS Teachers and school staff can play a role in the educational well-being of court-involved youth. However, they need trauma-specific knowledge and resources to be effective.

Evaluation of a trauma-informed school intervention with girls in a residential facility school: student perceptions of school environment

In response to the high nationwide prevalence of psychological trauma among court-involved youth who have been exposed to abuse and neglect and the associated far-reaching adverse consequences, there are calls to develop a trauma-informed workforce across the various systems (child welfare, juvenile justice, mental health, and education) designed to serve this population. We describe a pilot test of a modified version of the Heart of Teaching and Learning (HTL) curriculum, an intervention designed to increase trauma-informed practices in education settings. This program was implemented in a public charter school that exclusively serves court-involved youth placed in residential treatment. The intervention was associated with decreases in trauma symptoms experienced by youth. Because student perceptions of teachers were high both before and after implementation of the curriculum, no statistically significant changes were observed. The article concludes with a discussion of the ways in which the curriculum can be used to help prepare a national education workforce capable of implementing trauma-informed evidence-based practices in school settings.

Use of the Monarch Room as an Alternative to Suspension in Addressing School Discipline Issues Among Court-Involved Youth

Suspension is commonly used in schools, yet these practices can adversely affect students’ education well-being and do not improve student behavior. This study assesses the use of the Monarch Room (MR) intervention, a trauma-informed alternative to school discipline suspension policies, among 620 court-involved girls placed in residential care and enrolled in an urban-located public charter school. Teachers readily utilized the intervention as a first response to dealing with problematic behavior, and as a result, MR use significantly decreased reliance on suspension practices. Multiple stays in residential treatment and race were significant predictors of MR use.

Parents Describe Finding Income and Resources for Their Medicaid-Eligible Children With Disabilities

In the U.S. social system, the roles of work and parenthood are often in conflict, and this conflict is especially problematic for parents of children with special needs. This study was designed to give parents an opportunity to describe their experiences in finding income and resources while caring for a Medicaid-eligible child with a chronic illness or disability. Three themes emerged: work and parenting responsibilities constantly intersected; resources for families were often insufficient or unavailable; and when parents received help, the helpers took extraordinary measures. Findings were compared to those of emerging literature; in addition, parents offered many practice and policy suggestions. Ecological and social construction theory frames were supported, including a need for family-focused perspectives.

Predictors and Outcomes of School Attachment and School Involvement in a Sample of Girls in Residential Treatment

ABSTRACT Researchers examined associations between number of schools attended, school attachment and involvement and social support among 86 girls (mean age = 15 years) living in a residential treatment center. Associations among school attachment and school involvement and symptoms of depression were also explored. Results indicated no association between numbers of schools attended and school attachment, involvement, or social support. Classmate support and support from people in school in general were significant predictors of school attachment and involvement, although teacher support was not. School attachment and involvement were not related to students’ reported symptoms of depression. Implications for policy and practice are discussed.

American Indians’ Response to Physical Pain: Functional Limitations and Help-Seeking Behaviors

Seventy-five American Indians, ages 25 to 84, representing 14 tribal nations, participated in this study. The historical, cultural, and behavioral responses to physical pain were examined. Data were collected over a 7-month period with a survey instrument that included the Universal Pain Scale, activities of daily living, causes of pain, cultural beliefs, and self-help-seeking behaviors. Also, recommendations for Western biomedical health care professionals are offered to improve services for the American Indian population. Findings demonstrate that culture plays a crucial role in wellness and significantly affects help-seeking behaviors, treatment regimens, responses to pain, and pain management.

Timely Health Service Utilization of Older Foster Youth by Insurance Type

PURPOSE To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of first well-child visits (health care physicals). METHODS A three-year retrospective study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 1,657 youth, ages 10-20 years, who were in foster care during the 2009-2012 study period was used to examine the odds of receiving a timely well-child visit within the recommended 30-day time frame controlling for race, age, days from foster care entry to Medicaid enrollment, and number of foster care placements. RESULTS Youth entering foster care during the HMO period were more likely to receive a timely well-child visit than those in the FFS period (odds ratio, 2.46; 95% confidence interval, 1.84-3.29; p < .0001) and days to the first visit decreased from a median of 62 days for those who entered foster care during the FFS period to 29 days for the HMO period. Among the other factors examined, more than 14 days to Medicaid enrollment, being non-Hispanic black and having five or more placements were negatively associated with receipt of a timely first well-child visit. CONCLUSIONS Those youth who entered foster care during the HMO period had significantly greater odds of receiving a timely first well-child visit; however, disparities in access to preventive health care remain a concern for minority foster care youth, those who experience delayed Medicaid enrollment and those who experienced multiple placements.

Oral Health Care Needs of Young Adults Transitioning from Foster Care

Children who have aged out of the foster care system face considerable barriers in accessing oral health care. Although this population of foster care alumni may have Medicaid insurance while they are in care to cover dental care, 39 percent of youths who have aged out of foster care do not have dental insurance. This mixed methods study examines factors that contribute to the oral health care disparities of children who have transitioned from foster care. Multivariate analysis revealed that foster care alumni without dental insurance are 93.5 percent less likely to have their dental needs met than those with dental insurance. Themes from the qualitative data indicated a lack of oral health care, quality-of-life issues, and lack of support to access ongoing dental care. Most state Medicaid programs do not provide comprehensive dental care for adults past the age of 20, contributing to oral health disparities among this population. The addition of oral health care coverage under the Patient Protection and Affordable Health Care Act of 2010 for foster care alumni would greatly enhance their quality of life. The article concludes with a discussion of the implications for the role of social workers in promoting oral health care for foster care youths.

Civic Literacy and Social Work Education: Results From a Multi-Site Study

ABSTRACT Given the decline in civic literacy among Americans, social work educators can no longer assume that students come prepared with the civic knowledge necessary for competent advocacy or policy practice. This article examines rates of civic knowledge among social work students at four social work education programs across the United States (U.S.). Findings indicate that although social work students score higher than the general U.S. adult population, their civic knowledge scores are still low, with nearly a third of these students falling in the failing range. Results suggest that social work students need additional content on civic knowledge.