Gene Griffin

Constellations of Interpersonal Trauma and Symptoms in Child Welfare: Implications for a Developmental Trauma Framework

Patterns of trauma exposure and symptoms were examined in a sample of 16,212 children in Illinois child welfare. Data were collected on trauma histories, child and caregiver needs and strengths, and analyzed in light of the proposed Developmental Trauma Disorder diagnostic criteria. Youth exposed to both interpersonal violence and attachment-based (“non-violent”) traumas within the caregiving system had significantly higher levels of affective/physiological, attentional/behavioral, and self/relational dysregulation in addition to posttraumatic stress symptoms compared to youth with either type of trauma alone or in relation to other trauma experiences. These complexly traumatized children exhibited higher levels of functional impairment and were more likely to have placement disruptions and psychiatric hospitalizations. Findings suggest a developmental trauma framework can more adequately capture the spectrum of needs of these multiply traumatized youth than existing diagnostic formulations. Utilizing this framework for assessment, treatment planning, and intervention can lead to more targeted and effective services for these children.

Strengths Moderate the Impact of Trauma on Risk Behaviors in Child Welfare.

Objectives: To determine whether traumatic experiences of children entering the child welfare system have an impact on their risk behaviors and whether these behaviors are moderated by childrens strengths. Method: The Illinois Department of Children and Family Services administered the Child and Adolescent Needs and Strengths (CANS) measure to 8,131 children as they entered custody and analyzed Traumatic Experiences, Risk Behaviors and Strengths using polytomous logistic regression models. Results: Children entering child welfare have suffered multiple traumatic experiences. There is a strong linear relationship between the number of these experiences and the level of the childrens high risk behaviors. However, there is an interactive effect between traumatic experiences and childrens strengths on the risk behaviors, with strengths having a greater moderating effect as the number of traumatic experiences increases. Conclusions: Children entering the child welfare system present with complicated histories that include multiple traumatic experiences and multiple high risk behaviors. However, the more strengths these children have developed, the less likely they are to engage in high-risk behaviors. This resilience has major implications for both prevention and treatment.

Using a Trauma-Informed Approach in Juvenile Justice Institutions

Society struggles with mistreated, acting-out youth, vacillating between offering help and punishing. The Supreme Court has recently considered issues of adolescence and brain development when reviewing youth sentences; however, sentencing goals remain a local policy decision. Traditionally, our juvenile justice system follows either a punitive or a mental health model. This article offers a trauma-informed model, arguing that it is consistent with the Supreme Court’s approach and with sentencing goals. It reviews how the trauma-informed model differs from the two previous models, why this is preferable, and how to implement the new model in juvenile justice settings.

Infusing protective factors for children in foster care.

This article looks at an example of infusing protective factors into a child welfare system. Focusing on Illinois and its state child welfare agency, the article reviews some of the research on the relationship between risk behaviors and protective factors of traumatized youth. Next, it looks at adapting treatment and evidence-based early intervention practices to local child welfare settings. These interventions are placed in the wider context of a state plan to enhance protective factors. The article reviews how the state and local plans have been influenced by federal policies and how the Illinois experience might help refine future policy.

Understanding Bad Girls: The Role of Trauma in Antisocial Behavior Among Female Youth

There is a substantial body of research on delinquent behavior and symptoms of conduct disorder among young males; however, less attention has been dedicated to understanding the female population. The aim of this study is to examine young girls’ severity of needs related to conduct disorder and delinquent behavior in relation to various past traumatic experiences. We hypothesized that for girls the presence of these needs will be correlated with physical and sexual abuse. Furthermore, we propose the relationship of trauma to conduct-related needs will be higher among females as compared to males. Data were collected on 1,479 girls ages 12–18 who entered into state child welfare custody. Each participant has been assessed using the Child and Adolescent Needs and Strengths (CANS), which helps identify mental health needs and strengths of every youth. Results show partial support for the hypothesis that sexual abuse has a significant correlation with conduct disorder symptoms; however, physical abuse showed no significant correlation with severe conduct disorder symptoms. Surprisingly, school and community violence had the highest correlation with conduct disorder symptoms. The results clearly establish a relationship between lifetime trauma experiences and the presentation of symptoms of conduct disorder among adolescent females. These results were not replicated among comparison sample of adolescent males.

Restraint and Critical Incident Reduction Following Introduction of the Neurosequential Model of Therapeutics (NMT)

ABSTRACT Children with developmental trauma are at risk for severe and complex behavioral problems, often requiring long-term residential and day treatment. The Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive approach to clinical work with a capacity-building component focusing on attachment, the impact of maltreatment and trauma, and emerging concepts in developmental psychology, neuroscience and traumatology. Research has demonstrated its effectiveness with trauma-exposed populations. NMT training may help providers working with trauma-exposed youth prevent critical incidents and reduce restraints. Restraint and critical incident data were obtained from 10 organizations providing residential and/or day-treatment services following exposure to, or certification in, the NMT. Data from the Pre-NMT Introduction period through to the Maintenance phase of NMT Certification were used to examine changes in restraints and critical incidents across phases of NMT exposure/certification. Multilevel logistic regression models suggested that NMT exposure and/or certification was associated with significant reductions in restraints and critical incidents. Reductions were sustained throughout the Maintenance phase. Estimates of potential staff hour and financial savings associated with these reductions are discussed. Implementation of the NMT in residential and day-treatment settings may result in staff, behavioral health provider, and organization-level changes that reduce critical incidents and restraint use.

Multiple traumatic experiences and the expression of traumatic stress symptoms for children and adolescents

In order to understand the differential presentation of trauma stress symptoms over the course of development from children to adolescents, a sample of more than 11,000 children and adolescents were studied who were identified as to whether they had experienced multiple trauma experiences prior to placement in child welfare custody. Six age groups were compared on their presentation of symptoms associated with traumatic experiences. Trauma stress symptoms were dramatically different for children and adolescents despite the similarity of trauma experiences. Implications for understanding and addressing multiple trauma experiences across a developmental trajectory are discussed.

Erratum to Constellations of Interpersonal Trauma and Symptoms in Child Welfare: Implications for a Developmental Trauma Framework (J Fam Viol, (2014), 29, (1-4), 10.1007/s10896-013-9559-0)

The original version of this article unfortunately contained a mistake. The fourth paragraph under the subsection Symptom Clusters and Outcomes in the Results section is corrected as follows: Further, in addition to showing an increased likelihood of developmental trauma symptom patterns, the complexly (violent/non-violent) traumatized youth in this sample, experienced significantly worse child welfare placement outcomes than did those with either violent or non-violent trauma exposure alone. Based on Zero-inflated Poisson regression analyses and Incident Rate Ratios, youth exposed to both violent and nonviolent interpersonal trauma experienced 1.26 times (or 26%)more placement disruptions in the 2 years following entry into care compared to those youth with other types of trauma (p <.001). In comparison, youth exposed to non-violent trauma alone also experienced significantly more placement disruptions (by 1.15 times or 15%) during this time frame (p<.001); yet there was no significantly increased likelihood of placement changes for youth who had been exposed to violent trauma alone. The pattern is different for psychiatric hospitalization: the incident rate was 1.7 times higher for youth with violent/non-violent trauma (p <.001) and 1.37 times higher for youth with violent trauma (p <.001) compared to youth with other types of trauma.