1. Improving Outcomes with Effective Trauma-Informed Interventions

2. Charles Wilson, MSSW Senior Director
Sam and Rose Stein Endowed Chair in Child Protection
Centers for Developmental and Behavioral Sciences
Chadwick Center for Children and Families
Rady Children’s Hospital-San Diego

3. Why is This Relevant to Management of Psychotropic Medication
Trauma is all too common for children and youth served in foster care
The link between traumatic experience, behavior, and how the system responds
The link between our behavior in the system and the child’s response to our efforts

4. Definition of a Trauma-Informed System
A trauma-informed child welfare system is one in which all parties involved recognize and respond to the varying impact of traumatic stress on children, caregivers and those who have contact with the system.  Programs and organizations within the system infuse this knowledge, awareness and skills into their organizational cultures, policies, and practices.  They act in collaboration, using the best available science, to facilitate and support resiliency and recovery. 
- CTISP National Advisory Committee

5. Seeing Through a Trauma Lens
When we can see the opportunity to minimize trauma reminders/triggers and reduce the need to control mood and behavior with psychotropic medications…
…we stop making it worse!

6. Seeing Through a Trauma Lens
The better we can differentiate maladaptive behavior that will respond to psychosocial interventions from pathology that requires psychotropic intervention

7. In Fact, Many Children in Foster Care Do Receive Mental Health Services
Stambaugh, L.F., Leslie, L.K., Ringeisen, H., Smith, K., & Hodgkin, D. (2012). NSCAW Child Well-Being Spotlight: Children in Out-of-Home Placements Receive More Psychotropic Medication and Other Mental Health Services than Children Who Remain In-Home Following a Maltreatment Investigation. OPRE Report #2012-XX, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Find this report and those on similar topics online at: abuse_neglect/nscaw/

8. Seeing Through a Trauma Lens
The better we can see the opportunity to deploy evidence based or informed psychosocial interventions that can produce positive result - with minimal side effects….
…we will also see the value to strategically combining psychotropic and psychosocial interventions in some cases.

9. Essential Elements of a Trauma-Informed Child-Serving System
Maximize Physical and Psychological Safety for the Child, Family and CW Workforce
Identifying Trauma-related Needs of the Child, and Family
Enhancing Child Well-Being and Resiliency
Enhancing Family Well-being and Resiliency
Enhancing the Well-Being and Resiliency of those Working in the System
Partnering with Youth and Families
Partnering with System Agencies
Screening, Assessment
Role of Caregivers with Trauma History
Evidence Based Treatments

10. The Keys to Change Are in This Room
Expectation from the top leadership
for a move to a trauma informed environment - from the receptionist at the front desk to caseworkers and therapists
Policy framework
to support the transformation
Capacity of the workforce
to retool to an evidence based approach
Financing approach
that supports learning and delivering new evidence based practices