In the realm of trauma-informed clinical assessments, there exists a profound realization: that children’s needs go beyond diagnoses and clinical treatment and that non-clinical recommendations are just as significant to a child’s day-to-day functioning and overall thriving. One striking example I have seen that came from a Trauma-intensive Comprehensive Clinical Assessment (TiCCA) that underscores this point is a simple yet impactful recommendation to rearrange a child’s bedroom. During the TiCCA, the clinician noted that the child had issues with sleep that was affecting their well-being in various domains of their life. After delving deeper, the clinician discovered that, due to traumatic experiences, the child struggled to sleep at night if they could not see their bedroom door. This discovery allowed the clinician to make a specific recommendation regarding the child’s sleep arrangements. By ensuring the child could see their door from where their bed was located, the result was improved sleep, leading to improved behavior and a reduction in school tardiness, ultimately improving school and well-being outcomes.
Ten years ago, Benchmarks introduced the Partnering for Excellence project, giving rise to the TiCCA. This innovative assessment, also used in Benchmarks’ Standardized Assessment Protocol project, not only provides detailed background information on the child undergoing evaluation but also delves into holistic family dynamics. The TiCCA equips clinicians with a profound understanding of the child's trauma history, facilitating trauma-informed diagnoses and recommendations.
The TiCCA includes several measures, including the Alabama Parenting Questionnaire (APQ), Brief Symptom Inventory (BSI), Parenting Stress Index (PSI), Trauma Symptom Checklist for Children (TSCC), Child Behavior Checklist (CBCL), and others. The TiCCA also includes the Standardized Social Determinants of Health (SDOH) Screening Measure, which assesses the conditions in which the child and their family live and grow. By considering these conditions, the TiCCA provides a comprehensive understanding of the well-being of the child and their family, as well as potential barriers to resilience. Tailored recommendations based on the SDOH and other measures ensure holistic clinical support that includes both evidence-based treatments as well as non-clinical recommendations.
Having had the privilege of reviewing numerous TiCCAs during my tenure on Benchmarks' Center for Quality Integration (CQi) staff, I have witnessed diverse recommendations tailored to individual needs such as continued participation in sports, regular medical and dental visits, moving a beloved pet into a kinship placement, maintaining daily routines, parental assessments, equine therapy, and even preserving a child's connection to their place of worship. Ensuring these diverse recommendations are carried out positively impacts the child’s behavioral health outcomes as well as their overall ability to thrive in their environment.
While therapeutic recommendations are integral to clinical assessments, acknowledging that not all needs can be met through therapy is essential. By combining evidence-based therapies with non-clinical recommendations, trauma assessments like the TiCCA provide comprehensive support, fostering the overall recovery and resilience of children navigating the challenging aftermath of trauma. In the ever-evolving landscape of trauma care, the multifaceted approach of the TiCCA continues to be instrumental in creating a path towards holistic healing and transformative outcomes for those in need.
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