Summary: This proposal utilizes trauma-informed principles to design an intervention targeted at helping foster parents and children in LA County. The intervention will educate foster parents on trauma-informed care and how to build strong relationships with their foster children. The foster children will work on resilience and relationship building in order to lessen effects of previous traumatic experiences.
Statement of Need: Foster children experience trauma at a greater rate than children in the general population (Beyerlein & Bloch, 2014). They are especially more likely to have experienced neglect and/or abuse (Dorsey et al., 2012). 51% of children in the welfare system have experienced 4 or more Adverse Childhood Experiences(ACEs) (Generations United, 2015). Individuals with four or more ACEs are 12 times more likely than those without such experiences to have serious negative health outcomes in adulthood such as cancer or ischemic heart disease (Generations United, 2015). This means there is a vast number of children in the foster care system that are at risk for serious negative health outcomes in their future. As well, foster children that have experienced neglect and abuse are more likely to have behavioral problems, problems in school, and higher use of illicit substances (Gypen et al., 2017).
As of December 2021, there were over 30,000 children receiving LA County’s Child Welfare Services (LA DCFS, 2021). Of the almost 10,000 children referred to the service in December of 2021, over 7,500 had endured some form of neglect or abuse (LA DCFS, 2021). Over 55% of the children in the system are under 9 years old and thus at a prime age to intervene early and start building resiliency (LA DCFS, 2021).
One key factor for developing resiliency in the face of childhood trauma is the opportunity to create connections with stable adults and peers (APA, 2014). These supportive relationships help a child understand that even though something bad has happened to them they can talk about it and move forward with people that care about them (APA, 2014). Children in the child welfare system need to be placed with foster parents that have been educated in trauma informed care. This intervention will be set up to help these foster parents build the capabilities they need to be the consistent and strong relationships that foster resiliency in these vulnerable children. These children need stable adult relationships in their life as well as opportunities to build social relationships with peers.
Public Health Framework: The program utilizes a multi-level public health framework to improve the lives of foster children in LA County. We are looking to see not only improved health outcomes in these children, but improved social, behavioral, and educational outcomes as well as increased ability to build strong relationships and cope with traumatic experiences. The intervention involves primary, secondary and tertiary prevention levels to support the mental health and welfare of the children involved (Scattergood Foundation, 2016). At the primary level, the foster parents will be educated in trauma informed approaches in order to discourage further experiences that could negatively affect the child. At the primary level we intend to stop trauma before it occurs (Scattergood Foundation, 2016). At the secondary level, children involved in the program will be screened for ACEs to better evaluate the care each individual child needs. Also at the secondary level, by implementing resiliency and self-efficacy building activities the children will be given strategies to cope with past traumatic experiences before they advance to further negative health effects (Scattergood Foundation, 2016). Finally at the tertiary level, any child who is already experiencing mental or physical health effects as a result of previous traumatic experiences will be given individual care in hopes of increasing their quality of life in all areas of wellness (Scattergood Foundation, 2016).
On a more broad level, a holistic public health framework will be utilized. We intend to maximize the benefit to all by including multiple levels of intervention, targeting several vulnerable groups within the population, and aiming to improve outcomes for the good of society. We will use a public health framework to empower and support both the foster parents and foster children. Those running the intervention will employ continual learning within the framework and open-mindedness to continue to grow the success of the program and the health of those involved in it.
Levels of Social Ecological Model: The program will address the individual, interpersonal, and policy levels of CDC’s Socioecological Model. Individual level interventions target factors like behavior, values, and knowledge of the individual themself (CDC, 2022). In this program the children and the foster parents will be impacted at the individual level by teaching them about the effects of trauma and how to cope with trauma and build resilience through educational lessons and therapy. We have chosen to address this level because there must be behavior and attitude changes in the individual in order to see growth. No matter how an intervention affects other levels, if an individual is not willing to take certain steps to see a change it will not be effective.
Relationship level interventions focus on interpersonal relationships between the targeted individuals and their family and peers (CDC, 2022). This level will be targeted by trying to foster healthier relationships and healthy conversation between the foster parents and children in order to begin to resolve trauma from past experiences and prevent new traumatic experiences from occurring. The children and foster parents will also form relationships with other children and foster parents during their group lessons and therapy. This level is being addressed because a core aspect of building resilience in an individual is increasing their ability to create strong and meaningful relationships with others. Healthy interactions of daily live with peers and family will strongly encourage an individual to see that change is possible and embrace the challenges in order to become better in the long-run.
Policy level interventions work to change broad societal factors that influence individuals, relationships, and the community (CDC, 2022). This level will be targeted as the intervention involving educational lessons for potential foster parents is intended to lead to a policy change in how the foster system works. If the intended outcomes of that intervention are successful it could be influential in creating a policy beyond LA County that requires proper trauma informed education for potential foster parents. This is important because a big change like that is needed societally to ensure that foster children are being cared for by properly educated individuals who can provide the support necessary for them to build resiliency and move past old trauma and not experience new traumatic experiences.
Trauma-Informed Principles This Grant Will Utilize: All 6 of SAMHSA’s key principles for a trauma informed approach will be utilized in this program (SAMHSA, 2014). These principles are (1) safety, (2) trustworthiness/transparency, (3) peer support, (4) collaboration/mutuality, (5) empowerment, voice and choice, and (6) cultural, historical, and gender issues (SAMHSA, 2014). To provide safety the group therapy and educational lessons will take place in a community building in a safe part of LA. The rooms will be designed to provide comfort and warmth. It will be enforced that during those meetings, there is to be no degradation or non-constructive criticism of others as to provide a safe space emotionally and mentally. The children will also be closely monitored during their sessions to ensure that all interactions between children are safe. There will be a strong emphasis on building trustworthiness between staff and participants, and all expectations and activities will be transparently defined for participants. Peer support will also be emphasized as these groups of both children and adults will be made up of people who are going through the same experiences. They will be able to help each other and build relationships as they have lived through similar experiences and can speak firsthand on what they have been through.
Collaboration will be utilized because there will ample opportunity for participants to voice their opinion about how things are being run, what things are working and what aren’t so that the participants and staff mutually benefit from activities and lessons. The staff will be open to learning from the participants in the same way the participants will learn from the staff. That also ties into empowerment, voice and choice. By allowing the foster parents and children to speak up about what they are enjoying and what needs to change, they will be able to self-advocate to ensure their needs are met. The staff will have a semi-structured guideline for each meetings activities but the participants will be given the opportunity to run things how they see fit and are truly the one guiding how each session goes. Finally, there will not be bias or stereotypes used to guide the intervention. All participants will be seen as equal, while still allowing for consideration of additional challenges certain participants may deal with because of historical trauma. Different genders, cultures, religions, and races/ethnicities will all be accepted and celebrated and because the groups will involve diverse individuals they will be able to learn from one another.
References:
American Psychological Association. (2014). The road to resilience. https://advising.unc.edu/wp-co...ad-to-Resiliency.pdf
Beyerlein, B. A., & Bloch, E. (2014). Need for trauma-informed care within the foster care system: A policy issue. Child Welfare, 93(3), 7–22. https://www.jstor.org/stable/48623435
Centers for Disease Control and Prevention. (2022). The social-ecological model: A framework for prevention. https://www.cdc.gov/violencepr...ecologicalmodel.html
Dorsey, S., Burns, B.J., Southerland, D.G., Cox, J.R., Wagner, H.R., & Farmer, E.N. (2012). Prior trauma exposure for youth in treatment foster care. Journal of Child & Family Studies, 21, 816-824. doi 10.1007/s10826-011-9542-4
Generations United. (2017). In loving arms: The protective role of grandparents and other relatives in raising children exposed to trauma. https://www.gu.org/app/uploads...Report-SOGF-2017.pdf
Gypen, L., Vanderfaeillie, J., Me Maeyer, S., Belenger, L., & Van Holen, F. (2017). Outcomes of children who grew up in foster care: Systematic review. Children and Youth Services Review, 76, 74-83. https://doi.org/10.1016/j.childyouth.2017.02.035
Los Angeles Department of Children and Family Services. (2021, December). Child welfare services data: Monthly fact sheet. https://dcfs.lacounty.gov/wp-c...et-December-2021.pdf
Scattergood Foundation. (2016). Trauma-informed philanthropy. https://www.scattergoodfoundat...23&previous=1320
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. http://store.samhsa.gov/sites/.../priv/sma14-4884.pdf
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