Launching a Great Change

by Michele Rosenberg

In DC, we’re committed to doing all we can to help our most troubled kids, so we were elated to win the five-year grant from the U.S. Department of Health and Human Services in the fall of 2012. Here was the support we needed to enhance social workers’ clinical skills and get everyone on a child’s service team sharing a common understanding and language about trauma. But talk about a challenge! Managing change is never easy, and this vision called for a big, broad, bold transformation.

Daunted but determined, we plunged in—and our efforts paid off. In the first year, we trained over 1,900 people. DC is a small system, so that’s a noteworthy start on our ambitious vision. How did we do it? Here are four change-management strategies we’re using.

Drawing on Experts
TST ExpertsWe partnered with three national experts to guide us. Dr. Glenn Saxe, MD, is chair of the Department of Child & Adolescent Psychiatry at New York University and director of the NYU Child Study Center. Founded in 1997, the Center seeks to improve the treatment of child psychiatric disorders through scientific practice, research, and education. Dr. Adam Brown is a clinical psychologist and assistant professor at the NYU Child Study Center. Kelly McCauley is director, Evidence-Informed Initiatives, at KVC Health Systems headquartered in Kansas. KVC is a non-profit corporation providing medical and behavioral health care, social services, and education to children and families in five states—and a private-sector leader in using Trauma Systems Therapy (TST) with child victims of abuse and neglect.

Grouping ‘Doers’ and Phasing Training
Targeting direct services personnel first, we divided social workers into four cohorts of about 150. In May 2013, Cohort 1 started a five-week training curriculum to learn and to begin to apply the principles of TST. Experts Dr. Brown and Kelly McCauley served as the trainer-coaches. The book Dr. Saxe co-authored in 2007 became the text for the course, with guided reading and discussion. The curriculum also included two days of in-person training, followed by a series of conference calls to present actual cases and get expert advice. In 2013, new cohorts started in May, June, September, and October. In 2014, we launched a fifth cohort that will complete the curriculum this summer.

Expanding Outreach
Meanwhile, the experts also held a series of two-hour orientations for stakeholders. To build awareness and interest, we invited foster parents, attorneys, judges, managers from other public and private child-serving agencies, and our own agency leadership to hear the basics about becoming trauma-informed.

Building Internal Capability
Now in the second year of the grant, we’re working to institutionalize some of these strategies. Our internal trainers will soon become certified in TST and will then incorporate the trauma curriculum into regular training for social workers. A local psychologist experienced in treating children in the DC system is becoming our home-grown trauma expert. The trauma perspective is becoming a regular topic during social worker supervision and team meetings.

The transformation we’re seeking is broad and deep. We have a long way to go but feel good about the start we’ve made. Stay tuned for the perspectives of our experts and some of our social workers as we continue on this journey to make District child welfare trauma-informed.