By Marie Morilus-Black
Research findings indicate that 51 percent of children in foster care have experienced serious trauma. Further, somewhere between 83 and 91 percent of children living in challenging neighborhoods – where a significant portion of our in-home population resides – suffer from trauma. Often, their parents have a history of trauma that has gone untreated.Embed from Getty Images
With those kinds of staggering statistics, it’s imperative that we focus on the trauma first. That’s why the July 1 implementation of the Child and Adolescent Functional Assessment Scale (CAFAS)® and the Preschool and Early Childhood Functional Assessment Scale (PECFAS)® functional assessment tools along with the Caregiver Strength and Barriers Assessment (CSBA) represent a powerful next step in our journey to becoming a trauma-informed public child welfare system.
These objective, third-party tools standardize the assessments and serve as indicators of what’s going on in that parents or that child’s life. They will allow us to measure and track a parent or a child’s progress in healing.
This work is important to me because all the research stresses that you have to treat the trauma first before children – and even before the entire family – can benefit from other kinds of help.
I was the State Children and Youth Services Director at the District of Columbia Department of Behavioral Health for nearly six years before joining CFSA last January. While at DBH, I was heavily involved in partnering with CFSA to identify comprehensive screening and assessment tools that numerous organizations throughout the city could adopt.
That partnership really happened in synch with my role at DBH. We implemented the assessment tool last November at DBH, an experience that served as a perfect foreshadowing and segue for my helming the newly created role of Deputy Director of the Office of Well Being at CFSA. Approximately 50 percent of the cases at DBH are also CFSA-involved. When CFSA created the Office of Well Being with all of the related components – espousing everything from behavioral health to substance abuse and education to daycare – I gravitated to how this office addressed the whole person and family. In my previous position, I focused on the children exclusively, and now I’m thrilled to naturally expand to focusing on children and families and all the related needs they have, including the service needs of the adults in their lives.
CFSA has taken a little bit more time to implement the assessment tools because the agency wanted to integrate them into our automated case management system. My experience and lessons learned implementing the assessment tool at DBH informs the work we are doing now at CFSA.
I really believe that the way that we are integrating the trauma work and the functional assessments into our case planning process not only addresses the trauma of the children but also of the parents. This approach makes us a leader in the child welfare community because we are truly building a trauma-informed child welfare system of care. We are beginning to look at how that work will then impact well-being. Currently, we are working with Chapin Hall at the University of Chicago – a research and policy center focused on a mission of improving the well-being of children and youth, families, and their communities – to develop some specific well-being indicators we can track to ensure we are actually achieving the outcomes we want.
Since the last blog post, we also have the following updates:
We’ve trained nearly 3,000 staff, foster parents, members of the community and other stakeholders on trauma-informed care.
In the fall, we will start a whole new series of training for community partners and for new staff. We’re also executing a train-the-trainer model so that we will have local capacity to do the training ourselves. There is interest in training recreational staff throughout the city so that even more people who interface with kids on a daily basis become trauma knowledgeable. I want adults who work with our kids to focus on “what happened to our kids vs. what is wrong with our kids.”
We have launched the screening instruments that will assess for trauma.
The Child Stress Disorder Checklist is a screening that we do for trauma while the Caregiver Strengths and Barriers Assessment is a screening that we give parents that includes a trauma component.
On July 1, we are launching the functional assessments that will trauma-inform our integrated case plans.
The CAFAS® and the PECFAS® tools will not only trauma-inform the integrated case plan but will also show if the plans are leading to better outcomes. We will be able to answer the question, “are our kids and parents getting better?”
We’ve conducted an evaluation following the training and have discovered some key findings.
- 94 percent think these practices will help children and families who have experienced traumatic events.
- 93 percent report better understanding of a child’s symptoms in the context of his or her world.
- 83 percent see trauma-informed practice contributing to more effective, comprehensive, and individualized intervention planning for children.
- 86 percent think trauma-informed practice is a viable way to break down barriers between service systems.
I originally wanted to be a child psychiatrist. One of my mentors asked me why, and I told her I wanted to counsel families and help improve their lives. I began to reconsider after she pointed out that they do a lot of medication therapy. While medication therapy has its place, I didn’t want that to be my first go-to solution for helping to heal families.
An internship with Crisis Services in Buffalo, NY, and interviews I conducted with psychiatrists at state psychiatric facilities underscored my mentor’s point and made me realized that a lot of that work doesn’t deal with the family treatment that I wanted to do. A paid fellowship and scholarship-funded graduate degree later, I shifted my focus and passion to social work and a career in human services.
I look forward to shepherding the great work of the trauma team and the Office of Well Being forward here at CFSA. As we continue to embed trauma best practices into the way we assist our children and youth, we look forward to offering an art class or karate class to help our young people combat trauma versus medicating the issue or worse yet – leaving them to fight alone.