Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California’s Child Welfare Systems

Brent R. Crandal, Andrea L. Hazen, Jennifer Rolls Reutz

Abstract


A central aspect of trauma-informed care in child welfare (CW) systems is the use of a trauma-informed screening process. This includes the use of a broadly administered measurement approach to assist professionals in identifying current trauma-related symptomology or a history of potentially traumatizing events. With a high prevalence of unmet mental health needs among CW-involved children, screening can be a crucial step as systems strive to identify children impacted by trauma. This paper offers a summary of CW screening approaches in county-administered CW systems across California. Through a web-administered survey, 46 county administrators reported on their screening practices and perceptions. Information about ages of children screened and screening tools used, perceptions of screening implementation priorities, degree of implementation and satisfaction with screening processes is provided. Several implementation considerations for future trauma-informed care efforts are offered including maintaining a focus on childhood trauma, closing the science-practice gap, and evaluating the state of the science.


Keywords


Childhood trauma; trauma-informed care; screening; implementation; child welfare

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References


Aarons, G. A., & Chaffin, M. (2013). Scaling-up evidence-based practices in child welfare services systems. CYF News. Retrieved from http://www.apa.org/pi/families/resources/newsletter/2013/04/child-welfare.aspx

Attorney General’s National Task Force on Children Exposed to Violence. (2012). Defending childhood. Washington, DC: Department of Justice.

Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., & Landsverk, J. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 960-970. doi: https://doi.org/10.1097/01.chi.0000127590.95585.65

California Department of Health Services [CDHS]. (2017). Katie A. Settlement Agreement Implementation. Retrieved from http://www.dhcs.ca.gov/Pages/KatieAImplementation.aspx

California Department of Social Services [CDSS], & California Department of Health Care Services [CDHCS]. (n.d.). Pathways to mental health services: Core practice model guide. Retrieved from Katie A. Settlement Agreement Implementation website: http://www.dhcs.ca.gov/Documents/KACorePracticeModelGuideFINAL3-1-13.pdf

CDSS. (2017). Welcome to the Information and Resource Guide. Retrieved from http://www.cdss.ca.gov/inforesources/Guide

Conradi, L., Wherry, J., & Kisiel, C. (2011). Linking child welfare and mental health using trauma-informed screening and assessment practices. Child Welfare, 90(6), 129-147.

Crandal, B., & Conradi, L. (2013). Review of child and adolescent trauma screening tools. San Diego, CA: Rady Children's Hospital, Chadwick Center for Children and Families.

Crandal, B. R., Foster, S. L., Chapman, J. E., Cunningham, P. B., Brennan, P. A., & Whitmore, E. A. (2015). Therapist perception of treatment outcome: Evaluating treatment outcomes among youth with antisocial behavior problems. Psychological Assessment, 27(2), 710-725. doi: https://doi.org/10.1037/a0038555

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258. doi: https://doi.org/10.1016/S0749-3797(98)00017-8

Gardner, W., Lucas, A., Kolko, D. J., & Campo, J. V. (2007). Comparison of the PSC-17 and alternative mental health screens in an at-risk primary care sample. Journal of the American Academy of Child & Adolescent Psychiatry, 46(5), 611-618. doi: https://doi.org/10.1097/chi.0b013e318032384b

Garland, A. F., Hough, R. L., Landsverk, J. A., McCabe, K. M., Yeh, M., Ganger, W. C., & Reynolds, B. J. (2000). Racial and ethnic variations in mental health care utilization among children in foster care. Children's Services: Social Policy, Research, and Practice, 3, 133-146. doi: https://doi.org/10.1207/S15326918CS0303_1

Garland, A. F., Landsverk, J. A., & Lau, A. S. (2003). Racial/ethnic disparities in mental health service use among children in foster care. Children and Youth Services Review, 25, 491-507. doi: https://doi.org/10.1016/S0190-7409(03)00032-X

Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. The British Journal of Psychiatry, 177(6), 534-539. doi: https://doi.org/10.1192/bjp.177.6.534

Hanson, R. F., & Lang, J. (2016). A critical look at trauma-informed care among agencies and systems serving maltreated youth and their families. Child Maltreatment, 21(2), 95-100. doi: https://doi.org/10.1177/1077559516635274

Haynes, S. N., Smith, G. T., & Hunsley, J. D. (2011). Scientific foundations of clinical assessment. New York: Taylor & Francis.

Horwitz, S. M., Hurlburt, M. S., Goldhaber-Fiebert, J. D., Heneghan, A. M., Zhang, J., Rolls-Reutz, J., ... Stein, R. E. (2012). Mental health services use by children investigated by child welfare agencies. Pediatrics, 130, 861-869. doi: https://doi.org/10.1542/peds.2012-1330

Ingram, D. D., & Franco, S. J. (2014). 2013 NCHS urban–rural classification scheme for counties. Vital and Health Statistics, 2(166), 1-73. Retrieved from https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf

Kerns, S. E., Pullmann, M. D., Negrete, A., Uomoto, J. A., Berliner, L., Shogren, D., ... Putnam, B. (2016). Development and implementation of a child welfare workforce strategy to build a trauma-informed system of support for foster care. Child Maltreatment, 21(2), 135-146. doi: https://doi.org/10.1177/1077559516633307

Kim, M., & Garcia, A. R. (2016). Measuring racial/ethnic disparities in mental health service use among children referred to the child welfare system. Child Maltreatment, 21(3), 218-227. doi: https://doi.org/10.1177/1077559516656397

Ko, S. J., Ford, J. D., Kassam-Adams, N., Berkowitz, S. J., Wilson, C., Wong, M., ... Layne, C. M. (2008). Creating trauma-informed systems: Child welfare, education, first responders, health care, juvenile justice. Professional Psychology: Research and Practice, 39(4), 396-404. doi: https://doi.org/10.1037/0735-7028.39.4.396

Kosanovich, A., Joseph, R. M., & Hasbargen, K. (2005). Child welfare consent decrees: Analysis of thirty-five court actions from 1995 to 2005. Retrieved from The Hill’s website: http://thehill.com/sites/default/files/consentdecrees_0.pdf

Larkin, H., Felitti, V. J., & Anda, R. F. (2014). Social work and adverse childhood experiences research: Implications for practice and health policy. Social Work in Public Health, 29, 1-16. doi: https://doi.org/10.1080/19371918.2011.619433

Leslie, L. K., Hurlburt, M. S., Landsverk, J., Barth, R., & Slymen, D. J. (2004). Outpatient mental health services for children in foster care: A national perspective. Child Abuse & Neglect, 28, 697–712. doi: https://doi.org/10.1016/j.chiabu.2004.01.004

McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 815-830. doi: https://doi.org/10.1016/j.jaac.2013.05.011

Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49, 980-989. doi: https://doi.org/10.1016/j.jaac.2010.05.017

National Child Traumatic Stress Network. (2007). Creating trauma-informed systems. Retrieved from http://www.nctsn.org/resources/topics/creating-trauma-informed-systems

Palinkas, L. (2015). Innovation and the use of research evidence in public youth-serving systems. A Forum hosted by the American Youth Policy Forum. Retrieved from http://www.aypf.org/resources/examining-strategies-to-improve-the-use-of-research-evidence-in-child-welfare/

Palinkas, L. A., Short, C., & Wong, M. (2015). Research-practice partnerships for implementation of evidence-based practices in child welfare and child mental health. Retrieved from http://wtgrantfoundation.org/resource/research-practice-policy-partnerships-for-implementation-of-evidence-based-practices-in-child-welfare-and-child-mental-health

Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879-903. doi: https://doi.org/10.1037/0021-9010.88.5.879

Raffle, A. E., & Gray, J. A. M. (2007). Screening: Evidence and practice. New York: Oxford University Press. doi: https://doi.org/10.1093/acprof:oso/9780199214495.001.0001

Raghavan, R., Inoue, M., Ettner, S. L., Hamilton, B. H., & Landsverk, J. (2010). A preliminary analysis of the receipt of mental health services consistent with national standards among children in the child welfare system. American Journal of Public Health, 100(4), 742-749. doi: https://doi.org/10.2105/AJPH.2008.151472

Taylor, N., Wilson, C., & Igelman, R. (2006). In pursuit of a more trauma-informed child welfare system. APSAC Advisor, 18, 4-9.

Testa, M. F., DePanfilis, D., Huebner, R., Dionne, R., Deakins, B., & Baldwin, M. (2014). Bridging the gap between research and practice: The work of the steering team for the child welfare research and evaluation translational framework workgroup. Journal of Public Child Welfare, 8(4), 333-353. doi: https://doi.org/10.1080/15548732.2014.915910

U.S. Census Bureau. (2015). Annual estimates of the resident population: April 1, 2010 to July 1, 2015. Source: U.S. Census Bureau, Population Division Release Dates: For the United States, regions, divisions, states, and Puerto Rico Commonwealth, December 2015. For counties, municipios, metropolitan statistical areas, micropolitan statistical areas, metropolitan divisions, and combined statistical areas, March 2016. For Cities and Towns (Incorporated Places and Minor Civil Divisions), May 2016.

U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2011). Bryan Samuels, Commissioner, Testimony before the Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security Senate Committee on Homeland Security and Governmental Affairs United States Senate December 1, 2011. Retrieved from http://www.hhs.gov/asl/testify/2011/06/t20110616a.html

U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2016). Child maltreatment 2014. Available from http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2011). Leading change: A plan for SAMHSA’s roles and actions 2011-2014. (HHS Publication No. [SMA] 11-4629). Rockville, MD: Author.

Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., … & Kai, C. (2016). CCWIP reports. Retrieved from University of California at Berkeley California Child Welfare Indicators Project’s website: http://cssr.berkeley.edu/ucb_childwelfare




DOI: http://dx.doi.org/10.18060/21278

Copyright (c) 2017 Brent R. Crandal

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