Evaluation of Preventive Service to Families with a Prior History in Child Protective Services: A Comparison of Treatment as Usual to Trauma Systems Therapy
Coombes, Margaret Lillian
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Children who are abused or maltreated may experience negative consequences or trauma symptoms that are not immediately apparent or may emerge over time. Child welfare interventions are intended to prevent future incidents of child abuse and decrease the negative outcomes that result from such traumatic events (English, et al., 2005; Herrenkohl & Herrenkohl, 2009; Vranceanu, Hobfoll, & Johnson, 2007). However, the child welfare system frequently uses interventions that are not evidence based or have treatment unknown outcomes (Wethington, Hahn, Fuqua-Whitley, Sipe, Crosby, Johnson, et al., 2008). This longitudinal secondary data analysis compared family outcomes of Treatment as Usual (TAU) to Trauma Systems Therapy (TST), and assessed if either service had significant treatment outcomes. The sample was taken from families referred by Monroe County Child Protective Services (CPS) to the Hillside Children's Center preventive program. There were 106 families admitted into the preventive service, and 40 discharged from March 1, 2010 to February 1, 2011. During the intervention study, the initial research design procedures changed, due to real world problems within the non-profit agency. The sample size was small, but the analysis showed TST families had some significant outcomes at discharge, higher percentages of successful face-to-face visits, and, in one component of the Family Functioning Assessment, TST families' living conditions measured improved, more so, than families who received TAU. This research has implications for future non-profit agencies that are committed to measuring outcomes and learning what works best with families who have been active in the child welfare system and have experienced traumatic events. According to the research, families known to CPS have a history of trauma, and could be re-traumatized by the system's interventions (Igelman, Conradi, & Ryan, 2007). The study brings to the forefront questions concerning the families' ability to recognize trauma and accurately report their traumatic events, and the recognition that children may present with atypical behaviors as a result of multiple traumas (Gobin & Freyd, 2009). Additionally, it is important to acknowledge the impact on clinicians, whose daily work exposes them to families with various degrees of trauma and complex environmental issues (Collins, 2009).