Home Visiting and Trauma Informed Care. Leslie McAllister And Kim Eithun Harshner

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1 Home Visiting and Trauma Informed Care Leslie McAllister And Kim Eithun Harshner

2 In this webinar, we will: Briefly review ACEs and how childhood trauma affects adult outcomes, including parenting Provide a description of the National Child Traumatic Stress Network s (NCTSN) components of a trauma-informed child and family service system as a framework Apply the NCTSN framework in the development of the Wisconsin home visiting system

3

4 Study launched by CDC & Kaiser Permanente in the mid-1990s (Robert Anda; Vincent Felitti) >17,000 patients in San Diego, CA responded to a brief survey documenting childhood experiences of: Abuse & neglect Domestic violence Household crime Household mental illness & substance abuse Divorce

5 HV WI ACE Study

6 Number of ACEs* Female Prevalence (%) WI Home Visiting ACE Study or more *Sum of 10 ACEs: Physical abuse, Sexual abuse, Psychological abuse, Physical neglect, Emotional neglect; Parent substance abuse; Parent mental illness; Household crime; Domestic violence; Parent separation or divorce.

7 Communicate with compassion. Understand the prevalence and impact of trauma. Promote safety Share power. Pursue the person s strengths, choice and autonomy. Healing happens in relationships. Earn trust. Embrace diversity. Respect human rights. Provide holistic care.

8 According to the NCTSN, a child and family service system with a trauma-informed perspective is one in which programs, agencies, and service providers: - Screen for trauma - Assess and treat for trauma - Provide resources and information about impact of and treatment for trauma - Promote resilience and protective factors - Address parent/caregiver trauma - Emphasize collaboration across service systems - Provide adequate support for staff working with families that experienced trauma

9 Routinely screen for trauma exposure and related symptoms Family Foundations Comprehensive Home Visiting (FFHV) programs screen for parental stress, domestic violence, maternal depression, and adverse childhood experiences, all of which help providers tailor services more effectively.

10 Use culturally appropriate, evidence-based assessments and treatment for traumatic stress and associated mental health symptoms FFHV provides opportunities to: Use screening and assessment tools to more effectively connect families to appropriate mental health services Integrate infant mental health consultation into practice Implement interventions with mothers at risk for or experiencing depression and families with infants and toddlers

11 Make resources available to children, families, and providers on trauma exposure, its impact, and treatment Home visitors share information about ACEs and resiliency with caregivers. Wisconsin focuses resources on helping home visitors better understand trauma and its impact on behavior, service engagement, and child and family outcomes. Home visiting programs are involved in local efforts to address trauma and exposure to toxic stress of young children.

12 Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. Home visiting programs use a family-centered approach, engaging parents as partners in goal setting and case planning. Home visiting curricula are designed to help parents better understand child development and coach parents to be their child s primary teacher. Programs are grounded in the Strengthening Families framework.

13 Address parent and caregiver trauma and its impact on the family system. Best practice promotes a whole-family approach, focusing equally and intentionally on both parent and child. Childhood Experiences Survey provides a chance to talk with caregivers about how their past experiences shape their parenting. Home visitors discuss the importance of self-care and offer real strategies that parents can implement.

14 Health care Home Visiting Birth to 3 Infant Mental Health Children s Social and Emotional Development Youth and Parents with Lived Experience Child Care Head Start/Early Head Start Pre K and Kindergarten

15 Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff resilience.

16 Complements to Wisconsin s Trauma- Informed Home Visiting System: Reflective Practice Project Communities of Practice Mother-Infant Therapy Groups

17

18 Department of Health Office of Children s Mental Health Children s Trust Fund Children s Social and Emotional Development Other Stakeholders Youth and Parents with Lived Experience Department of Children and Families Department of Corrections Department of Public Instruction

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20 Creating Trauma-Informed & Developmentally Appropriate Systems of Care in Child Abuse and Neglect Prevention: es.pdf Trauma Informed and Developmentally Sensitive Services for Children: National Child Traumatic Stress Network:

21 Leslie McAllister, Department of Children and Families: Kim Eithun Harshner, Office of Children s Mental Health:

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