Two-generational trauma-informed assessment improves documentation and service referral frequency in a child protection program

Abstract

BackgroundTwo-generational trauma-informed assessment (TIA) helps providers conduct holistic family well-being assessment (FWbA). This tool makes it possible to use families’ trauma history in the case-finding process. ObjectiveThis study compares the documentation and frequency of adverse childhood experiences (ACEs) and service referral rates for index children and their caretakers in two groups of families evaluated in a child abuse clinic (CAC). Participants and settingThe sample consisted of 364 children stratified into two groups: Group 1 - children seen in the CAC after implementation of FWbA in years 2014, 2015, 2016 and Group 2 - children seen in the CAC prior to implementation of FWbA in years 2011, 2012, 2013. MethodsResearchers utilized retrospective chart review method and analyzed data regarding ACEs and service referrals for patients and their caregivers. ResultsDocumentation of ACEs was higher in Group 1 for children (77.7 % vs 26.6 %,p < 0.0001) and caretakers (60.7 % vs 7.3 % p < 0.0001). Caretakers in Group 1 had a higher rate of four or more ACEs (47.0 % vs 5.1 % p < 0.001) while the increase for children was not statistically significant (61.4 % vs 51.1 %, p = 0.110). Both children and caretakers were referred to more services in Group 1 (2.7 + 1.5 vs 1.5 + 1.3, and 3.0 + 1.9 vs 1.2 + 1.2, respectively, p < 0.0001). ConclusionsIn families evaluated for child abuse and neglect, conducting TIA in addition to conventional psychosocial evaluation increased documentation regarding trauma history, which led to increased referral rates.