Initial Implementation of a Trauma-Informed Data-Driven Case Planning Approach in Child Welfare

Background/Purpose: 

Many children in foster care experience behavioral health and trauma-related needs, which negatively affect their social-emotional well-being and permanency (Ai et al., 2013). Despite a growing awareness of the impact of trauma and behavioral health needs, the child welfare field continues to struggle with incorporating specific trauma-informed practices into usual care. The U.S. Children’s Bureau responded by investing in three grantee cohorts across approximately 20 sites to ensure that children were screened for behavioral health needs and that those needs were addressed. This study examined the initial implementation of a trauma-informed case planning approach in child welfare. Using an implementation framework and focusing on the core competency drivers of: 1) staff selection, 2) training, 3) coaching, and 4) fidelity assessment (Metz & Bartley, 2012), this study seeks to build a greater understanding of the competency drivers that influenced early implementation of a trauma-informed practice from the frontline child welfare worker perspective.

Methods:  The project setting was a statewide demonstration project in a Midwestern state. Four focus groups were conducted with frontline child welfare workers (n=28) implementing a new trauma-informed assessment and case planning approach. Participants were recruited from rural and urban regions where the new strategies had been implemented for approximately 8-12 months. Interviews were audio-recorded, transcribed, coded, and analyzed using modified analytic induction (Bogdan & Biklen, 1998). Member checking and negative case analysis were used to confirm identified themes.

Results:  Data analyses revealed themes that were compared and contrasted with each of the four core competency drivers. Staff selection: While the implementation did not include a strategic hiring process, workers expressed a need for newly-hired staff to be trained in the trauma-informed practice early in their employment. Training: Workers identified training on trauma-informed assessments and case planning as highly applicable to daily child welfare practice. They also expressed an appreciation of the role play and practice elements of training. Training barriers included concerns with the gap between training and implementation of assessments, and discrepancies between initial training by agency leadership and later training conducted by agency trainers. The challenge of transferring knowledge from the completion of the assessments (task) to how assessments could inform case planning practices (purpose) also emerged during analysis. Coaching: Formal coaching was not provided by the agencies; however, themes emerged within the analysis that support coaching as a vital element of implementation. Fidelity assessment: Workers acknowledged a need for accountability and identified a desire for continuous support when utilizing assessments for ongoing case planning.

Conclusion:  This study contributes to the implementation literature by showing that distinct but interconnected factors within the core competency drivers influence the initial implementation of a trauma-informed practice in child welfare. Findings demonstrate the complexity of implementing a large-scale child welfare approach and the necessity of building a coaching infrastructure that provides ongoing support to practitioners implementing new practices. Policy and practice implications for responding to barriers and improving effective implementation in child welfare are discussed.