Staff Rejection Sensitivity and Attitudes about Trauma-Informed Care: Implications for the Child Welfare Workforce

Background: As new imperatives to create a Trauma-Informed child welfare system emerged, much attention has been paid to the necessary ingredients for successful implementation of new models like Trauma Informed Care (TIC). Nonetheless, we have very little understanding of the ways in which workers’ own developmental history and relational characteristics interact. This represents a significant gap in our knowledge about workforce characteristics and formal organizational supports staff need to conduct their work in accordance with emerging best practices.

Understanding the relationship between rejection sensitivity (RS), attitudes toward TIC, and intent to turnover may be key for informing the implementation of TIC and the promotion of a resilient and stable workforce. Workers with a higher RS may be less likely to embrace the relational principles of TIC while more likely to interpret the significant affective and behavioral dysregulation of clients as willful slights requiring punitive responses.

Methods: Frontline staff and supervisors of three U.S. child and family serving (CFS) agencies working with child welfare-involved families were administered a survey prior to being trained in a Trauma-Informed intervention, the Attachment, Regulation and Competency (ARC) model. Agencies were selected based on their involvement in a new initiative to adopt and implement the ARC model into treatment for Substance Use Disorders (SUD). The survey is part of a larger study investigating the integration of TIC, parent-infant mental health, and SUD treatment in CFS agencies working with child welfare-involved families. The sample, drawn from 271 clinical and non-clinical participant staff, was predominantly female (77%), ethnically diverse (55% White, non-Latino; 24% Black; 12% Hispanic or Latino of any race; 6% Multiracial; 3% Asian), and university graduates (65%).

The Attitudes Related to Trauma-Informed Care (ARTIC) scale was used to evaluate staff attitudes to the implementation of TIC. The Rejection Sensitivity Questionnaire, Adult Version (A-RSQ) was used to measure RS in social relationships. We utilized OLS regression analyses to examine the association between staff characteristics and their attitudes toward TIC.

Results: Bivariate Pearson correlations between ARTIC overall score revealed significant associations with several key staff variables, including education (r = .25, p < .01), previous TIC training (r = -.16, p < .05), knowledge about violence and trauma (r = .37, p < .001), RS (r = -.30, p < .001), and staff intention to turnover and leave their agency (r= -.34, p < .001). OLS analysis found that both staff education (β = .28, p < .01) and RS (β = -.24, p < .05) were associated with overall ARTIC score, in a model that accounts for 25% of the variance in endorsement of trauma-informed behaviors (F(7, 119) = 5.44).

Implications: These findings suggest that staff histories of relational loss and trauma may impact both workforce buy-in and readiness to implement TIC. Therefore, identifying staff with higher RS during or post-hire and providing specific supports to them, such as reflective supervision, may enhance both service delivery and staff experiences’ of their work.