Statewide Expansion of Trauma-Informed Training and Technical Assistance for Early Childhood Providers: Improving Providers: Attitudes Toward Trauma-Informed Care

Background:

Addressing the constellation of risks associated with early childhood adversity requires responses from organizations and professionals from a range of systems, including health, early intervention, and education systems. However, many early childhood professionals report a lack of training on how to address trauma within their settings. The current project includes data from the first 15 months of a statewide initiative aimed at increasing trauma-informed capacity of child-serving organizations and providers. Training included trauma-informed technical assistance (TA) for organizations and a half-day trauma informed Child Adult Relationship Enhancement (CARE) training for providers. We examined satisfaction and usage of TA, and changes in trauma-informed attitudes related to CARE training participation.

Methods:

Regarding TA, organizations were invited to participate in TA to support their implementation of trauma-informed care practices, including support around increasing training, workforce well-being, trauma screening, service referral, and reflective supervision/consultation. A monthly survey was sent to organization leadership to solicit feedback about their TA experience. The most commonly served organizational sectors were community-based social services (53%), mental health agencies (20%), and early education/child care agencies (13%).

Regarding CARE training, providers were recruited to participate in the CARE training from various settings in a Mountain West state, primarily organizations that engaged with TA. As of March 2024, 425 providers had participated in the training and at least one survey wave. Trainings were conducted by pairs of licensed mental health professionals and held virtually or in person. Participants completed a 10-question measure of trauma-informed attitudes (ARTIC) at three points: baseline (pre-training, n=424), 2-weeks post-training (post-training, n=148), and 6-months follow-up (follow-up, n=59). Piecewise growth modeling analyses were run in HLM software, which models the training period (pre-training to post-training) and follow-up period (post-training to 6-month follow-up) as distinct processes of change.

Results:

From December 2022 through March 2024, 40 organizations from across the state participated in 81 TA sessions. Most (98%) of the organizations participating in the TA received support with CARE implementation, 80% identified additional trauma-informed training opportunities, and 28% accessed mental health referral support for young children. The majority of organizations who provided feedback (82%, n=22) endorsed being “extremely satisfied” with the TA provided.

Results of the CARE training evaluation indicated significant increases in trauma-informed attitudes from baseline to 2-week post-training (coefficient= .23, p < .001) and no significant difference in scores from post-training to the 6-month follow-up (coefficient= -.01, p = .817), indicating long-term maintenance of training effects. Variance components indicate significant within-person differences in rates of change in trauma-informed attitudes during both change periods (p<.001) that were not explained by modality (virtual v. in-person).

Conclusions:

The findings of this study suggest that a half-day training provided as part of a statewide initiative to increase the trauma-informed capacity of child-serving agencies can have long-term effects on early childhood providers’ trauma-informed attitudes. Consistency and shared language among providers and across organizations, such as is promoted through common training, can facilitate referrals and collaboration across professional sectors, which should be examined in future research.