Efficient Strategies to Support Trauma-Informed Care for Children and Youth in Foster Care

Friday 10:30 – 1:45 Breakout A5

Presentor: Suzanne Kerns

Suzanne Kerns, University of Washington; Barb Putnam, Washington State Children’s Administration; Joe Avalos, Washington State Division of Behavioral Health and Recovery; Michael Pullmann, University of Washington; Andie Uomoto, University of Washington; Andrea Negrete, University of Washington ; Dae Shogren, Children’s Administration


There are national calls to create trauma-informed systems of care for children and youth in foster care. However, the extent to which these efforts actually change practice behavior and child wellbeing is not well established. In this presentation, we describe workforce training efforts that support ‘crux points’ that influence the pathway from identification to referral to receipt of services. Guided by several factors previously identified (Kerns et al., 2014), the efforts include: 1) statewide implementation of a trauma screening tool, 2) development of training for child welfare screeners on conducting, interpreting, and sharing results, and 3) development and implementation of two curricula for child welfare workers: a pre-service training for all incoming workers and an in-service training for existing workers. The trainings were efficiently designed with differential degrees of depth and intensity to meet worker needs during their first year of employment. Early results indicate a bi-modal distribution in the extent to which social workers feel comfortable administering trauma screenings. The social worker curriculum is highly acceptable and participants report increased confidence in applying knowledge for case planning by one standard deviation from pre-training to the post-training. Lessons learned from the implementation of this statewide workforce initiative will be discussed.


Using Integrated Administrative Data to Evaluate Implementation of a Behavioral Health and Trauma Screening for Children and Youth in Foster Care

Friday 10:30 – 1:45 Breakout A5

Presentor: Michael D. Pullmann

Michael D. Pullmann, University of Washington, Division of Public Behavioral Health and Justice Policy; Barbara Lucenko, Washington State Department of Social and Health Services, Research and Data Analysis Division; Suzanne Kerns, University of Washington, Division of Public Behavioral Health and Justice Policy



Effective statewide implementation of new approaches to identifying and treating youth in foster care with behavioral health problems requires monitoring of process and outcomes, but data collection efforts for such analyses can be expensive and burdensome. Administrative information systems can provide high-quality, efficient, and readily available data (i.e. good, cheap, and fast), but these data are often underutilized due to administrative, technical, and legal concerns. This presentation will describe the integration of Medicaid and social service information in Washington State, challenges and complexities in using such integrated information, and how this infrastructure has been leveraged in an evaluation of an academic-government partnership, Creating Connections. Creating Connections has implemented a screening protocol to identify mental health and trauma-related symptoms in youth who are entering foster care, track their progress over time, and refer them to appropriate services. Preliminary analyses will be presented, summarizing potential system-level impacts of the screening on proportions of youth who are identified, referred to, and engaged in services, the types of services received, and the impact on outcomes in the juvenile justice and other systems.


Intermediary Organizations as a Vehicle to Promote Efficiency and Speed of Implementation

Friday 10:30 – 1:45 Breakout A5

Presentor: Robert P. Franks, Ph.D.

Robert P. Franks, Ph.D., President and CEO, Judge Baker Children’s Center, Boston, MA; Christopher Bory, Psy.D., Judge Baker Children’s Center



The goal of this presentation is to describe how intermediary organizations can promote efficiency and speed of implementation through the Active Implementation Framework as defined by the National Implementation Research Network (NIRN).   This presentation will draw from case examples and descriptive research to describe how intermediaries are integrally involved in active implementation.  The discussion will focus on the intermediary’s role in selecting effective interventions and co-creating capacity; creating well-defined implementation teams, structuring implementation methods; and helping to create and facilitate enabling contexts that result in socially significant outcomes.  Specifically, examples will be provided of the intermediary’s role in facilitating efficient progress through the implementation process by playing a critical role in structuring and driving the change process and developing and using tools to support implementation. The intermediary’s role in facilitating competency, organizational, and leadership drivers through structured implementation and engagement of key stakeholders will also be discussed.  And finally, the intermediary’s role in promoting fidelity and sustainability through quality improvement and plan-do-study-act cycles will also be described.  This presentation will demonstrate that intermediaries can help drive efficiency and speed of implementation by acting as a facilitator of the active implementation process leading to positive social outcomes and sustained practice change.