Providing Trauma Informed Care in Child Welfare
Do children in the child welfare system experience medical treatment in the same ways that children in the general population do? To some degree, yes, they do. At the same time, there are notable differences in the life experiences and family circumstances of children in foster care compared to their peers outside the child welfare system. It's important to understand what these differences are and how they may influence responses to medical events among children in foster care.
Three main issues affect how children in foster care experience medical treatment:
- Level of medical and developmental need
- How medical services are delivered
- Experiences before, during, and after treatment
Level of Medical and Developmental Need
- Repeated ear infections
- Other respiratory problems
- Severe allergies
- Eczema or other skin diseases
Trauma Informed Care in Child Welfare : How Medical Services are Delivered
All too often, children in foster care receive medical attention in Emergency Departments. The Emergency Department may be a first stop for children after being removed from their homes, or it may be a frequent destination for those who lack a consistent primary care provider due to multiple changes in foster care placement. Patient and family centered care may be disrupted in child welfare families due to this inconsistency, causing increased stress on the child and resource family. The sights and sounds of an Emergency Department can be frightening to any child, and even more so for one who has been separated from family members.
Trauma Informed Care in Child Welfare : Experiences Before, During, and After Treatment
Children typically become involved with the child welfare system because they have been abused or neglected, and these experiences affect their responses to medical care.
- When medical treatment is invasive, painful, or prolonged, it may be a trigger or reminder of past traumas, such as physical or sexual abuse.
- Even routine physical exams may be extremely uncomfortable for children who have been sexually abused.
- Children who have been abused or neglected may not initially trust adults to keep them safe---even health care providers.
Thus, previous traumatic experiences may increase the risk for medical traumatic stress among children in care.
Not having an adult caregiver who is consistently present to provide support and information is one of the most critical differences in how these children experience medical care.
More about Medical Traumatic Stress
The resources below will take you to more information about medical traumatic stress. As you review the information, keep in mind the ways in which children in foster care may experience medical treatment differently.
- Medical Traumatic Stress: Know the Facts
- Prevalence / Signs & Symptoms / Who is at Risk?
- What is Traumatic About Medical Experiences?
- Traumatic Stress Trajectory
- Developmental Considerations
- For Health Care Professionals: Pediatric Medical Traumatic Stress (PMTS) and Working with the Child Welfare System (1.0 CEU)