A paradigm shift in responding to children who have experienced trauma: The Australian treatment and care for kids program

There is now considerable evidence to suggest that children placed in foster care experience greater levels of adversity compared to those in the general population. Early adversity has been shown to continue across the lifespan: those who have experienced the sustained trauma of threat or deprivation have a range of poor life outcomes including homelessness, poor mental health, and over-representation in the criminal justice system and low educational attainment. This paper reports on a study of a program response to children who have experienced trauma and are placed in out-of-home care. The program model, known as Treatment and Care for Kids (TrACK), introduced a paradigm shift in the treatment and care of children in Australia, in that it was designed to provide intensive, home-based therapeutic intervention for children presenting with complex trauma and challenging behaviours. This program sought to integrate knowledge about the neurobiology of trauma with therapeutic practice and care, reflecting growing recognition that 'care is not enough' to achieve holistic and effective healing for children who have experienced severe trauma. As such, the relationship that encircles the child was seen as the vehicle for recovery. The study examined client files and interviewed carers, key professionals and young people who had experienced the therapeutic care program since its inception 18 years ago. Data, informed by narrative inquiry methodology, were analysed. Key findings highlight the significance of relational practice to interrupt the projected trauma trajectory and for young people to stabilise and self-regulate.