Process, practices, and outcomes of trauma-focused services in a statewide treatment foster care program

Many youth in treatment foster care (TFC) have been exposed to traumatic life events that are associated with negative health outcomes, yet few studies have examined how TFC programs are addressing the needs of trauma-exposed youth. This study used clinical data from 542 youth enrolled in TFC services within a statewide publicly funded mental health system from 2008 to 2018 to explore (a) how many youth receive trauma treatment, including youth diagnosed with PTSD, (b) to what extent common elements for youth trauma treatment are among the interventions employed during months when trauma was included as a treatment focus, and (c) clinician-reported trauma treatment progress. Only 34% of all youth in TFC, and 56% of youth diagnosed with PTSD, received treatment with any focus on trauma during the first six months of TFC. Therapists used a variety of therapeutic strategies during months when trauma was treated, some of which were consistent with the evidence-base for youth traumatic stress. Therapists reported 36% of youth with some trauma treatment focus made, at most, minimal improvement on trauma concerns during this time. Considerations for research and clinical practice in trauma-focused treatment foster care services are discussed.