A center pioneered at CSU to focus on assessing complex trauma in children was awarded the Jim Drendel Community is the Solution Award by the Department of Health and Human Services of Larimer County on April 6.
The Child Trauma and Resilience Assessment Center is part of the Marriage and Family Therapy Program in the Human Development and Family Studies department, where both graduate and undergraduate students get a taste of working hands-on in the field.
“It’s really touching for CTRAC to be recognized,” CTRAC Director Stephanie Seng said. “The idea that we’ve built something that’s making a difference, and to recognize our clinicians and students who have worked so hard to make that difference, is so fulfilling.”
A shift in approach
One of the center’s many goals is to develop a more trauma-informed community by training and collaborating with providers in the community to shift the way we think about treating families who have experienced trauma. Modeled after a program through Western Michigan University and a partnership with DHS in Fort Collins, the center is a place where families and children learn about the impact of trauma on their lives and create a plan to begin healing.
Jim Drendel recently retired as division manager of Children, Youth and Family Services for Larimer County. During his time with DHS, he was an advocate for finding a better way to serve children and their families. He strongly believed in forming community partnerships to harness the power of trauma-informed care. Drendel led a movement to bring trauma assessments to Colorado and helped secure a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) in partnership with six other Colorado counties to provide trauma-informed care workshops and train providers to conduct trauma assessments.
The assessment process
Every child who goes through the Larimer County DHS system is given a trauma screen, which looks at traumatic events, symptoms and behaviors that can indicate potential trauma. Children who score above a certain number are then referred for a trauma assessment conducted by a lead clinician, accompanied by graduate students in the Marriage and Family Therapy program at CSU.
The 20- to 25-hour assessment includes four parts. Background information about the family or child is gathered and reviewed, then collateral interviews are conducted with caregivers, teachers, case workers and anyone else who is directly involved with the child’s life. The child then spends the entire day at CTRAC completing cognitive screenings, surveys and games so clinicians can get a sense of how the trauma may be affecting brain development and executive functioning. In the afternoon, the child undergoes a psycho-social interview in which the goal is to help children share how trauma may be impacting their life.
“What we know is that trauma changes the brain, it impacts the way we think and respond to things,” Seng said. “It is common for children and adolescents who have been exposed to trauma to be easily triggered into reactive functioning as a way to protect themselves. We often talk about it with kids as ‘flipping their lids.’”
That’s where CTRAC comes in. When triggered, children may respond in a self-protective way because they feel threatened, but often, the response from adults is negative, due to a lack of understanding surrounding the brain-based connection between children’s actions and their trauma.
The CTRAC team is careful to not assume they know the trauma that the child has endured or how that trauma may be affecting them.
“There can be lots of things that can be impacting the child that we overlook, because we think we know and make assumptions about what trauma looks like,” Seng said.
After the child is assessed, the information is then gathered into a report with recommendations focused on building resiliency in the child and family, made by the clinicians and graduate students.
In the past, clinicians have recommended providing the child with a heart rate monitor, so they can learn to monitor their heartbeat and recognize some of their triggers. Other recommendations have included allowing the child to job-shadow a professional in the field they’d like to enter, where they’re able to build confidence in their skills and explore something they are interested in.
Once the report is written, the child is allowed to read through the report. The child’s caregivers are brought in to review and discuss the findings, helping them to understand more about the child and their trauma experience.
The final report is then sent to DHS, and the child’s care team — including teachers, coaches, mentors, caseworkers and parents — meet for a final time to go through the recommendations individually and discuss the plan for executing them.
Seng, who helped start the center, has seen CTRAC go from having only two employees to having six full-time clinicians, an administrative assistant and seven interns join the team over the past three years.
CTRAC has also partnered with DHS to implement a SAMHSA grant that is designed to help keep kids and families together, and to offer training across the state in trauma-informed care and assessments like those constructed at CTRAC.
“I absolutely love working with these students,” Seng said. “So, it’s really touching for CTRAC to be recognized. Our department has been so supportive, and to see our students grow into these talented clinicians, and to watch our clinicians impact these kids so positively, is so rewarding.”
The Department of Human Development and Family Studies is part of CSU’s College of Health and Human Sciences.