| Objective. The purpose of this study is to examine the initial clinical presentation and the response to trauma-focused, empirically-supported treatments for children in the child welfare system who have experienced multiple types of trauma experiences. Methods. Participants were 68 youths from four community agencies who were enrolled in a foster care stabilization program, were identified as having experienced either multiple or one type of interpersonal trauma experience, and were having mental health difficulties. The subjects participated in one of two trauma-focused, empirically-supported treatments and were assessed for traumatic stress symptoms, risk behaviors, overall functioning, behavioral and emotional needs, and strengths before treatment, at intervals over the course of treatment, and at treatment completion. Data collection included reports from the parent or case worker, child, and clinician. Results. Compared to children with a single type of interpersonal trauma experience, children with multiple interpersonal trauma experiences had greater and more complex Behavioral and Emotional Needs and Risk Behaviors, and fewer Strengths at baseline and showed less improvement in Behavioral and Emotional Needs, particularly symptoms of depression and problems with attachment, after a trauma-focused intervention. Children with a history of sexual abuse had lower levels of Functioning and higher severity of Risk Behaviors at baseline than non-sexually abused children. Discussion. Trauma-focused interventions were successfully implemented in a child welfare setting and were effective at reducing problems related to adjustment to trauma of several types. A history of multiple interpersonal trauma experiences had an effect on initial severity of trauma symptoms and while this group showed clinically significant improvement after trauma-focused interventions, they showed less, or slower, improvement than children with one interpersonal trauma experience. |
