Trauma-Informed Care: What Problem Are We Trying to Solve?

By Molly Tierney    October 14, 2022

This scenario won’t be difficult for any child welfare caseworker to imagine: You’ve just been handed a new case focused on a teenager. In preparing to meet this teen, you review the file and learn that she’s been having serious conflicts with her mom. In fact, Mom didn’t just talk about kicking the teen out of the home; she followed through on the threat.

By the time you’re sitting down to meet this teen, she’s in a very bad place emotionally. As she responds to your questions, she brings a full gamut of difficult emotions. You feel your body tense, and your heart begins to race. You’re only human, and "fight or flight" is kicking in.

What do you do next?

Do you take a deep breath and reprimand the teen for behaving inappropriately toward you and/or other staff? Do you remind her of other rules and regulations she needs to follow? Or do you offer up a list of possible support services available to help her?

From where I sit, the most important question any caseworker can ask is this: What problem am I trying to solve?

Addressing your to-do list—including focusing on the teen’s compliance with rules—is one “problem.” But I would argue that it’s not the highest priority.

What if you viewed the problem not as her surly or disrespectful behavior but as the complex challenges that have brought her into your caseload?

That’s the crux of trauma-informed care. And when you lead with that approach, you meet any child or teen where they are: exhausted, angry, and fearful. In desperate need of a glimmer of hope that things can be better.

Unfortunately, no one can wave a magic wand and fix all their problems. But you can be physically and emotionally present for the teen. And you can do what the best parents do: demonstrate unconditional care and concern.

That can represent a significant shift in mindset and behavior—so much so that I believe every caseworker can benefit from focused training and practice in trauma-informed care.

Learning to Provide Trauma-informed Care

Trauma-informed care acknowledges the profound effects of ongoing trauma. That includes trauma children and youth have personally experienced, as well as trauma passed down through generations of their families. It helps us get to some of the root causes of adolescent mental health issues.

As with most things, delivering this kind of care takes practice. Caseworkers, supervisors, and other child welfare stakeholders need support learning the relevant tools and techniques.

That’s why we need Alayna. She’s a teenager who lives in virtual reality (VR)—more specifically, in a VR scenario focused on trauma-informed care and adolescent mental health.

Interacting in virtual reality can be a low-risk, high-reward experience. It provides an opportunity for child welfare professionals and stakeholders to practice navigating the challenges of supporting a teen in crisis. And it offers that chance with zero risk to the safety or well-being of any families or their children.

The most effective VR scenarios are highly realistic, and for many users, interacting with Alayna is likely to elicit a fight-or-flight reaction. It also provides a chance to practice working through that response and focusing instead on making critical choices about how to support Alayna. What information should you share with her? How should you present hard truths to her? How can you simply be present with her and her pain?

Many teens in the real world are grappling with the effects of complex, intergenerational trauma. There may be no simple solutions or guaranteed happy endings, but these youth are in our care. They’re worth our investment of patience, compassionate presence, and thoughtful support. Working with Alayna is a powerful reminder of why—and how—to deliver that kind of support.

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About the Author

Molly Tierney

Molly is a Managing Director and Child Welfare Industry Lead in Accenture’s North America Public Sector Practice, where she leverages her 25+ years of expertise to enable states and cities to improve outcomes for citizens. Prior to joining Accenture, Molly spent almost 10 years as the Director for the Baltimore City Department of Social Services, where she managed the City’s child welfare and public assistance programs. During that time, she gave a TED Talk focused on foster care.

Trauma-Informed Care: What Problem Are We Trying to Solve?

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