Children's services practice notes : for North Carolina's child welfare workers [2005 : June, v.10 : no.3]

Children's Services к*пиигеп s DcrviLCb * PRACTICE WO TES For North Carolina's Child Welfare Workers ► From the NC Division of Social Services and the Family and Children's Resource Program Volume 10, Number 3 June 2005 Children's Services Practice Notes is a publication for child welfare workers produced four times a year by the North Caro¬ lina Division of Social Services and the Family and Children's Resource Program, part of the Jordan Institute for Families and the School of Social Work at the University of North Caro¬ lina at Chapel Hill. In summarizing recent research, we try to give you new ideas for refining your practice. However, this publication is not intended to replace child welfare training, regular supervision, or peer con¬ sultation — only to enhance them. Let us hear from you! To comment about something that appears in this or any other issue of Children's Services Practice Notes, please send your comments to: John McMahon Jordan Institute for Families School of Social Work UNC-Chapel Hill Chapel Hill, NC 27599-3550 johnmcmahon@mindspring.com Newsletter Staff Lane Cooke, MSW, Advisor Ray Kirk, PhD, Advisor John McMahon, MA, Writer Visit Our Website To read this or past issues of Practice Notes online, go to <www.practicenotes.org>. References for the articles in this issue can be found at < www. practicenotes.org> POSTTRAU M ATIC STRESS DISORDER Researchers recently examined outcomes for 659 young adults who had been placed in family foster care as children. One of the most remarkable things they discovered was that one in four (25.2%) of these foster care "alumni" had experienced posttrau- matic stress disorder (PTSD) within the pre¬ vious 1 2 months (Pecora et al., 2005). This rate of PTSD is nearly double that of US war veterans. People who think of PTSD as something caused only by the trauma and terror of mili¬ tary combat will probably be shocked by this finding. However, if you work in child wel¬ fare, shock is probably not your reaction. You know all too well the effects abuse, ne¬ glect, and placement instability can have on children. And yet the implications of this find¬ ing for your work are huge. As you will learn in this issue, PTSD sig¬ nificantly undermines a child's well-being. $ PTSD is one of the most common diagnoses of children in foster care. Left untreated, it can put children at risk for school difficulties, at¬ tachment problems, additional psychologi¬ cal disorders, sub¬ stance abuse, and physical illness. When the children grow up, PTSD can interfere with economic self-suffi¬ ciency. The trauma experienced by children can also profoundly affect child welfare workers. Family support and child welfare work¬ ers and their agencies must be able to rec¬ ognize the signs of PTSD and they must be prepared to respond in an appropriate and timely way when they come across it. The health and well-being of children — perhaps their very futures — depend on it. ♦ PTSD AND CHILDREN IN THE CHILD WELFARE SYSTEM A trauma is a psychologically distressing event that is outside the range of usual hu¬ man experience, one that induces an ab¬ normally intense and prolonged stress re¬ sponse (Child Trauma Academy, 2002). Despite the fact that they are outside the range of usual human experience, traumatic events are fairly common, even among chil¬ dren. In their study of children and adoles¬ cents (9-16 years old) in Western North Carolina, Costello etal. (2002) found that 25% had experienced at least one poten¬ tially traumatic event. In her review of the literature, Solomon (2005) found 90% of people surveyed experience at least one traumatic event during their lifetimes. Events that can induce trauma include the sudden death of a loved one, assaultive vio¬ lence (combat, domestic violence, rape, tor¬ ture, mugging), serious accidents, natural disasters, witnessing someone being injured or killed, or discovering a dead body. In child welfare, physical and sexual abuse are common sources of trauma in children. Other causes of childhood trauma can include animal attacks (dog bite), life- threatening illnesses, and prolonged sepa¬ ration from caretakers. TYPICAL REACTIONS Normal, immediate reactions to trauma cover a wide range and can include over¬ whelming feelings of helplessness, fear, with¬ drawal, depression, and anger. Reactions may last for weeks or months but cont. p. 2