Chapin Hall

Trauma-Focused Cognitive Behavioral Therapy May Be Effective as Prevention Service

What We Did

The Chapin Hall team conducted a qualitative study using structured interviews and focus groups to assess the implementation of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) in the child welfare system in Illinois. We interviewed nine child welfare caseworkers, conducted five focus groups with eleven TF-CBT clinicians, and interviewed three TF-CBT agency administrators. Data collection focused on the referral process, family engagement, and the success of TF-CBT in supporting child safety and permanency goals. Additionally, clinicians discussed their experiences with TF-CBT fidelity, family engagement, and coordinating services with child welfare caseworkers. 

What We Found

1. Alignment with family needs: TF-CBT’s goals and strategies strongly align with the trauma-related needs of many families receiving child welfare services in Illinois. These needs include addressing trauma symptoms and building coping skills. 
2. Challenges in engagement: Caseworkers and clinicians shared significant challenges with engaging families in TF-CBT, including barriers to engagement like material hardship, negative experiences with the child welfare system, and families’ incomplete understanding of the impact of traumatic events on their lives. 
3. Support strategies: Caseworkers and clinicians actively support family uptake of TF-CBT referrals through careful sequencing of referrals, communicating the benefits of service participation, and providing psychoeducation on trauma and its impacts. 
4. Multiple modalities: To reduce barriers to completing TF-CBT, clinicians offer the model through various modalities, including schools, libraries, and virtual settings. 

What it Means

• Effectiveness of TF-CBT: The alignment of TF-CBT with the trauma-related needs of families indicates its potential effectiveness as a prevention service for families involved in the child welfare system. 

• Need for enhanced engagement: The challenges in engaging families highlight the need for enhanced strategies to improve participation, such as addressing material hardships and providing better education to families about trauma and the goals of TF-CBT as a service. 

• Importance of Support Structures: Using multiple service modalities and providing psychoeducation are critical in reducing barriers and supporting families through the TF-CBT process, suggesting that these strategies should be expanded and reinforced​ as Illinois continues to implement TF-CBT. 

Read the report