Understanding Strengths in Relation to Complex Trauma and Mental Health Symptoms within Child Welfare
Strengths can have a potent effect in mitigating the impact of trauma on mental health needs and functioning. Yet, evidence is limited on the role that strengths may have in ameliorating trauma-related or mental health symptoms over time. Providing a comprehensive assessment that includes strengths, as well as needs, is an important step in making appropriate service recommendations for youth in child welfare. This study assessed 7,483 children and adolescents entering an intensive stabilization program through the Illinois child welfare system. The interaction of individual, child strengths in relation to complex trauma exposure, traumatic stress symptoms, risk behaviors, and other mental health needs were examined. Results indicated strengths are relatively stable over time and inversely associated with several negative outcomes, including risk behaviors (−.32, p < .001), emotional/ behavioral needs (−.33, p < .001) and overall functioning (−.47, p < .001). Traumatic stress symptoms were also related to increases in these negative outcomes. Overall, strengths had a buffering effect on traumatic stress symptoms and outcomes over time. The role of strengths in relation to traumatic stress symptoms, however, was less consistent. Youth with histories of complex trauma exposure had significantly fewer useable strengths than youth without this exposure. However, strengths improved for both youth with and without complex trauma exposure over the course of stabilization services. These findings suggest that early identification and development of child strengths can mitigate risk-taking behaviors, mental health, and functional difficulties among youth in the child welfare system. Implications for more targeted trauma-informed and strengths-based assessment, and treatment/service planning are discussed.
KeywordsStrengths Resilience Complex trauma Traumatic stress Mental health symptoms
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with animals performed by any of the authors. This study does not involved direct work with human subjects given the use of secondary data. However, all applicable institutional guidelines for the care and use of human subjects were followed including the protection of confidential information based on the data utilized for this study.
Informed consent was not obtained because we are using administrative and clinical data that was previously collected in conjunction with routine program activities. This study was conducted using secondary data with no direct contact with human subjects.
- Chapin, R. (2014). Social policy for effective practice: A strengths approach. New York, NY: Routledge.Google Scholar
- Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., & van der Kolk, B. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.Google Scholar
- Ford, J. D. (2005). Treatment implications of altered neurobiology, affect regulation and information processing following child maltreatment. Psychiatric Annals, 35, 410–419.Google Scholar
- Kisiel, C., Blaustein, M., Fogler, J., Ellis, H., & Saxe, G. N. (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. In J. S. Lyons, & D. A. Weiner (Eds.). Behavioral health care: Assessment, service planning, and total clinical outcomes management (pp. 17.1–17.15). Kingston, NJ: Civic Research Institute.Google Scholar
- Kisiel, C., Maj, N., Torgersen, E., den Dunnen, W., Villa, C., & Fehrenbach, T. (2016). Assessment of the complex effects of trauma across child serving settings: Measurement properties of the CANS-trauma comprehensive. Manuscript in preparation.Google Scholar
- Kisiel, C., Torgersen, E., Weil, L.E.G., & Fehrenbach, T. (in press). Use of a standardized assessment instrument within child welfare: Utility and applications of the Child and Adolescent Needs and Strengths. In V.C. Strand & G. Sprang (Eds.), Developing trauma informed child welfare agencies and services. New York, NY: Springer.Google Scholar
- Lyons, J. S. (2004). Redressing the emperor: Improving the children’s public mental health system. Westport, CT: Greenwood Publishing Group.Google Scholar
- Lyons, J. S., Gawron, T., & Kisiel, C. (2005). Child and adolescent needs and strengths: Comprehensive assessment for illinois department of children and family services manual. Winnetka, IL: The Buddin-Praed Foundation.Google Scholar
- Lyons, J. S., Small, L., Weiner, D. A., & Kisiel, C. (2008). Child and Adolescent Needs and Strengths: Illinois Department of Children and Family Services (Version 2.0). Chicago, IL: Praed Foundation.Google Scholar
- Lyons, J. S., Uziel-Miller, N. D., Reyes, F., & Sokol, P. T. (2000). Strengths of children and adolescents in residential settings: Prevalence and associations with psychopathology and discharge placement. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 176–181.CrossRefGoogle Scholar
- J. S. Lyons, & D. A. Weiner (Eds.) (2009). Behavioral health care: Assessment, service planning, and total clinical outcomes management. Kingston, NJ: Civic Research Institute.Google Scholar
- Schumacker, R. E., & Lomax, R. G. (2004). A beginner’s guide to structural equation modeling. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., Publishers.Google Scholar
- Spinazzola, J., Ford, J. D., Zucker, M., van der Kolk, B. A., Silva, S., Smith, S. F., & Blaustein, M. (2005). Survey evaluates complex trauma exposure, outcome, and intervention among children and adolescents. Psychiatric Annals, 35, 433–439.Google Scholar
- van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401–408.Google Scholar
- Weick, A. (1992). Building a strengths perspective for social work. In D. Saleebey (Ed.). The strengths perspective in social work practice (pp. 18–26). White Plains, NY: Longman.Google Scholar