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Child abuse and neglect is a serious and pervasive public health problem, with child victims often suffering adverse, long-term consequences. Approximately 3.6 million reports of maltreatment were made to child protective services (CPS) in 2014, involving 6.6 million children; over 415,100 children experienced abuse and neglect that was severe enough to require them to be removed from their homes and placed in foster care (Child Welfare Information Gateway, 2013; 2016). The negative effects of maltreatment may be compounded by family disruption and repeated placement disruptions, leading to multiple experiences of separation and loss that place children’s mental health and well-being further at risk (Kisiel, Fehrenbach, Small, & Lyons, 2009). Public awareness of the complex traumatic experiences of maltreated children has increased in recent years, as has understanding of children’s experiences in the context of child welfare service delivery. Research has shown that children who are exposed to complex trauma are at greater risk for emotional and behavioral problems, which may contribute to placement instability and delay permanency. Many foster parents and kinship caregivers are not well equipped to care for these children and to stabilize them so that their placements remain intact.

State child welfare systems are charged with supporting children in foster care, maintaining stable placements for them, and working toward permanency. To achieve these goals, child welfare agencies must develop and maintain a cadre of staff, foster parents, and kinship caregivers who can identify trauma symptoms and provide appropriate supports to children who have been exposed to trauma. A critical component of developing a capable foster care and child welfare system is system-wide adaptation of a trauma-informed approach. Child Trends completed a five-year evaluation of the implementation of Trauma Systems Therapy (TST) in KVC Health Systems (KVC), a public child welfare agency. As a result of the positive findings from this initial evaluation of TST, the Annie E. Casey Foundation (AECF) partnered with KVC and New York University (NYU) to provide technical assistance to two public child welfare agencies – in Washington County, Virginia and Richland County, Ohio – to implement Trauma Systems Therapy-Foster Care (TST-FC, an adapted version of TST for public child welfare). Child Trends evaluated the implementation process. In this report, we present findings from our examination of how two public child welfare agencies implemented TST-FC.