A Toolkit for Child Welfare Agencies to Help Young People Heal and Thrive During and After Natural Disasters

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Approximately 14 percent of children and youth have experienced at least one natural disaster prior to age 18, and most children and youth have been affected by a pandemic—COVID-19.

The United States is among the top five countries in the world that are most affected by natural disasters, with an average of over 20 natural disasters per year from 2010-2020. Approximately 14 percent of children and youth have experienced at least one natural disaster prior to age 18 and the majority of children and youth have been affected by the COVID-19 pandemic. Although the circumstances surrounding natural disasters and COVID-19 are different, the physical and emotional impacts on children, youth, and families can be similar.

Young people are especially vulnerable to the negative effects of natural disasters, and those who are involved in the child welfare system are at particularly high risk for experiencing disaster-related traumatic stress and other mental health and behavioral challenges. However, all children and youth have the capacity for resilience and healing when they receive the right types of supports.

This Toolkit is for child welfare staff, supervisors, and administrators who work with and on behalf of children, youth, and families who experience a natural disaster. The information and resources included in the Toolkit provide evidence- and trauma-informed guidance for promoting positive outcomes for children and youth who experience natural disasters.

The complete version of this toolkit, including full references, is available in English or Spanish.

Purpose and Audience of the Toolkit

This evidence-informed Toolkit was developed by Child Trends with support from The Annie E. Casey Foundation and in partnership with the National Child Traumatic Stress Network. The information and resources contained in the Toolkit aim to support child welfare staff and administrators in their efforts to enhance state, tribal, territory, and county-led efforts to promote healing and resilience among system-involved children and youth who are exposed to a natural disaster. The materials in the Toolkit have not been tested with children and youth during pandemics, which occur only rarely (e.g., every 25-30 years for influenza pandemics), but they may nonetheless be useful during and after pandemics given that natural disasters and pandemics have a number of similar challenges.

Staff and administrators can use the information and resources in the Toolkit to promote healing and resilience among children and youth in the child welfare system during and after a natural disaster. The Toolkit can also be integrated into state, tribal, territory, county, and agency disaster plans.

Intended Audience

A Toolkit for Child Welfare Agencies to Help Young People Heal and Thrive During and After Natural Disasters is a collection of tools and resources for child welfare frontline staff and administrators and their community partners. Many children and youth are involved in the child welfare system, but this Toolkit presents separate information and recommendations for the child welfare system to ensure that the resources are as relevant as possible to each service setting.

The aims of this Toolkit are to:

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  • Support child welfare agencies in their efforts to promote healing and resilience among children and youth, from birth to age 21, during and after a natural disaster.

  • Provide resources for incorporating youth, program, and community voices into plans to support positive development among system-involved children and youth who experience natural disasters.

  • Summarize evidence to date on trauma, healing, and resilience during and after natural disasters to increase knowledge among agency administrators, staff, and supervisors, and to provide the foundation for pursuing Toolkit recommendations.

  • Offer tools for infusing agencies and systems with trauma-informed care (TIC) to mitigate disaster-related trauma and other adversities that are common among children and youth involved in the child welfare system.

  • Describe strategies to promote culturally and linguistically responsive care during and after a natural disaster.

  • Provide actionable guidance for partnering with community service providers to support healing and resilience among children and youth during and after natural disasters (e.g., guidance for schools, early childhood education, community mental health and substance abuse programs, home visiting, legal system, and primary care facilities, along with services to meet families’ basic needs).

For more information on the research behind the toolkit, please download the full toolkit.

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Glossary

Adversity is a broad term that refers to a wide range of circumstances or events that pose a serious threat to an individual’s physical or psychological well-being.

Anti-bias is opposing discrimination against people based on race, ethnicity, religion, sexual orientation, gender identity, or other factors.

Anti-racist is a process of explicitly identifying and opposing racism and the policies, systems, and behaviors that perpetuate racism.

Complex trauma occurs when an individual is exposed to multiple forms of severe and chronic trauma that often begin early in life and occur in the context of important interpersonal relationships.

Equity is just and fair inclusion. Equity is achieved by environments, systems, and policies that support equal access to opportunity.

Gender identity is a personal sense of one’s own gender as male, female, or another gender (e.g., gender neutral, non-binary, transgender).

Natural disaster is a natural event such as a flood, earthquake, or hurricane that may cause great damage or loss of life.

Healing is the process of repairing and recovering from disruptions to an individual’s well-being.

Pandemic is an outbreak of a disease that occurs over a widespread geographic area and affects a significant proportion of the population.

Prevention is the process of stopping problems from arising (e.g., mental health problems, developmental or behavioral problems, disease). Primary prevention aims to avoid the development of symptoms or distress in individuals from occurring in the first place; secondary prevention aims to detect and address problems as early in their course as possible; and tertiary prevention aims to reduce the negative impact of already established problems by helping individuals return to healthy functioning.

Program, community, and youth voice means that program, community, and youth expertise is prioritized through the inclusion and active participation of these groups in the development of interventions, resources, and supports designed for them.

Protective factors are conditions or attri­butes of individuals, families, communi­ties or the larger society that mitigate or eliminate risk.

Resilience is the process of positive adaptation to adversity that arises through interactions between individuals and their environments.

Secondary adversities are often generated by traumatic incidents and can impact different aspects of an individual’s life. Examples of secondary adversities that can accompany a natural disaster are loss of property or possessions, the death of a loved one, or long-term displacement or relocation.

Secondary traumatic stress is stress that results from learning or hearing about trauma experiences of someone else. 

Sexual orientation refers to the sex of those to whom one is sexually and/or romantically attracted (e.g., lesbian, gay, bisexual, heterosexual, asexual, pansexual).

Trauma is one possible outcome of exposure to adversity. Trauma occurs when a person perceives an event or set of circumstances as extremely frightening, harmful, or threatening—either emotionally, physically, or both—and it overwhelms their capacity to cope.

Traumatic stress is any feeling of distress related to exposure to a traumatic event(s).

This Toolkit has three sections:

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  • Section 1, Recommendations for Promoting Healing and Resilience Among Children and Youth Involved in Child Welfare Who Experience Natural Disasters: Provides actionable recommendations for administrators, supervisors, and staff to prepare for natural disasters and respond to children and youth involved in these systems who experience a natural disaster.

    Go to Recommendations
  • Section 2, Promoting Healing and Resilience After Natural Disasters for Children and Youth Involved in Child Welfare: Provides an overview of trauma-informed care and resilience for children and youth involved in the child welfare system who experience a natural disaster.

    Go to Healing and Resilience
  • Section 3, Interventions to Support Healing and Resilience Among Children, Youth, and Families Who Experience a Natural Disaster: Provides an overview of promising and evidence-based, trauma-informed frameworks and interventions to support children and youth who experience a natural disaster.

    Go to Interventions

Section 1

Recommendations for Promoting Healing and Resilience Among Children and Youth Involved in Child Welfare Who Experience Natural Disasters

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This section includes actionable recommendations for child welfare administrators and for supervisors and staff to support children, youth, and families involved in the child welfare system who have experienced a natural disaster. Many of these recommendations may also be useful for responding to a pandemic. Recommendations are organized by timing of implementation—before a disaster occurs, during or immediately afterward, or for the intermediate and long-term recovery.

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How to prepare BEFORE a natural disaster occurs

Ensuring that your agency is prepared and trauma-informed can go a long way to help children and youth recover and heal from a natural disaster. Below are recommendations for administrators, supervisors, and staff to prepare for how to promote healing and resilience among youth when a natural disaster occurs.

Recommendation 1: Establish trauma-informed, agency-wide and system-wide plans and policies for natural disasters.

Natural disasters can place additional demands on child welfare agencies to respond to family safety concerns and needs. Not only is it best practice for child welfare agencies to prepare for natural disasters before they occur, but federal law also requires state child welfare agencies to establish disaster plans. Use trauma-informed care and emotional well-being principles in disaster plans, policies, and procedures at the state, tribal, territory, and local level to help children, youth, and their families recover from a natural disaster.

Recommendation 1 for Administrators:

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Child welfare administrators should establish natural disaster-specific plans and policies that align with trauma-informed care and prioritize the emotional and physical well-being of children and youth.

  • Ensure that natural disaster planning includes specific information about how to address child, youth, and staff emotional well-being and trauma. Consider establishing memorandums of understanding with mental health agencies to assist in resource sharing and recovery.

  • Develop partnerships with community agencies, organizations that tailor resources to specific populations (e.g., children or youth who are immigrants or from families of immigrants, LGBTQ+), and religious organizations for assisting families with basic needs (e.g., clothing, food pantries).

  • Engage in formal partnerships with local emergency response and community agencies to ensure the child welfare agency and system is included in community preparedness.

  • Provide training and staff development on how to effectively implement the disaster plan. Consider cross-agency trainings involving all individuals who may interact with children and youth during a natural disaster to promote relationship-building and collaboration, including parents/caregivers, community members, child welfare staff, mental health providers, first responders, schools, and emergency personnel.

    Share comprehensive disaster plans widely within the child welfare agency and with community partners to ensure all stakeholders have access to disaster response information. Practice and review disaster plan implementation regularly with staff, including drills and evaluation of the drills (e.g., identifying lessons learned, amending plan as needed). Sharing and practicing disaster plans in advance of a natural disaster helps agencies collaborate and implement plans more effectively when the disaster does occur.

Recommendation 1 for Supervisors and Staff:

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Child welfare supervisors and staff should work together with children, youth, and their families to develop emergency plans before a natural disaster occurs and ensure the plan aligns with a trauma-informed approach and prioritizes the emotional well-being of children and youth.

  • Partner with children, youth, and their families to develop a family preparedness, safety, and communication plan and review the plan regularly. The plan should include measures for ensuring physical safety when a disaster occurs (e.g., shelter in place, escape routes), tailored to the type(s) of disaster that occur in the local area. The plan should also address what to do when children are at home and school. Include plans for communication if a child or youth is separated from parents or other caregiver(s) during the disaster, including easily accessible contact information for family members, caseworkers, therapists, and other supports. Identify alternative, safe placement options, in combination with a plan for reunification. Review the plan every few months, particularly for children and youth who may experience changes in placement or who may be transitioning out of care. For a sample family preparedness, safety, and communication plan, download the NCTSN family preparedness plan and wallet card.

  • Ensure that children, youth, and their families are informed about the nature and timing of common disasters and pandemics in your area (i.e., what time of year they tend to occur), common reactions among children and youth (particularly those with trauma histories), and how to access updated official disaster information.

  • Assist families with identifying reliable information sources about natural disasters (e.g., website, radio, emergency lines). Encourage parents and caregivers to give children factual information about the disaster in simple, developmentally appropriate terms. Share apps with parents and caregivers for ideas on talking with children and youth about natural disasters (e.g., Help Kids Cope app, Bounce Back Now app).

    Assemble an emergency supply kit and plans for meeting the child, youth, and family’s basic needs when a disaster occurs. Children and youth should have access to enough water, food, and other emergency supplies for at least three days and secure access to medications for at least seven days. Help children, youth, and their caregivers identify resources for basic needs after emergency supplies have been used, including whom to call for support. For a list of resources and templates for family emergency planning, go to https://www.ready.gov.

Recommendation 2: As a foundation for natural disaster response, build a trauma-informed child welfare agency and system focused on healing and resilience.

For child welfare agencies and systems to provide a trauma-informed response to natural disasters, it is critical to establish an agency-wide and system-wide commitment to trauma-informed policies and daily practices before a natural disaster occurs. A trauma-informed child welfare system is one that is healing- and resilience-focused, with children and youth having access to the supports and services they need. Child welfare systems that are trauma-informed before a natural disaster occurs are better able to address the needs of children, youth, and families, resulting in better outcomes, such as reduced use of long-term behavioral health services, fewer transitions in placements, and reduced use of psychotropic medications.

Recommendation 2 for Administrators:

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Child welfare administrators should implement or enhance comprehensive, agency-wide, and system-wide policies, procedures, and infrastructure that are trauma-informed and prioritize the emotional and physical well-being of children and youth.

  • Include trauma-informed principles and language in agency-wide and system-wide policies and procedures, identifying exposure to natural disaster as a type of adversity that can lead to trauma.

  • Conduct an organizational self-assessment for trauma-informed organizations. To get started, see the Put It Into Practice #4 resource.

  • Implement training using an evidence- and trauma-informed curriculum tailored to the needs of children, youth, and families in the child welfare system; the curriculum should be implemented systemwide within the agency and throughout state, local, territory, and tribal child welfare systems (e.g., National Child Traumatic Stress Network’s Child Welfare Trauma Training Toolkit).

  • Conduct universal screening using a valid, reliable, age-appropriate, and culturally sensitive universal screening tool to identify types of adversity exposure and symptoms of trauma in response to a natural disaster (e.g., UCLA Brief COVID-19 Screen for Child/Adolescent PTSD; Child PTSD Symptom Scale). Screening for adversity and trauma should be conducted as one component of a comprehensive, developmentally sensitive approach to assessing strengths and needs, including resilience and protective factors (e.g., PACEs Questionnaire).

  • Consult intervention registries, such as the Title IV-E Prevention Services Clearinghouse or the Blueprints for Healthy Youth Development, to identify effective preventive and therapeutic interventions for children, youth, and families that meet federal criteria for reimbursement.

    Develop strong partnerships with mental health and community service organizations, as well as a system for referral and follow-up (see Section 3 of this Toolkit for a list of evidence-informed trauma and mental health interventions).

Recommendation 2 for Supervisors and Staff:

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Child welfare supervisors and staff should seek out and participate in trauma-informed and natural disaster-specific training and professional development to support engagement in practices that promote social and emotional well-being and positive development and behavior among children and youth who have experienced trauma.

  • Engage in comprehensive training and professional development opportunities in trauma-informed practices for child welfare supervisors and staff, such as the Child Welfare Trauma Training Toolkit.

  • Complete training in evidence-informed models for natural disaster preparedness and response, such as Psychological First Aid (PFA). For more information on these models, see Section 3 of this toolkit.

  • Conduct universal screening for adversity and trauma symptoms with children and youth on your caseload, using a valid, reliable, and developmentally- and culturally- sensitive tool (e.g., UCLA Brief COVID-19 Screen for Child/Adolescent PTSD; Child PTSD Symptom Scale; Young Child PTSD Screener).

  • Become familiar with evidence-based treatments and supports for children and youth experiencing trauma; develop relationships with providers, community agencies, and schools that offer these types of services and supports; and make appropriate referrals to support the emotional well-being of children and youth. For a list of these approaches, see Section 2 of this toolkit and reference intervention registries, such as the California Evidence-Based Clearinghouse for Child Welfare (www.cebc4cw.org) or Blueprints for Health Youth Development (www.blueprintsprograms.org), to obtain specific information on types of interventions, their level of evidence, for whom interventions were designed, and eligibility for federal reimbursement.

Recommendation 3: Ensure natural disaster plans, policies, and practices are culturally inclusive and intentionally address disproportionality.

Black, Latinx, American Indian, Alaska Native, and LGBTQ+ youth experience disproportionate exposure to adversity and trauma and are overrepresented in the child welfare system. To be effective in disaster response and promote child and youth well-being, child welfare agency policies must incorporate anti-racist, anti-oppression guidance for administrators, supervisors, and staff to actively protect children, youth, and families from institutional racism and discrimination, which can cause further trauma, including during a natural disaster.

Recommendation 3 for Administrators:

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Child welfare administrators should ensure that disaster policies and procedures that incorporate anti-racist, anti-oppression guidance address the needs of children and youth who are disproportionately impacted by natural disasters and other adversities, and/or who are overrepresented in the child welfare system, including Black, Latinx, American Indian, Alaska Native, and LGBTQ+ children and youth.

  • Create a senior management position dedicated to promoting diversity, equity, and inclusion at the organizational level and ensure the individual in this position participates in disaster preparedness and response planning.

  • Actively partner with children, youth, and families (e.g., through interviews, focus groups, committees and councils, or other approaches) to develop language, review and assess information on disparate impact, and utilize equity-focused resources to guide disaster response planning. Ensure you partner with groups who are overrepresented in child welfare.

  • Incorporate anti-racist and anti-discrimination policies and procedures within disaster plans and policies to reduce inequities in the child welfare system using a systematic approach, such as a racial equity impact analysis (REIA). Establish a policy review team to conduct the REIA of disaster plans and policies, ensuring representation of impacted groups on the team.

  • Incorporate LGBTQ+ responsive language and approaches in disaster plans and policies and explicitly outline strategies for staff to affirm LGBTQ+ identities and strengths during a natural disaster. Ensure supports are applicable to both families of choice and families of origin for LGBTQ+ youth.

  • Establish a plan for supporting the basic needs of families during a natural disaster, particularly in communities with high levels of poverty and lack of access to basic resources and services (e.g., provision of culture-specific foods, clothing, religious supports).

    Partner with schools, early childhood programs, mental health agencies, crisis response teams, and other community agencies that are committed to culturally responsive, anti-racist, and/or LGBTQ-affirming practices. Partner with agencies and interpreters that can provide services and resources in the child/youth’s preferred language.

Recommendation 3 for Supervisors and Staff:

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Child welfare supervisors and staff should engage in professional development and practices that are anti-racist and anti-oppressive, and that address disproportionality of representation in the child welfare system.

  • Seek out and participate in training and professional development on racial diversity, equity, and inclusion, particularly regarding disproportionality in the child welfare system. The California Evidence Based Clearinghouse has rated several models on their evidence for reducing disproportionality (e.g., Family Assessment Response, Preliminary Protective Hearing Benchcard)—become familiar with these models and their practices.

  • Seek out and participate in training on the needs of LGBTQ+ children and youth using formalized resources and models. Use identity-affirming language when working with children and youth, ensure that resources are LGBTQ+ focused and affirming, and identify LGBTQ+-affirming referrals for outside services.

  • Talk and raise awareness about diversity, equity, and inclusion. Explicitly ask staff about discrimination and racism they have experienced and seek ways to address and prevent future harm. Engage in meaningful conversations with supervisors and colleagues about racial and ethnic diversity in the workforce. These discussions should be intentional and semi-structured. Group discussions should be moderated by a leader with expertise in diversity, equity, and inclusion and should follow best practices for discussing these topics.

Recommendation 4: Establish natural disaster communication protocols and plans for staff and families.

When a natural disaster occurs, there are often short- or long-term challenges with maintaining regular communication with family, friends, and other supports. Child welfare agencies should identify and use alternative communication and monitoring strategies, including virtual meetings, electronic communication, and telephone contact, when in-person contact with children, youth, or families is not possible. Building an infrastructure, including supplying both staff and families with the necessary equipment, for alternative methods of communication before a natural disaster is critical for a seamless transition during an emergency.

Recommendation 4 for Administrators:

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Child welfare administrators should establish staff protocols for maintaining regular contact with children, youth, and families during and after a natural disaster occurs.

  • Establish formal protocols for frequent and ongoing contact with children, youth, and families during and after a natural disaster occurs to monitor their physical and emotional risk, safety, and well-being and to keep them informed about the disaster and available resources while following safety guidelines.

  • Build agency capacity for a seamless transition to virtual services (e.g., telehealth) before a natural disaster and continuously monitor opportunities for emergency and grant funding for virtual services and technology supports.

  • Develop electronic and printable resource libraries for staff to quickly access and provide information to children, youth, and their caregivers on natural disasters, their effects, and approaches to addressing the physical and emotional needs of children and youth.

Recommendation 4 for Supervisors and Staff:

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Child welfare supervisors and staff should partner with children, youth, and families to establish communication plans in the event of a natural disaster and review the plan regularly.

  • Incorporate disaster communication plans into regular goal setting and service planning with children, youth, and families, including contingency plans for when in-person contact is unavailable, methods for getting in touch with loved ones within and outside the home or residential setting, and alternative emergency contacts and supports when electronic communication may be limited.

  • Review the disaster communication plan regularly or any time a placement changes or another major transition occurs.

  • Identify and become familiar with natural disaster-related resources for families and consider keeping printable copies of resource lists easily accessible to staff, children, youth, and their caregivers. Include information on natural disasters, their effects, and approaches to addressing the physical and emotional needs of children, youth, and their families.

Recommendation 5: Proactively identify and address staff needs related to secondary traumatic stress and well-being.

Child welfare staff can be directly impacted by a natural disaster and as essential workers may be separated from their families and support systems or experience property loss and displacement. In addition, due to the nature and demand of their work, child welfare staff are at risk for experiencing secondary traumatic stress, burnout, and poor emotional and physical well-being. Staff well-being contributes to productivity, self-compassion and compassion for others, and positive engagement with children, youth, and families. Child welfare agencies and systems must proactively identify and address staff well-being before a natural disaster occurs and make concerted efforts to monitor secondary traumatic stress reactions during times of emergency.

Recommendation 5 for Administrators:

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Child welfare administrators should establish an organizational culture that prioritizes the physical and emotional well-being of staff and administrators.

  • If staff were directly impacted by the disaster, take immediate steps to support their physical and emotional well-being by connecting staff with available supports within the agency/system and in the community.

  • Formalize strategies for preventing, identifying, and addressing secondary traumatic stress and vicarious trauma among child welfare staff and administrators by creating and implementing a workforce wellness plan that promotes high-quality, trauma-informed services and reduces staff burnout and turnover.

  • Model self-care and work-life balance for supervisors and staff throughout the organization.

  • Increase staff awareness of the potential impacts of working with traumatized individuals on their own well-being, and emphasize the importance of prioritizing self-care (e.g., mindfulness, exercise, good nutrition, rest, social support, counseling).

  • Assess staff well-being by routinely screening for secondary traumatic stress among staff (e.g., Professional Quality of Life Measure; Secondary Traumatic Stress Informed Organization Assessment Tool) and in the organization (e.g., Secondary Traumatic Stress Informed Organization Assessment), and offer information for self-care activities, employee assistance, or obtaining external sources of support.

  • Provide consistent, high-quality reflective and trauma-informed supervision that focuses on positive and supportive professional relationships.

    Create “trauma-free zones” or “self-care rooms” to provide a space for mental and physical nourishment (i.e., snacks, water), including wellness activities (e.g., mindfulness, yoga, exercise, quiet time, time to connect with supportive colleagues) and resources on trauma, healing, and resilience for staff, supervisors, and administrators.

Recommendation 5 for Supervisors and Staff:

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Child welfare supervisors and staff should prioritize self-care and physical and emotional well-being in their work through regular, routine activities and practices.

  • Identify sources of social support and enjoyable activities outside of the workplace, such as spending time with family, spiritual/religious groups, clubs, or hobbies and make a routine for spending time engaging in them each week. The best way to make a routine into a habit is to share your intentions with someone else who can help encourage you in your goals.

  • Reach out to supportive colleagues and supervisors about work-related stress or when you have a tough day or when a case does not end well.

  • Remember the importance of your work and your reason for working in child welfare, centering your thoughts on the beneficial aspects of your work.

  • Keep an eye out for unhealthy coping methods, such as drinking too much alcohol, substance use, increased arguments or tension with family or friends, or losing too much sleep. Be aware of community resources and employee assistance programs to support you with these needs if they arise. Share these resources with a colleague who may benefit from them and follow-up to check if they were successfully connected.

Recommendation 6: Administrators should coordinate and collaborate with community and other service organizations before a natural disaster occurs to support preparedness, healing, and resilience.

Providing an effective, trauma-informed response to natural disasters by child welfare agencies requires collaborative leadership from administrators. Partnering with community agencies and other services organizations before a disaster occurs is a best practice in child welfare. During a natural disaster, these collaborations become even more critical for mobilizing an effective and timely response.

  • Closely monitor changes in federal, state, territory, tribal, and county child welfare policies designed to address disaster-related challenges and to support child, youth, family, and staff well-being.

  • Engage in cross-system collaboration and disaster planning with other national, state, and local child- and family-serving organizations, community organizations, and emergency systems (e.g., Red Cross, FEMA, law enforcement, schools) to coordinate a trauma-informed response.

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How to respond DURING and AFTER a natural disaster occurs

Experiencing a natural disaster can result in anxiety, stress, and fear among children and youth in the child welfare system, all of whom have already experienced some form of adversity or trauma. Natural disasters can pose new challenges, such as displacement, death or injury to a parent/caregiver or a pet, loss of possessions, or loss of contact with social supports. As with all types of trauma, children and youth experience a range of emotions and reactions to natural disasters, with many recovering and healing without ongoing formal intervention. Age, prior experiences of trauma, support from a primary caregiver and other social supports, and the severity of impact of the natural disaster are all important factors in child and youth response.

There are several strategies and supports child welfare systems can use to help children and youth recover. Many of these strategies will be implemented primarily by direct service supervisors and staff who work with children and youth on a day-to-day basis. However, in addition to mobilizing an agency and system-wide response, there are several specific actions administrators can also take during and after a natural disaster to promote emotional well-being for children and youth. This section outlines broad natural disaster response recommendations for administrators, followed by more specific recommendations for direct service supervisors and staff.

Recommendation 7: Administrators should continually monitor safety protocols and support staff and families to cope with uncertainty and maintain routines even if evacuation occurs.

When a natural disaster occurs, administrators are also faced with rapidly changing landscapes and must closely monitor changes in policies, recommendations for best practices, and funding opportunities.

  • Monitor updates to best practices for safety monitoring and emerging, promising approaches to addressing disaster-related trauma, in addition to existing evidence-informed approaches (see Section 3).

  • Establish protocol and procedures for identifying and addressing primary and secondary trauma reactions among staff, particularly those regularly working in the field with children, youth, and families. Connect staff with supports for coping with uncertainty and encourage maintenance of routines, even in the event of displacement or evacuation.

  • Monitor emergency and related funding opportunities to build agency infrastructure to respond to disaster-related needs for children and youth and maintain consistent service delivery (e.g., investing in telehealth, mental health training/consultation).

Recommendation 8: Supervisors and staff should use and refer to evidence- and trauma-informed training, services, and supports for children, youth, and families who experience a natural disaster.

Using evidence-informed, trauma-focused approaches to respond to children and youth involved in child welfare who experience a natural disaster is important for preventing and mitigating the long-term negative impacts and for promoting healing and resilience. Engaging parents and caregivers in emergency response, particularly for young children, is imperative to processing and recovering from a natural disaster. Research shows that parent and caregiver response during and after a natural disaster are correlated with child and youth response.

Because children and youth rely on their caregivers for information, basic needs, and support, it is important to talk with parents and caregivers about modeling calm reactions and taking their own time to process what has happened. Supporting parents and caregivers to develop family emergency and communication plans and to learn common reactions to natural disasters, how to support themselves, and how to respond to children and youth in their care are all critical components to a trauma-informed disaster response in child welfare systems.

  • In the days and weeks after a natural disaster occurs, use an evidence-informed approach to support children and youth (e.g., Psychological First Aid). Before asking questions or collecting information from children, youth, and their families, begin by establishing regular contact and engaging with children and youth on your caseload; assessing for physical and emotional risk and safety; offering ways to provide support and comfort; and connecting the child or youth to resources for stabilization, if there is ongoing crisis (e.g., loss of home). For additional tips on how to respond to a natural disaster in the immediate aftermath, see the Put It Into Practice #5 resource. For additional information on Psychological First Aid, see Section 3 of this toolkit.

  • Encourage parents and caregivers to develop awareness and skills for supporting children and youth in their care during and after a natural disaster. Parents/caregivers should provide factual information on what has happened and what to expect after a natural disaster; discourage over-exposure to media about the natural disaster; download the Help Kids Cope app developed by the NCTSN for tips on talking to children and youth about natural disasters; and encourage engaging in regular routines as much as possible to instill a sense of normalcy. Visit www.nctsn.org for additional disaster-specific resources for parents/caregivers and staff, which are updated regularly for major disasters.

  • Avoid using “debriefing” techniques by having children and youth talk about the details of the natural disaster in the immediate aftermath, as these approaches can actually increase risk for ongoing posttraumatic stress. If a child or youth shows ongoing reactions of trauma, referral to a structured, trauma-focused intervention is warranted. See Section 3 of this toolkit for a list of evidence-based, trauma-informed models for children and youth in child welfare who have experienced a natural disaster.

  • After initial contact is made and support and stabilization services have been provided (if necessary), begin gathering information about the needs of the child, youth, and families. Remember to discuss practical assistance with basic needs and supports, in addition to connection with social supports, information on coping with common reactions, and linkage to outside services if necessary. Psychological First Aid offers several guides, handouts, and resources for talking about coping and common reactions with children and youth (see Section 3). For additional tips for talking to children and youth about natural disasters, see the Put It Into Practice resources for this section. For discussion guides on talking with parents/caregivers of young children about several types of natural disasters in a variety of language, see the Trinka and Sam books developed by the National Child Traumatic Stress Network.

Recommendation 9: Supervisors and staff should maintain close and regular contact with children, youth, and families in the weeks and months following a natural disaster to provide them with information and support.

Providing consistent social support during and after adversity and trauma is one of the most effective ways to prevent or reduce long-term, trauma-related mental health concerns and to promote healing and resilience. To effectively provide a vehicle for children, youth, and families to share their disaster-related needs, child welfare supervisors and staff must initiate and maintain regular contact with children and youth during and after a natural disaster.

  • Maintain weekly or biweekly contact with children, youth, and families in the weeks and months following a natural disaster and provide information on common reactions and supports. Ensure that children and youth have a way to get in touch with you in a timely manner.

  • When in-person contact is not possible, it is essential to identify alternative ways to connect with children and youth and to help them establish and maintain contact with others in their support network, including through the use of technology (e.g., telephone, text messaging, virtual meetings, WhatsApp).

  • Support and help maintain social connections between children and youth’s families, friends, and communities to provide social support and ongoing information about their safety.

    Tailor strategies to the child’s age and developmental stage. For young children, case planning and implementation requires close contact with their primary caregivers. Ensure that older children, adolescents, and transition-age youth have contact with peers, siblings, caring adults, and/or other social supports.

Recommendation 10: Recognize that certain family challenges, such as child abuse and neglect, domestic violence, and parental mental health and substance abuse problems, tend to increase during natural disasters, and be prepared to identify and respond with appropriate supports.

Research shows that violence in the home and child maltreatment increase during and shortly after natural disasters. Proactively conducting risk and safety assessments, trauma-focused screenings, and referrals to trauma-informed, culturally sensitive services and supports increases the chances that children and youth will recover from a natural disaster.

  • Actively monitor the well-being, strengths, and needs of children, youth, and their parents/caregivers. Screen children and youth for disaster-related and other trauma symptoms using a valid, reliable, and developmentally- and culturally- sensitive tool (e.g., UCLA Brief COVID-19 Screen for Child/Adolescent PTSD; Child PTSD Symptom Scale, Young Child PTSD Screener; SAMHSA Child/Youth and Adult Assessment and Referral Tools).

  • Conduct developmental screenings of children and youth to identify their strengths and needs and to inform effective intervention.

  • For children and youth experiencing moderate levels of distress in the weeks following a natural disaster, consider using a short-term, evidence-based model to promote coping with natural disasters, such as Skills for Psychological Recovery (SPR). See Section 3 of this toolkit for more information on SPR.

  • For children and youth experiencing severe distress or who have not shown improvement six weeks after a natural disaster, refer them for formal evidence-based, trauma-informed treatment. For a list of evidence-based treatments that have been used with youth in child welfare and/or in response to natural disasters, see Section 3 of this toolkit.

Recommendation 11: Monitor staff well-being for signs of secondary traumatic stress and vicarious trauma, and create regular opportunities for staff to engage in self-care and to improve their work-life balance.

When a natural disaster occurs, child welfare supervisors and staff often experience similar stressors and events as the children and youth in their care. Monitoring and addressing signs of burnout and secondary traumatic stress are critical for sustaining the emotional well-being of the child welfare workforce, and it becomes even more critical during times of emergency.

  • Learn about the signs of secondary and vicarious trauma and monitor yourself for these signs during and after a natural disaster. Try using a standardized tool to check your reactions (e.g., PROQoL; Secondary Traumatic Stress Scale).

  • Use strategies and activities to prevent or reduce trauma symptoms, such as relaxation (e.g., deep breathing, visual imagery), engaging in enjoyable activities or socialization, and processing and expressing feelings (e.g., through journaling, art, music). If symptoms persist, talk to your supervisor, colleagues, or employee assistance to obtain additional support and consider reaching out to a mental health provider.

Put It Into Practice:

1. Five Ways to Support Children and Youth in Child Welfare Who Experience a Natural Disaster (PDF)
Use this resource DURING and IMMEDIATELY AFTER a natural disaster occurs

2. Dos and Don’ts for Talking with Children and Youth About a Natural Disaster (PDF)
Use this resource AFTER a natural disaster occurs, once the child or youth is ready to receive support

3. Questions for Older Children and Youth About Their Strengths and Needs (PDF)
Use this resource DURING and AFTER a natural disaster occurs

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Child Welfare Resource Library 1: Recommendations for Promoting Healing and Resilience Among Children and Youth Involved in Child Welfare Who Experience Natural Disasters

Bounce Back Now App National Child Traumatic Stress Network

Disaster Planning for Child Welfare Agencies Child Welfare Information Gateway

Family Preparedness: Thinking Ahead National Child Traumatic Stress Network

Family Preparedness Wallet Card National Child Traumatic Stress Network

Help Kids Cope App National Child Traumatic Stress Network

Racial Equity Discussion Guide U.S. Department of Health and Human Services

Race Matters: Racial Equity Impact Analysis The Annie E. Casey Foundation

Toolkit to Support Child Welfare Agencies in Serving LGBTQ Children, Youth, and Families U.S. Department of Health and Human Services

Trinka and Sam Book Series (available or multiple types of disaster) National Child Traumatic Stress Network

Well-being of the Workforce U.S. Department of Health and Human Services

Section 2

Promoting Healing and Resilience After Natural Disasters

Array

This second section of the toolkit provides foundational concepts and research on the impact of trauma from natural disasters on children and youth in the child welfare system. It also describes how integrating trauma-informed care systemwide in state, county, tribal, and territory child welfare systems can support healing, resilience, and equitable outcomes for all children, youth, and families after a natural disaster.

Both natural disasters and child maltreatment constitute forms of adversity that can be traumatizing to young people of all ages. Most children receiving child welfare services have already experienced abuse or neglect by caregivers, in addition to the natural disaster and secondary adversities associated with these experiences. The combination of these adversities place children and youth receiving child welfare services at especially high risk for trauma and related hardships, such as mental and physical health challenges, difficulties forming healthy relationships, poor school performance, and limited educational and occupational success. Black, Latinx, American Indian, Alaska Native, and lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ+) children and youth experience higher rates of secondary adversity related to natural disaster (e.g., displacement, property loss) and are overrepresented in the child welfare system. Thus, child welfare agencies must use an anti-bias, anti-racist approach focused on child, youth, and family strengths along with trauma-informed care (TIC) to be truly effective in natural disaster response. In addition, services must address the specific needs of each child, youth, and family, accounting for their age and developmental stage, racial and ethnic background, sexual orientation, and gender identity.

Given the extent of exposure to trauma, loss, separation, and other adversities among families involved in the child welfare system, staff, supervisors, and administrators must be proactive in preventing and mitigating trauma from natural disasters. As a foundation for best practice, trauma-informed care is increasingly recognized as an effective approach to promoting healing and resilience in the child welfare system.,, As Casey Family Programs noted, child welfare agencies must be trauma-informed because, “Perhaps no other child-serving system encounters a higher percentage of children and parents with trauma histories than child protection agencies.”

The good news is that, with the right supports, all children and youth have the capacity to thrive after adversity or trauma, including after natural disasters. Child welfare agencies are best equipped to partner with young people to support their well-being during and after natural disasters when they incorporate the best evidence to date on trauma, healing, and resilience into their policies and daily practices.

What are trauma and grief, and how do they impact children and youth?

Over half of all children in the United States, approximately 35 million individuals under 18, experience trauma. Trauma occurs when a child, youth, or adult perceives an event or set of circumstances as overwhelmingly frightening, harmful, or threatening, whether emotionally, physically, or both. It is one possible outcome of childhood exposure to adversity, not an inevitable consequence. Grief occurs when there has been a death of a loved one or when other losses occur.

Some children, youth, and families experience trauma and grief as a result of natural disasters. For example, up to 30 percent of children who have lived through a natural disaster develop long-term mental health challenges, including posttraumatic stress disorder (PTSD). This statistic highlights the importance of taking proactive steps to prevent the re-traumatization of young people with a history of abuse and neglect when a natural disaster occurs. Natural disasters can cause children and youth who have previously experienced trauma to experience re-traumatization, the re-experiencing of prior trauma—consciously or unconsciously—which can also interfere with healing and recovery from prior trauma.

How do trauma and grief impact children and youth in the child welfare system?

To support healing and resilience among children and youth during and after natural disasters, it is essential that child welfare staff, supervisors, and administrators understand how trauma and grief impact the lives of children and youth in their care and how to address their related needs.

When a natural disaster occurs, children and youth in the child welfare system must cope with multiple adversities that accumulate over time. Not only do they have a history of child abuse and neglect, but many children and youth served by child welfare also experience endure:

  • Separation from family, home, school, and community when placed in foster care
  • Death of loved one(s)
  • Multiple out-of-home placements
  • Domestic violence
  • Challenges resulting from parental mental health needs and/or substance abuse
  • Poverty
  • Community violence

Complex trauma places a child or youth at especially high risk for behavior problems, difficulty forming healthy relationships with caregivers and others, and mental health problems, which decrease the chances that a child or youth is successful in important life domains, such as home, school, and work.

In other words, a natural disaster can be especially difficult for maltreated children and youth due to an accumulation of adversity in their lives. The build-up of severe and pervasive traumatic events of an interpersonal nature that often begin early in life (e.g., removal from home, multiple placements in foster care, substance abuse and mental health problems in the family) is referred to as complex trauma. Complex trauma places a child or youth at especially high risk for behavior problems, difficulty forming healthy relationships with caregivers and others, and mental health problems, which decrease the chances that a child or youth is successful in important life domains, such as home, school, and work. Some children and youth who experience the death or loss of a loved one may have ongoing challenges and have difficulty remembering their loves one in a positive way. Children and youth may have trauma reactions following a death that was sudden, unexpected, or anticipated (e.g., due to illness).

How do natural disasters affect children and youth?

More than half of families and nearly 14 percent of all children and youth in the United States have experienced a natural disaster.Childhood exposure to natural disasters is widespread. More than half of families and nearly 14 percent of all children and youth in the United States have experienced a natural disaster. Furthermore, climate change has increased the frequency and severity of natural disasters across the globe, with rates of climate-related disasters tripling in the last 30 years.

While natural disasters cause immediate distress for nearly everyone involved, many young people recover relatively quickly and return to pre-disaster levels of functioning, while others struggle with serious challenges. In fact, a higher proportion of young people develop mental health problems after a natural disaster than adults, including traumatic stress reactions and posttraumatic stress disorder (PTSD). This may occur through direct physical or psychological harm, or indirectly when important people in children’s lives are affected, such as a parent/primary caregiver, sibling, educator, mental health provider, or caseworker. Children or youth may be separated from their caregivers, homes, belongings, and communities; some are injured and/or witness others being injured or killed; and many endure long periods of stress, fear, and grief. Those with prior histories of adversity and trauma tend to have more significant reactions to natural disasters than those without ongoing or a prior history of adversity.

Although the evidence is still emerging in child and youth response to COVID-19, pandemics can also result in similar or related types of adversity, stress, and trauma as other types of disaster. A review of the literature on the impacts of natural disasters on children shows that certain children and youth are more susceptible to physical, mental health, and learning difficulties in the long-term when they:

  • Were severely injured or ill due to the natural disaster or a family member has experienced significant injuries or illness
  • Endured other forms of trauma after the natural disaster
  • Experienced multiple events that are dangerous or life-threatening during the disaster
  • Experienced a death of a loved one or pet
  • Believed there was a direct threat to their life or a family member’s life during the disaster
  • Experienced multiple adversities after a disaster
  • Missed school for an extended period of time or had to drop out
  • Were at greater risk for property loss and personal impact after the natural disaster (i.e., due to poverty, systemic racism, and oppression)
  • Had a family member/caregiver who was a rescue worker or essential worker

Factors that contribute to child and youth outcomes after natural disasters include a wide range of risk and protective characteristics of the individual, family, and community, as well as the nature of the disaster.

Factors contributing to a young person’s reaction to a natural disaster

Adapted from: Lai, B. S., & La Greca, A. (2020). Understanding the impacts of natural disasters on children. Washington, D.C.: Society for Research in Child Development. https://www.srcd.org/sites/default/files/resources/FINAL_SRCDCEB-NaturalDisasters_0.pdf

During natural disasters, conditions can shift rapidly, depending on the nature of the event (e.g., flooding during a hurricane; displacement due to a wildfire) and the local, state, and federal response (e.g., whether there is a formal Disaster Declaration that allows public officials to use emergency resources to protect life, property, and public health). Given the often unpredictable and shifting conditions of natural disasters, frequent and ongoing communication with children, youth, and their caregivers is necessary to assess their well-being and needs as they shift, and to provide appropriate, trauma-informed supports along the way.

What do children and youth need during and after a natural disaster?

Children and youth are more likely to heal from complex trauma and exhibit resilience in the face of a natural disaster when the environments with which they interact most often are responsive to their specific needs. Child welfare agencies, juvenile justice settings, schools, early childhood education programs, mental health agencies, primary care settings, and other community-based services can increase young people’s chances of resilience by communicating directly with children, youth, and their parents/caregivers about their immediate and longer-term needs.

Child welfare agencies, juvenile justice settings, schools, early childhood education programs, mental health agencies, primary care settings, and other community-based services can increase young people’s chances of resilience to the combined effects of child maltreatment and natural disasters by continually communicating with children, youth, and their caregivers about their immediate and long-term needs.

Because each child, youth, and family has their own strengths and needs during a natural disaster, this requires caseworkers and other front-line staff to maintain frequent contact with them to assess their status using approaches that are feasible at that time, such as conducting visits virtually. Research and practice show that talking to children, youth, and their caregivers about specific areas of strength and need are especially useful for promoting healing and resilience.

To determine key areas of need for system-involved children and youth who experience a natural disaster, Child Trends engaged in several research-based activities to better understand the perspectives of youth, child welfare administrators, and the scientific literature. We conducted interviews with adults over age 18 who had received child welfare and/or juvenile justice services as youth during different types of natural disasters (Anchorage, Alaska; Santa Barbara, California; Baton Rouge, Louisiana). Key needs identified by youth during these focus groups and interviews are shown and detailed below. For further information on research methods, see the PDF toolkit in English or Spanish.

Four needs identified by youth formerly involved in the child welfare system during and after a natural disaster

Information and resources

“More information about what is happening would help a lot. It’s a lot scarier when you don’t know what’s going on. Everyone’s freaking out about it, but you don’t know what they’re freaking out about. I was confused. Why are you running and dragging me along? I’m [an adult now], and I [still] remember every single part that happened.”

-Youth formerly involved in child welfare and/or juvenile justice

First, children and youth needed sufficient information and resources. Children and youth wanted more information about the natural disaster, what to expect, and anticipated impacts on their lives. They wanted more consistent communication about the event delivered calmly by adults in charge of their care. Youth reported that not being provided adequate information about the event and its consequences, as well as exposure to staff who were stressed and overwhelmed, increased their anxieties and worries. Overall, youth wanted more structure and support from the adults in their environment in order for them to manage their own stress and feelings.

Social connections

“Communication was a big issue because I felt they were cutting off a lot of our communication by taking our phones. For those who have family or a support system outside, who needed to stay in contact when they’re feeling down or low or going through something, that probably was one of the biggest issues.”

-Youth formerly involved in child welfare and/or juvenile justice

Youth reported feeling socially isolated and stated a clear desire to have stronger social connections during a natural disaster. For example, they wished they had more regular contact with supportive family members and adults, including biological, kinship, and foster family members. This was especially important during times that the disaster-imposed barriers that made it difficult to locate and reach loved ones. In some instances, separation from social connections occurred because youth or family members were displaced from their community. In other cases, the agency made a change in the child’s foster home placement. In still other cases, individual family members and friends lacked access to the equipment necessary to allow for virtual visits when in-person visits were limited or not allowed. Several youth also wanted more intensive formal supports from a caseworker. For example, some youth recalled that check-ins with a caseworker did not occur regularly during a natural disaster, a period of time during which they desired more frequent contact.

Physical safety and well-being

Youth reported concerns about physical safety of their residences, buildings, and classrooms in the immediate aftermath of a natural disaster, particularly after earthquakes, where aftershocks continue for days or weeks after the initial quake. Youth reported differences in safety measures between residential or congregate housing and private foster homes (e.g., bolting down pictures or furniture after an earthquake), which impact youth’s feelings of physical safety when transitioning between homes.

Emotional safety and well-being

Youth shared different experiences with receiving support for their emotional safety and wellness during and after a natural disaster. Few youth in Toolkit focus groups reported receiving support from formal services, such as a mental health provider or counselor. Some relied on informal sources of support from foster siblings, case managers, or foster parents, but there was inconsistency in the supports they received. Some youth who were experiencing acute stress reactions were dismissed or encouraged to move on without giving adequate time and space to process the events and provide reassurance. When consistent, nurturing supports were available, however, they were extremely helpful to the emotional safety and wellness of system-involved youth during a natural disaster.

“Before I left [my residential placement], they made sure everyone was safe. They bolted the pictures and stuff on the walls so it wouldn’t fall off. But when I transitioned to a foster home, they didn’t do that.”
-Youth formerly involved in child welfare and/or juvenile justice

What protective factors promote healing and resilience after natural disasters?

Everyone in a child welfare agency and system has a role to play in promoting healing and resilience among children and youth after a natural disaster. Resilience and recovery are common, and the chances increase when children and youth have the right supports in place. For example, 2-3 years after Hurricane Katrina, over 72 percent of children exhibited signs of positive development after exposure to a natural disaster.

“Just having people you think are supposed to be there for you contact you. It would be reassuring that they cared, and that would help us out emotionally. Like you’re not alone, you know? Just to show us there are people out there to tell us we’ll be okay. I think that would be very helpful.”

-Youth formerly involved in child welfare and/or juvenile justice

Protective factors are characteristics of an individual, family, or broader environment that are associated with resilience. Resilience is not an individual trait that one does or does not have, but rather a process of positive adaptation to adversity. Protective factors increase the chances of resilience in the face of hardships, as opposed to risk factors, which are associated with negative outcomes of exposure to adversity (see table below). Respect for one’s racial, ethnic, and gender identity, as well as sexual orientation, is also essential to resilience among young people, as is respect for their voice and choice about what happens to them during and after a natural disaster.

Above all, the single most important protective factor is a safe, stable, and nurturing caregiver, particularly for very young children. Therefore, communicating with caregivers about their own needs and strengths, and how to partner with them to support healthy parenting is essential to promoting the well-being of children in their care. This requires attention to parental mental health, including healing from their own histories of trauma.

Protective Factors at the Individual, Family, School, and Community Level

Individual children or youth

Family

School

Community

Nurturing and sensitive caregivers

Nurturing by family, care of vulnerable members

Nurturing by school community, disability services

Social capital, care of vulnerable members

Close relationships, trust, belonging

Close relationships, trust, belonging, cohesion

Close relationships, trust, belonging, cohesion

Social connections, trust, belonging, cohesion

Self-regulation, executive function skills

Skilled family management

Skilled school leadership

Skilled governance, collective efficacy

Agency; active coping

Active coping

Active coping

Community action

Problem-solving and planning

Family problem-solving and planning

School problem-solving and planning

Collaborative community problem-solving, planning

Hope, optimism

Hope, optimism

Hope, optimism

Hope, optimism

Sense of individual meaning and purpose

Sense of family meaning, purpose, family coherence

Sense of school meaning, purpose, and coherence

Sense of community meaning, purpose, and coherence

Positive views of self, self-efficacy

Positive views of family

Positive views of school

Positive views of community

Positive habits, routines

Family routines, traditions, celebrations

School routines, traditions, celebrations

Community routines, traditions, celebrations

Bodily/biological resources (e.g., good health, regulation)

Material resources (e.g., clothing, food, shelter, safety)

Community resources (e.g., clean water, safety, health, mental health care)

Cultural and religious guidance, rituals, traditions, belonging, hope, meaning, and purpose

Source: Adapted from Masten, A. S., & Motti-Stefanidi, F. (2020). Multisystem resilience for children and youth in disaster: Reflections in the context of COVID-19. Adversity & Resilience Science, 1, 95-106.

What are the essential elements of a trauma-informed child welfare system?

Implementing TIC in child welfare agencies means that all staff and administrators understand the impact of trauma, are knowledgeable about the most effective pathways for healing and resilience, and have the knowledge and skills to meet the specific needs of all children and youth. Research suggests that child welfare agencies can help youth health and thrive by incorporating particular aspects of trauma-informed care. The National Child Traumatic Stress Network (NCTSN) and colleagues have defined a trauma-informed child welfare system as:

“I think it is a culture shift. And the more it’s built-in and integrated into the everyday practices, the more it’s just going to be natural to effectively respond to a traumatic event, whether it’s an individual event or more a widespread pandemic.”

-State administrator

…one in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child, using the best available science, to maximize physical and psychological safety, facilitate the recovery of the child and family, and support their ability to thrive.

The NCTSN and partners identified eight essential elements of a trauma-informed child welfare system. These same elements can be applied to other child and youth service setting seeking to understand and address childhood trauma, such as juvenile justice, education, mental health, primary care, and home visiting, among others.

Eight Essential Elements of a Trauma-Informed Child Welfare System

Source: Walsh, C., Pauter, S., & Hendricks, A. (2020). Child Welfare Trauma Training Toolkit (3rd ed.). Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress. https://www.nctsn.org/resources/child-welfare-trauma-training-toolkit

There is no single approach to trauma-informed care. Child welfare agencies can use the information above—particularly the 4 Rs, the Eight Essential Elements, the four needs identified by youth formerly involved in the child welfare system, and the tools in this Toolkit—to develop a plan to address trauma using a comprehensive, systemic approach. The evidence strongly suggests that offering ongoing professional development on trauma, healing, and resilience to both agency leaders and staff, as well as using evidence-informed interventions to address childhood trauma related to natural disasters, will enhance agency efforts to support children, youth, and families who have been exposed to a natural disaster. Sections 1 and 3 provide information on interventions and overall recommendations for state, county, tribal, and territory child welfare system to prevent and mitigate disaster-related trauma.

Additional tools for partnering with children, youth, and families to promote their well-being before, during, and after a natural disaster in Section 2 include the Resource Library and Evidence-at-a-Glance. Section 3 of the Toolkit describes evidence-informed interventions for incorporating trauma-informed care (TIC) into state, county, tribal, and territory child welfare systems to prevent and mitigate disaster-related trauma.

For more information on promoting healing and resilience, please download the full toolkit.

Download the PDF

Put It Into Practice:

4. Organizational Self-Assessment: How Trauma-Informed is Your Agency, Organization, or System? (PDF)
Use this resource BEFORE a natural disaster occurs

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Child Welfare Resource Library 2: Promoting Healing and Resilience After Natural disasters

Age-related Reactions to a Traumatic Event [caregiver resource] National Child Traumatic Stress Network

Child Welfare Practice to Address Racial Disproportionality and Disparity Child Welfare Information Gateway

Healthy Organizations: Why Should Child Welfare Agencies Be Trauma-Informed? Casey Family Foundation

Identifying the Intersection of Trauma and Sexual Orientation and Gender Identity National Child Traumatic Stress Network

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach Substance Abuse and Mental Health Services Administration

Understanding the Impacts of Natural Disasters on Children Society for Research on Child Development

What is a Trauma-informed Child and Family Service System? National Child Traumatic Stress Network

Trauma Informed Child Welfare Systems—A Rapid Evidence Review Bunting et al., 2019

Creating Trauma-Informed Child Welfare Systems: A Guide for Administrators (2nd ed.) Chadwick Trauma-Informed Systems Dissemination and Implementation Project

The Importance of a Trauma-Informed Child Welfare System Child Welfare Information Gateway

Section 3

Interventions to Support Healing and Resilience Among Children, Youth, and Families Who Experience a Natural Disaster

Array

There are several evidence-informed, trauma-focused models and interventions to support children and youth who have experienced natural disasters and promote healing. Many of these models and interventions share core components, and thus have considerable overlap with one another in their content and approach. Some models have been used specifically with children and youth involved in child welfare , while others have been used with a broader population of children and youth. Models may vary in the timing of implementation—some are used during or immediately after the natural disaster, others are used in the intermediate or long-term.

When choosing which models and interventions to use, it is important to consider whether the model or intervention:

  • Targets the goals or outcomes valued by children, youth, and families (e.g., providing immediate relief and referral to basic resources, reducing posttraumatic stress and other distress reactions).
  • Can be realistically implemented given the specific child, youth, family, agency, and community context, including local resources available, and following federal, state, and county policies.
  • Is appropriate for the age, race, ethnicity, gender identity, and sexual orientation of children, youth, and their families and their cultural and historical context (e.g., living in a foster home or group home, history of complex or historical trauma, cultural background).

The good news is that most children and youth show signs of resilience after exposure to natural disasters and return to normal functioning without receiving formal intervention—including those receiving child welfare services. For a smaller number of children and youth, clinical services are needed, specifically young people who experience significant mental health and behavioral problems that are best addressed through formal trauma- and grief-focused treatment with a mental health provider. Formal treatment is more likely to be needed following severe exposures, secondary adversities (e.g., severe injury/illness, other trauma and losses, housing instability), and pre-existing or co-occurring risk factors (e.g., prior trauma or mental health conditions). Making decisions about the appropriate level of support, services, and interventions following a natural disaster should follow a tiered approach, tailoring the intensity of the intervention to the needs of each child, youth, and family.

What are the most promising and evidence-informed interventions for children, youth, and families in the child welfare system who experience natural disasters?

In the response phase of a natural disaster, it is recommended to begin with a needs assessment of children, youth, and their families to determine the extent of potential exposures to trauma and loss, identify co-occurring adversities and strengths, and differentiate high-risk groups that may be in need of intensive supports. Needs assessments can be conducted in a variety of settings (e.g., home, school, community, shelter) using a semi-structured format. In addition, using a formal screening tool for posttraumatic stress reactions and secondary adversities is also recommended. For sample screening tools for children/youth and adults, see the Section 3 Resource Library.

There are also several psychoeducational materials, hotlines, and apps to help support children, youth, families, and those working with them:

Psychoeducational Materials

Mobile Apps

Online Course

My Disaster Recovery

Hotlines

  • National Suicide Prevention Lifeline, Call (800) 273-8255
  • Disaster Distress Helpline, Call or text (800)985-5990 (For Spanish, press “2”) to be connected to a trained counselor 24/7/365
  • The JED Foundation (for emotional health and suicide prevention), Call 1-800-273-TALK (8255) or text “START” to 741-741
  • Trevor Project (for LGBTQ+ youth), Call 1-866-488-7386 or text “START” to 678-678

There are several evidence-informed universal and targeted interventions (see figure below, Tiers 1 and 2) designed for preventing or reducing stress reactions and increasing positive supports among children and youth after a natural disaster. These models can be implemented by a range of providers in a variety of settings. It is recommended that staff, supervisors, and administrators in the child welfare system should seek training in one or more of these models to be prepared to respond when a natural disaster occurs. These models are not intended to serve as mental health treatments or long-term interventions.

There are also several evidence-informed indicated treatments and interventions (Tier 3) that have been developed and tested for children and youth in the child welfare system who experience trauma. These treatments are designed to be used by licensed mental health professionals with adequate clinical training. Child welfare administrators, supervisors, and staff should be familiar with these evidence-informed treatments when making referrals for children and youth under their care. 

Universal, Targeted, and Indicated Interventions

Source: The National Child Traumatic Stress Network, 2021

Universal and targeted interventions (Tiers 1 and 2)

In recent years, numerous disaster behavioral health interventions for children and youth have been developed and evaluated. Although few have evaluated interventions specifically for children and youth receiving child welfare services, several evidence-informed universal and targeted models have been widely implemented in a variety of settings impacted by natural disasters. The table below provides intervention names, descriptions, and evidence to date for three of the most promising Tier 1 and 2 interventions that are appropriate for service systems that work with children and youth of any age. These interventions can be used independently or in combination to meet the needs of a particular child, youth, or family in the days and weeks following a natural disaster.

Promising Tier 1 and Tier 2 Interventions

Intervention

Target Population(s)

Description

Evidence to date

PREPaRE Curriculum

(Brock et al., 2016)

School-employed mental health professionals, administrators, educators, and staff

The PREPaRE Curriculum was developed by the National Association of School Psychologists (NASP) as a crisis prevention and preparedness training curriculum for school implementation. The program consists of two workshops covering school-wide safety planning and a workshop for school mental health professionals focused specifically on crisis intervention and recovery. 

Learn more about PREPaRE, including training opportunities at: https://www.nasponline.org/professional-development/prepare-training-curriculum/about-prepare

Results from pre-post training evaluations indicate that PREPaRE improves knowledge of trauma-informed practices among those trained. There is not yet any evidence confirming that this training translates to better child outcomes in the face of a trauma, which is more challenging to study in the midst of disasters and crises. 

Psychological First Aid (PFA)

(Brymer et al., 2006)

Mental health and other disaster response workers who provide early assistance to affected children, youth, families, and adults as part of an organized disaster response effort. These providers may be embedded in a variety of settings, including clinics, schools, shelters, faith-based organizations, or community agencies.

Psychological First Aid (PFA) is a modular approach informed by empirical evidence on trauma-informed care to support youth, adults, and families in the immediate aftermath of disaster (i.e., within days to weeks of the event). The most comprehensive PFA guide was developed by the National Child Traumatic Stress Network and the National Center for PTSD. PFA is designed to address acute distress reactions and bolster longer-term adaptive functioning and coping. The delivery of PFA is designed for maximum flexibility to meet the needs of acute crisis settings, including intervention contact time, provider background (e.g., mental health, education, community programming), and delivery location (e.g., community center, home, school, child welfare facility). PFA has been translated into several languages and has been adapted for a range of settings. PFA has been adopted and recommended by a range of mental health experts in consensus conferences and peer-reviewed literature. It has also been included in service guidelines both for PTSD and as an early intervention for disaster survivors by the American Academy of Child and Adolescent Psychiatry and other international organizations. 

Learn more about PFA, including training opportunities at:  https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychological-recovery/about-pfa

PFA has widespread use and anchoring in empirically supported, trauma-informed, and cognitive-behavioral components of trauma-focused interventions and is supported by the American Academy of Child and Adolescent Psychiatry disaster parameter. Pre-post training evaluations of PFA have shown promising results for trainees, with statistically significant improvements in (a) knowledge items supportive of PFA delivery, (b) perceived self-efficacy to apply PFA interventions, and (c) confidence about being a resilient PFA provider. These evaluations have also shown decreased PTSD and depressive symptoms among youth treated by these trainees 10 months following the disaster.

Skills for Psychological Recovery (SPR)

(Berkowitz et al., 2010)

Mental health and other health workers (ideally with some prior experience in addressing traumatic stress or disasters) who provide ongoing support and assistance to affected children, youth, families, and adults as part of an organized disaster response effort. These providers may be embedded in a variety of settings, including clinics, schools, shelters, faith-based organizations, or community agencies. 

Skills for Psychological Recovery (SPR) may serve as a stand-alone intervention or an extension of PFA. It was developed for the intermediate recovery phase by the National Child Traumatic Stress Network and National Center for PTSD. SPR aims to build stress management and coping skills among youth, adults, and families in the weeks and months following a disaster or other traumatic event. SPR is not a formal mental health treatment. Rather, SPR is a framework for training adults in skills-based, secondary prevention. SPR can be delivered in a variety of settings, such as schools, clinics, homes, child welfare facilities, and community centers. 

Learn more about SPR, including training opportunities at:  https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychological-recovery/about-spr

In pre-post training evaluations, practitioners reported improved confidence in using each SPR intervention following training and at 6 months post-training. Based on available data, more than 6 out of 10 practitioners used an SPR intervention during the follow-up period, with each intervention used by over half of the practitioners at both 3 and 6 months. In an evaluation of SPR in Louisiana, approximately 80% of children and youth screened were referred to SPR, and among those who completed follow-up assessments, there was a significant reduction in behavioral and emotional symptoms over time after receiving services. Although children and youth receiving child welfare services were not a sub-population of focus in this study, they were served by the program. Specifically, 68% of children and youth were displaced from their homes and 25% had lived apart from their primary parent/caregiver during or after the disaster happened, with 10% being separated long-term. 

Indicated interventions for natural disasters (Tier 3)

There are a variety of formal disaster behavioral health interventions for children and youth identified in the literature. In general, cognitive behavioral approaches have the strongest evidence in rigorous studies that compare outcomes for those who received mental health intervention compared to those who did not. There is some evidence that group interventions may be equally effective as individual interventions and with better rates of completion, but group treatments also require careful examination of the pros and cons of discussing trauma-related content in a group setting with peers. The below figure shows common elements of Tier 3 (indicated) trauma- and evidence-informed interventions.

Common Components of Indicated (Tier 3) Evidence- and Trauma-informed Interventions for Children and Adolescents Who Experience a Natural Disaster

Source: Adapted from Pfefferbaum, B., & North, C. S. (2016). Child disaster mental health services: A review of the system of care, assessment approaches, and evidence base for intervention. Current Psychiatry Reports, 18(1), 5. doi:10.1007/s11920-015-0647-0

The California Evidence-Based Clearinghouse for Child Welfare indexes trauma-focused interventions for reducing trauma-related symptoms among children and adolescents. Interventions are categorized in three levels: well-supported, supported, or promising. Categorization is based on implementation considerations (existence of a manual), methodological considerations (published randomized controlled trials, reliable outcome measures, and follow-up data collection), and evidence of positive outcomes. The Blueprints for Healthy Youth Development is another registry of evidence-based and promising interventions focused on promoting healthy youth development.

A unique feature of the Clearinghouse is that it also rates intervention applicability to child welfare populations as High (designed or commonly used to meet the needs of children and youth receiving child welfare services), Medium (designed or commonly used to serve children and youth who are similar to child welfare populations in history, demographics, or needs), or Low (designed, or commonly used to serve children and youth with little or no apparent similarity to the child welfare services population). Some models have been used and evaluated specifically for natural disasters, though evidence of effectiveness for natural disasters is scarce.

The table below identifies Tier 3 trauma-focused interventions (as categorized by the Clearinghouse) with the strongest evidence of effectiveness. The table includes information on each intervention’s relevance to child welfare and published findings related to natural disasters. Parents and other caregivers should be included in the intervention whenever possible, especially treatment for young children. It is important to note that although some trauma-focused interventions may not have published findings specific to natural disasters, they may still have evidence for addressing trauma-related symptoms among children and youth generally and may have included disaster-exposed youth in their testing.

Trauma-Focused Interventions for Children, Youth, and Their Families with Evidence Ratings for Child Welfare and Published Findings on Natural Disasters

Level of Evidence

Intervention

Child Welfare Relevance

Published Findings 

on Natural Disasters 

Age (years)

Well-Supported

Trauma-Focused Cognitive Behavioral Therapy

High

Yes

3-18

Well-Supported

Eye Movement Desensitization and Reprocessing

Medium

Yes

4-18

Well-Supported

Prolonged Exposure Therapy for Adolescents

Medium

No

8-18

Supported

Child Parent Psychotherapy

High

Yes

0-5

Promising

Alternatives for Families: A Cognitive Behavioral Therapy

High

No

5-17

Promising

Child and Family Traumatic Stress Intervention

High

No

7-18

Promising

Combined Parent-Child Cognitive-Behavioral Therapy

High

No

3-17

Promising

Stepped Care TF-CBT

High

No

3-12

Promising

Bounce Back

Medium

Yes

5-11

Promising

Cognitive Behavioral Intervention for Trauma in Schools

Medium

Yes

10-18

Promising

KIDNET

Medium

Yes

7-16

Promising

Preschool PTSD Treatment

Medium

Yes

3-6

Promising

Cue-Centered Therapy

Medium

No

8-17

Promising

Fairy Tale Model

Medium

No

13-18

Promising

Grief and Trauma Intervention for Children

Medium

No

7-12

Promising

Risk Reduction through Family Therapy

Medium

No

13-18

Promising

Sanctuary Model (Systems Level Intervention)

Medium

No

12-20

Promising

Seeking Safety

Medium

No

13+

Promising

SITCAP-ART

Medium

No

13-18

Promising

Trauma-Focused Coping

Medium

No

9-18

Source: The California Evidence-Based Clearinghouse for Child Welfare. (n.d.). Welcome to the CEBC: California Evidence-Based Clearinghouse for Child Welfare. The California Department of Social Services Office of Child Abuse Prevention. https://www.cebc4cw.org/

For more information on interventions, please download the full toolkit.

Download the PDF
Curve line Decoration

Child Welfare Resource Library 3: Interventions to Support Healing and Resilience Among Children, Youth, and Families Who Experience a Natural Disaster

Blueprints for Healthy Youth Development

California Evidence-Based Clearinghouse for Child Welfare Rady’s Children’s Hospital San Diego, California Department of Social Services, & Office of Child Abuse Prevention

Child Welfare Trauma Training Toolkit (3rd ed.) National Child Traumatic Stress Network

Culture and Trauma National Child Traumatic Stress Network

New Directions in Child Abuse and Neglect Research, Chapter 6: Interventions and Service Delivery Systems Institute of Medicine and National Research Council

Psychological First Aid: Field Operations Guide (2nd ed.) National Center for PTSD and National Child Traumatic Stress Network

PREPaRE National Association of School Psychologists

SAMHSA Disaster Technical Assistance Center Supplemental Research Bulletin: Disaster Behavioral Health Interventions Inventory Substance Abuse and Mental Health Services Administration

Skills for Psychological Recovery (SPR) Field Operations Guide National Center for PTSD and National Child Traumatic Stress Network

Title IV-E Prevention Services Clearinghouse Abt Associates

Trauma-informed Strategies for Supporting Children and Youth in the Child Welfare System During COVID-19 Child Trends

Treatment for Traumatized Children, Youth, and Families Child Welfare Information Gateway

Natural Disaster Response Resources

Psychoeducational Materials

Mobile Apps

Online Course

My Disaster Recovery

Hotlines

  • National Suicide Prevention Lifeline, Call (800) 273-8255
  • Disaster Distress Helpline, Call or text (800)985-5990 (For Spanish, press “2”) to be connected to a trained counselor 24/7/365
  • The JED Foundation (for emotional health and suicide prevention), Call 1-800-273-TALK (8255) or text “START” to 741-741
  • Trevor Project (for LGBTQ+ youth), Call 1-866-488-7386 or text “START” to 678-678

Disclaimer and Acknowledgements

Disclaimer

This research was supported by the Annie E. Casey Foundation. The findings, conclusions, and recommendations presented in this toolkit are those of the authors alone, and do not necessarily reflect the opinions of the Foundation.

Established by Congress in 2000, the National Child Traumatic Stress Network (NCTSN) brings a singular and comprehensive focus to childhood trauma. NCTSN’s collaboration of frontline providers, researchers, and families is committed to raising the standard of care while increasing access to services. Combining knowledge of child development, expertise in the full range of child traumatic experiences, and dedication to evidence-based practices, the NCTSN changes the course of children’s lives by changing the course of their care.

Acknowledgements

The project team is grateful for the support of the Annie E. Casey Foundation, with special appreciation for Mildred Johnson’s guidance throughout the project. We also want to express our deep gratitude to the youth who participated in this project and contributed their lived expertise with natural disasters and involvement in the child welfare and/or juvenile justice systems. Similarly, we thank the child welfare and juvenile justice administrators and direct service staff who contributed their valuable insights to the toolkit. 

In addition, we thank our Senior Advisors, Melissa Brymer, Ellen Kahn, Joy Osofsky, and Isaiah Pickens, and the members of our Advisory Board, Marcos Santana Andújar, Toni Buxton, Melissa Brymer, Shannon Catanzaro, Nicolette Louissaint, Deborah Northburg, Joy Osofsky, Julie Segovia, and Gail Wasserman. Finally, we extend our thanks to our Child Trends colleagues, whose support was invaluable to the toolkit’s development: Deana Around Him, Bianca Faccio, Isabel Griffith, Esther Gross, Cassidy Guros, Alison McClay, Maria Ramos-Olazagasti, Dana Thomson, Alicia Torres, and Kara Ulmen.

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