Evidence over Conviction: Controlled studies of short- and long-term effects of psychoeducational interventions for trauma informed care to promote out-of-home cared children’s health and resilience

Background and AimTrauma-informed training for important caregivers is increasingly used internationally to promote the development and resilience of children in out-of-home care, but there is little scientific evidence for the effectiveness of these interventions.

The current project aims at evaluating the short and longer term effects of these interventions on three overarching areas:- Foster parents’ parental behaviors, cooperation with co-parents and perception of parental competence, parental self-efficay and the behavior of the placed child.- Residential care workers’ perceived self-efficacy, caregiver behavior,  understanding of the child’s behavior and trauma-informed attitude and behaviors.- Placed children’s behavioral and emotional difficulties, perceived wellbeing and security, placement stability and child-psychotherapy outcome.Methods and dataThe project consists of three controlled, quasiexperimental longitudinal studies with five measures and one qualitative study with two measures.

Our studies compare effects of psychoeducative intervention alone, or combined with either supervision or child trauma therapy.

We control for socioeconomic variables and intervention fidelity.ProcedureOur project evaluates trauma-informed interventions operated by Save the Children, which is the largest provider of trauma-informed training programs (TMO) in Sweden.

The project is uniquely collaborative as it is based on co-production with Save the Children and other important institutions within public welfare.

Foster parents, residential care workers and children in out-of-home care will be involved as key stakeholders in the planning and carrying out of the project, and also as participants in the studies.

The main costs of the projects are salaries.SignificanceChildhood trauma has profound, far-reaching consequences on child development and health, increasing the risk of mental illness, unemployment, poverty, and criminality in adulthood. Children in out-of-home care have often experiences of trauma.

Thus, the quality of daily interaction with foster parents or/and residential workers may be crucial for these children’s healing, well-being, and feeling of security.

Besides the much needed controlled test of the effects of trauma-informed psychoeducation, the project provides a basis for cost-effectiveness analyses of psychoeducational interventions, with implications for health-economy.