Creating the necessary infrastructure for a trauma-informed system of care for children and youth.

Understanding and addressing the impact of adverse life events is an important priority in the design of helping systems. However, creating trauma-informed systems requires efforts to embed effective trauma-informed work in routine practice. This article discusses a model for developing trauma-informed systems using the Transformational Collaborative Outcomes Management (TCOM) framework, a strategy for engineering person-centered care. Person-centered care is naturally congruent with trauma-informed care. We describe the initial stages of implementation of a trauma-informed standardized assessment process to support the sustained evolution of trauma-informed care. Distinguishing between traumatic experiences and traumatic stress is fundamental to an effective trauma-informed system. We describe two sets of analyses-one in a statewide child welfare system and the other in a statewide behavioral health system. These projects found opportunities in the analysis of the detection of traumatic stress based on traumatic experiences to inform practice and policy. Being trauma-informed in child welfare is distinct from being trauma-informed in behavioral health. In child welfare, it appears that a number of children are resilient in the face of traumatic experiences and do not require trauma treatment interventions. However, delayed and missed traumatic stress responses are common. In behavioral health, misses often occur among adolescents, particularly boys, who engage in acting out behavior. Opportunities for the ongoing development of trauma-informed systems using the TCOM framework are discussed.

The Parent Experience of Assessment Scale (PEAS): Development and Relation to Parent Satisfaction.

This study outlines the development of the Parent Experience of Assessment Scale (PEAS), which is based on principles of Therapeutic Assessment. The study includes pilot testing of a 64-item questionnaire across 134 participants, with psychometric analyses utilizing confirmatory factor analysis. The revised version consists of 24 items across five subscales with appropriate internal consistency reliability (alphas from .76 to .88). The PEAS demonstrates statistically significant relations with general parent satisfaction, with two subscales indicating significant direct effects via structural equation modeling. The PEAS has the potential utility to provide more nuanced clinical and investigative feedback regarding the parent process during child psychological assessment.