P0222 - Caregiver Experience with Trauma Educator Pilot: Qualitative Analysis of Participant Feedback

Program Goals
Caregiver/parental support of children who have disclosed sexual abuse has been demonstrated to lead to positive outcomes for children (van Toledo, A., and F. Seymour, 2016). A trauma educator (TE), modeled from the “diabetes educator” role, was integrated into a child abuse clinic to provide immediate and ongoing support to families. 52 child-caregiver dyads with children ages 3-16 were enrolled in the trauma educator service and referred to the TE. The TE provided support to patients and caregivers, which included referrals to evidence-based therapy services, educational materials on the impact of and response to trauma, and telephone coaching of caregivers to respond to trauma symptoms. Goals of the program include creating a resource easily accessible to caregivers, referring caregivers to trauma-informed services, and providing trauma education to improve caregivers’ response to their child’s trauma symptoms.

Evaluation
At six-months after initial screening, caregivers were contacted over the phone to answer open-ended questions about their experience in the TE service. Responses were collected and then analyzed using an online qualitative data analysis program for thematic analysis. Codes were assigned to excerpts of feedback and organized into a hierarchy to identify salient themes (Figure 1). Qualitative method allowed us to elicit aspects of TE service not reflected in quantitative data.

Themes were organized under three overarching categories: content of trauma education, experience with TE, and services accessed. Themes and codes in the “content of trauma education” category refer to what the caregiver identified as learning from the TE; for example, caregivers spoke about learning how to identify and manage manifestations of trauma in their children. Caregivers’ experience with TE ranged from positive to negative. Caregivers described the TE as “empathetic”, “knowledgeable”, and able to provide phone updates. Some caregivers spoke to the difficulty of discussing their child’s trauma with the TE. The code “waiting list” was applied with moderate frequency in concert with codes related to accessing services through TE referrals. Finally, caregivers indicated that they accessed a variety of services through the TE, including counseling, support groups, and parenting groups. Some caregivers also accessed similar resources without assistance from the TE. Counseling and support groups were identified by caregivers as most helpful.

Discussion
Caregivers expressed a predominantly positive experience working with the TE and spoke to accessibility and knowledge of the TE. Some caregivers accessed similar services with and without referral from the TE. Many identified counseling and support groups as most helpful. Frustration with waiting lists was a recurrent theme. This suggests that while the TE provides information on and referrals to appropriate resources, the TE does not necessarily improve or expedite access to the resources themselves. This may speak to the need for more trauma-focused services and providers.