Enhancing the Trauma-Informed Capacity of the Early Childhood Workforce

Overview: This study presents the influence of a trauma-informed training (Child Adult Relationship Enhancement) on early childhood professionals’ trauma-informed attitudes and cross-sector collaboration, and discusses the role of social workers in promoting trauma-informed early childhood systems and cross-professional partnerships to better serve young children and their families.Proposal text: Addressing the constellation of risks associated with early childhood adversity[1,2,3] requires professionals from a range of systems, including health, early intervention, and education systems. Yet often there remain gaps in knowledge or responses to early childhood trauma and mental health needs among professionals serving young children. It is not clear whether trauma-informed trainings are associated with increases in trauma-informed knowledge and confidence across early childhood professionals, nor whether these trainings improve collaboration and coordination.
The CARE model was adapted from Parent-Child Intervention Therapy (PCIT) as a way to support skill development for non-clinical professionals and caregivers that interact with a specific child.[4] Although the CARE model is described as suitable for a range of professionals, there is limited evidence to examine the efficacy of the CARE model across professionals. The current study examines the influence of a CARE training on trauma-informed attitudes and collaboration among a sample of early childhood providers (n=106) to determine the extent to which a half-day trauma-informed training supports enhanced awareness and collaboration among providers serving trauma-impacted young children and families. Specifically, we examined whether CARE training was associated with significant increases in trauma-informed attitudes[5] and collaboration from pre-training to a 2-month follow-up.
Providers were recruited to take part in the training and study from a range of settings in a Mountain West state, and included 27.4% (n=29) child care workers, 25.5% (n=27) early childhood educators, 19.8% (n=21) early intervention professionals, 8.5% (n=9) mental health professionals, and 8.5% (n=9) other professionals, including medical professionals (11 providers did not provide information about their professional role). Trainings were conducted in pairs by licensed mental health professionals trained in the CARE model and were conducted from in summer and fall of 2021. Training were held over a half-day, were limited to approximately 15 participants, and were held over Zoom due to limitations from the COVID-19 pandemic.
Linear growth trajectories using full maximum likelihood estimation were run using HLM software. The intercept was centered at baseline (pre-training), using two-week units of time, where t = 1 was post training and t=5 was the 2-month follow-up. Findings from the unconditional models indicate significant increases in trauma-informed Reactions (e.g., understanding of and strategies to mitigate secondary trauma; coefficient = .05, p = .007) and trauma-informed Causes (e.g., understanding of underlying causes of trauma-related behaviors; coefficient = .04, p = .041) per unit of time (2-week increment) and in the TI Causes model, significant variance in the slope was related to provider characteristics (Level 2).

The findings of this study suggest that a brief (half day) training can have lasting effects on aspects of early childhood providers’ trauma-informed attitudes, particularly related to knowledge of trauma and responses to trauma. Null findings regarding cross-professional collaboration indicate that a shared language regarding childhood trauma may not be enough to increase collaboration across sectors, and that more concerted efforts to connect interprofessional providers are needed. Social workers are often positioned in interdisciplinary settings and are uniquely poised to facilitate such interprofessional connection and collaboration.