Shifting the Child Welfare Paradigm: Complexities Faced Implementing Trauma-informed Care

Overall Abstract
Research documenting the impacts of complex trauma has resulted in the implementation of trauma-informed (TIC) in diverse child welfare settings. This symposium presents research findings that shed light on significant complexities inherent in implementing TIC for children impacted by complex trauma and the professionals charged with their day-to-day care.

Session Abstracts
(1) Restraint and Seclusion Use Among Children and Youth in Residential Care: Rethinking These Practices in a Trauma-informed Perspective
Histories of multiple interpersonal traumas accompanied by emotional and behavioral problems are common among children and youth placed in residential treatment care (RTC) as a result of child protection and youth justice involvement. In this presentation we will discuss these “problems,” from a trauma-informed perspective, as manifestations of biological impacts of complex trauma on the developing brain; and, examine the use of restraint and seclusion (R&S) in RTC to manage emotional and behavioral “problems”, before and after the implementation of TIC. The use of R&S in child welfare RTC in the province of Quebec, Canada, before ARC implementation will be presented followed by our post-implementation findings on the frequency of R&S. Our results suggest that there is a slight increase in R&S in the first months after implementation, followed by a significant decrease up until one year after implementation. We believe the slight increase in the first months reflects the complexity and challenges associated with TIC implementation in well-established child welfare systems. However, the significant decrease of R&S in the longer-term bolsters TIC as a promising shift in paradigm for children and youth with emotional and behavioral problems resulting from complex trauma.

(2) Moral Distress Among Residential Child Welfare Professionals
The well-being of residential child welfare professionals has been shown to be impacted by exposure to violence and abuse and details of the abuse and neglect, or complex trauma, sustained by the children they serve. These exposures are associated with rates of staff turnover, and rates and lengths of placements for children in residential care.  A secondary analysis using the narratives of ten educators was performed for an understanding of distress and potentially traumatic experiences (PTEs) to which they were exposed in the course of their work.  Their accounts of working with their primary clients revealed expected exposure and distress related to PTEs.  Their accounts also revealed an unexpected phenomenon- distress caused by systemic shortcomings and their own incapacity to engage in work that they believed would be effective over the long term in the lives of their young clients.  This study describes that distress and offers moral distress as a relevant conceptual framework to further the scholarly discussion about factors associated with staff turnover.  Organizational responses to reduce moral distress may reduce the distress educators can encounter in the helping relationships they are engaged in and reduce their desire to leave their profession. 

This session was originally presented as a live conference session in October 2020.

Target Audience


Learning Objectives


At the conclusion of this presentation, participants will be able to:

  • Identify past and ongoing traumatic experiences and sequelae commonly endured by children and youth that can impact their behaviour, increasing their risk of institutional restraints and seclusion in child welfare settings
  • Recognize worker characteristics associated with attitudes that promote the implementation of trauma-informed practices and strategies
  • Explain how potentially traumatic experiences at the organizational level may result in moral distress among professionals working with children who have experienced complex trauma
Course summary
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  • 1.50 ISSTD Certificate Program
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Presenter: Delphine Collin-Vézina, MSc, PhD
Presenter Bio: Dr. Delphine Collin-Vézina is the Director of the Centre for Research on Children and Families at McGill University. She is a licensed clinical psychologist and an Associate Professor at the McGill School of Social Work and an Associate Member in the Department of Pediatrics. She held the Tier II Canada Research Chair in Child Welfare from 2008-2018 and is now holding the Nicolas Steinmetz and Gilles Julien Chair in Community Social Pediatrics. She leads the research group on Social Responses to Complex Trauma (SR/CT) at McGill University. Her program of research seeks to better understand the impact of adverse and traumatic life events in the lives of children and youth, as well as their experiences with services geared towards them. She aims to promote and implement social responses which are better suited to meet the needs of this often marginalized population and their families. Her mission is realized through research across three axes: (1) Trauma-informed care implemented in different settings, such as child protection agencies, correctional services, and schools; (2) Children’s rights-based approaches, through community social pediatrics centres; (3) Best practices in the identification and responses to child sexual abuse across systems, and particularly within child protection services.


Presenter: Ginny Sprang, PhD
Presenter Bio: Ginny Sprang, Ph.D., is a Professor in the College of Medicine, Department of Psychiatry at the University of Kentucky, and the Executive Director of the UK Center on Trauma and Children. Dr. Sprang is the Principal Investigator of multiple federal and state grants that examine child traumatic stress, treatment effectiveness, and best practices protocols for a wide range of trauma survivors. Dr. Sprang serves as a Steering Committee member for the National Child Traumatic Stress Network, and is a chair emeritus of the Secondary Traumatic Stress Committee for the National Child Traumatic Stress Network. She served as a Special Interest Group Chair for the International Society for Traumatic Stress Studies for 13 years. Dr. Sprang currently serves as a consultant to the Department of Justice, Office of Victims of Crime. Dr. Sprang has published extensively in the area of child traumatic stress, commercial sexual exploitation of minors, victimization, and secondary traumatic stress.

Presenter: Alexandra Matte-Landry, BA, PhD
Presenter Bio: Dr. Alexandra Matte-Landry completed her PhD in clinical psychology and neuropsychology at Laval University (Quebec City, Canada) in September 2018. Since this time, she has been working as a postdoctoral fellow under the supervision of Dr. Delphine Collin-Vézina. Dr. Matte-Landry is a member of many research group: Centre for Research on Children and Families (CRCF), Centre de recherche universitaire sur les jeunes et les familles (CRUJEF), and Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS). Moreover, in the previous years, she has been granted doctoral and postdoctoral scholarship from private and government agencies. Her research interest include developmental psychopathology, child development, neuropsychology, child maltreatment, and restraint and seclusion in residential care. Dr. Matte-Landry has also developed an expertise in the management and analysis of large longitudinal data base. She is working on a systematic review on cognitive outcomes in children with complex trauma. She is also engaging in a nation-wide project of trauma-informed care implementation in residential settings for children and youth cared for by child protective services and youth justice system. Moreover, Dr. Matte-Landry is a licensed clinical psychologist and neuropsychologist who has been working with children and adolescents with psychiatric symptoms and disorders or brain damages for the past 7 years.


Presenter: Denise Brend, MSW, PhD
Presenter Bio: Denise Brend is a postdoctoral fellow at the Université de Sherbrooke working on the study "Implantation et évaluation modèle Attachement, Régulation et Compétences auprès d'enfants de 6 à12 ans". She is cosupervised by Canada Research Chairs: Dr. Nadine Lanctôt and Dr. Delphine Collin-Vézina (McGill University). Recipient of an FQRSC doctoral scholarship, in 2015 she was selected as a Research Fellow in the Research Training Programme of the International Psychoanalytical Association (London, U.K.). She has been a course and field instructor in the McGill School of Social Work. Currently, she is a permanent faculty member at Dawson College where she completed the New School teacher trainee program. Denise has 13 years of experience as a psychotherapist, a social worker in mental health, a clinical supervisor, and clinical trainer. She specializes in complex and work-related trauma. She is also the co-chair of a Special Interest Group on Interpretive Phenomenological Analysis with the McGill Qualitative Health Research Group.

Available Credit

  • 1.50 ISSTD Certificate Program
    This program is eligible for 1.50 credits in the ISSTD Certificate Program.


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