Search

Traumatic and other adverse experiences have been shown to affect a child’s social, emotional, physical, and neurological development. The concept of “Trauma Informed Care” (TIC) emerged in the 1990s from the growing awareness of the high prevalence of traumatic experiences among those receiving support in the public system. The focus on TIC has increased dramatically in recent years. This paper focuses on TIC for child trauma and the child welfare system. Considering that the TIC model will be developed in Japan in the future, it was thought that it would be useful to extract the elements deemed central to TIC practice in this area from previous studies. For this literature review, “Trauma informed care,” “residential care,” “child welfare,” and “training Trauma informed care,” “residential care,” “child welfare,” and “training” were used as keywords to search PubMed and PsycINFO. Nine articles were identifi ed. Of the nine studies that examined the impact of trauma-informed organizational interventions on staff knowledge, attitudes, or behaviors, eight found statistically significant improvements after training. The study results all reported positive impacts, such as increased staff knowledge, awareness, and confidence in traumainformed principles and practices. Of the eight studies that evaluated the eff ects in training staff to ensure that their knowledge, attitudes, or behaviors are trauma-informed, five found sustained effects three months to a year after the training ended. While the nine studies provided many insights, some challenges arose as well. In three of the nine studies, changes in staff knowledge, attitudes, and their own behavior toward care providers were measured by questionnaires developed by the training developers. In questionnaires developed by the training developers, the training content specific to the questions being asked would be emphasized, and their validity would be questionable. Additionally, few studies have been conducted on the sustainability of the training effects, and it is difficult to determine whether the changes in staff knowledge and attitudes have sufficiently demonstrated a lasting effect on their own development and on their interactions with clients. Future research should also examine how trauma-informed organizational interventions affect staff job satisfaction, turnover intentions, burnout tendencies, as well as the use of the most efficient measures of the effects of trauma-informed organizational interventions in effectiveness research. However, rather than relying only on quantitative evaluation, it is equally important to qualitatively evaluate staff learning and the effects they have experienced using methods such as semi-structured interviews. (394 words)

近年、米国を中心にトラウマインフォームドケアと呼ばれ、トラウマを念頭に置いたケアが普及している。本稿ではこのケアを本邦に導入することを目的として、その概念と米国で実践されているプログラムの内容をまとめ、問題点を検討した。トラウマは社会生態学的モデルで捉えられ、ケアの鍵概念としては「トラウマへの気づき」、「安全性の重視」、「コントロール感の回復」、「ストレングスに基づくアプローチ」が挙げられていた。子どものプログラムでは家族、養育者、支援者、管理者など子どもを取り巻く援助資源に働きかけ、連携していくことが推奨されていた。最後に、導入する際の問題点として、資源、マンパワー、負感情について検討を行った。, The care called Trauma-Informed Care(TIC) is spreading led by the United States. In this paper, we summarized the concept of TIC and the program practiced in the United States, and examined its problems for the purpose of introducing this care into Japan. In TIC, trauma was considered in Social-Ecological Model, and there were key concepts of "Trauma awareness", "Emphasis on safety", "Oppotunities to build control","Strengths-based approach". In child program, supporters who help survivors need to work on and collaborate with various resources like families, caregivers and managers. Finally, the problems for introducing into Japan were examined resouces, manpower and negative emotion.