E. Trauma Work in Texas

1. Reports

Building a Trauma-Informed Child Welfare System: A Blueprint[142]

Trauma-Informed Care Final Report, The Meadows Mental Health Policy Institute for Texas[143]

Texas Children Recovering from Trauma Final Project Report: A trauma-informed care transformation pilot under the Texas Department of State Health Services[144]

Meeting the Needs of High Needs Children in the Texas Child Welfare System, November 2015[145]

Understanding Trauma-Informed Care in the Texas Child Welfare System, Data and Recommendations from the Field, October 2015[146]

Respecting the Needs of Children and Youth in Texas Foster Care: Acknowledging Trauma and Promoting Positive Mental Health throughout the System, December 2014[147]

2. Legislation

In 2011, the Texas Family Code was amended to require DFPS to include training in trauma-informed programs and services in any training the department provides to foster parents, adoptive parents, kinship caregivers, department caseworkers, and department supervisors. Tex. Fam. Code § 264.015.

DFPS caseworkers are required to complete:

•   An initial, in-person training on trauma-informed care during their basic skills development training; and an annual refresher course online.

•   Supervisors and mentors are also required to complete a secondary trauma training.

•   DFPS internal learning management system offers several optional trainings on trauma-related topics.

Residential Child Care Contract (RCCC) Requirements:

•   As of September 1, 2015, DFPS required all caregivers and employees who are subject to RCCC for direct care to complete:

◦   at least eight hours of trauma-informed care training prior to being the only caregiver responsible for children; and

◦   at least two hours of trauma-informed care annually, and contractors may select their own curriculum/model for the annual refresher training.

Changes to the Human Resources Code in 2013 required trauma-informed care training for certain staff of county and state juvenile facilities, including probation officers, supervision officers, correctional officers, parole officers and court-supervised community-based program personnel. Tex. Hum. Res. Code § 221.002(c-1); § 249.009(19)

Since 2015, DFPS is required to institute a comprehensive psychosocial assessment tool to assess all children who enter the foster care system within 45 days. The tool must include a trauma assessment and an interview with at least one individual who knows the child. DFPS utilizes the Child Assessment of Needs and Strengths 2.0 (CANS) for children and youth placed in substitute care ages 3 to 17 years within 30 days. Tex. Fam. Code § 266.012.

3. Statewide Initiatives

The Statewide Collaborative on Trauma-Informed Care

In July 2017, the Children's Commission launched the Statewide Collaborative on Trauma-Informed Care (SCTIC), which aims to elevate trauma-informed policy in the Texas child welfare system by creating a statewide strategy to support system reform, organizational leadership, cross-systems collaboration, and community-led efforts with data-informed initiatives to develop champions, consensus, and funding. The SCTIC began with a planning group with the Children's Commission, Meadows Mental Health Policy Institute (MMHPI), Texas CASA, and the Department of Family and Protective Services and created workgroups to carry out its mission.

In February of 2019, the Children's Commission released Building a Trauma-Informed Child Welfare System: A Blueprint, a document based on the work and recommendations of the SCTIC workgroups. The SCTIC Implementation Task Force was formed in July 2019 to begin the work of implementing the Blueprint through continued collaboration with stakeholders.

Cross-Systems Trauma-Informed Care Transformation initiative

In 2019, the Texas Health and Human Services Commission (HHSC), Intellectual and Development Disability and Behavioral Health Services Department, Office of Mental Health Coordination (OMHC) introduced the Cross-Systems Trauma-Informed Care (CS-TIC) Transformation initiative. This initiative supports the Texas Statewide Behavioral Health Strategic Plan vision, “to ensure that Texas has a unified approach to the delivery of behavioral health services that allows all Texans to have access to care at the right time and place.” The authors of the Behavioral Health Strategic Plan noted that in order to achieve this vision, the “system must be trauma-informed and acknowledge the widespread impact of trauma, understand potential paths for recovery, and seek to actively resist re-traumatization,” and, “programs and services must be person-centered with the strengths and the needs of the person determining the types of services and supports provided.”

As part of this initiative, HHSC-OMHC established the CS-TIC, whose membership comprises representatives from state agencies who receive state funding for behavioral health training or services. The vision of the CS-TIC is a coordinated behavioral health system, as envisioned by the Behavioral Health Strategic Plan, which is healing-centered and trauma-informed in its foundation, and unified in its implementation of a person-centered and family-focused approach across Texas. The need for a coordinated statewide approach in building a trauma-informed behavioral health system through cross-agency partnerships was identified by the workgroup as a critical step towards developing an enhanced learning and understanding of the impact of trauma on people, organizations and systems. Through collaboration, agencies can mutually inform, unify and support trauma-informed care implementation efforts at all points of the service-delivery system.

Children's Advocacy Centers' (CACs) Practice Model

In 2013, the Texas Legislature raised the standard for mental health services in CACs, requiring that all mental health services be trauma-focused and evidence-based. Additionally, mental health services must be provided by professionals who have a master's degree and are licensed, or who are students in an accredited graduate program and supervised by a licensed mental health professional.

Trauma-Informed Care Specialty Network

Created by STAR Health, it allows its providers to list the training on trauma that they have pursued and helps identify providers who have been trained in trauma-informed care in the STAR Health network for caseworkers, caregivers, and others in the child welfare community. STAR Health also offers TIC trainings to CPA, kinship families, RTC staff, and Emergency Shelter staff.

The National Quality Improvement Center's Adoption and Guardianship Support and Preservation (QIC-AG)

This effort is funded through a five-year cooperative agreement between the Children's Bureau, Spaulding for Children, and its partners the University of North Carolina at Chapel Hill, the University of Texas at Austin and the University of Wisconsin-Milwaukee. The Texas site is implementing Pathways to Permanence 2: Parenting Children Who Have Experienced Trauma and Loss; a training for active caregivers and will be randomly given to groups of caregivers for children whose parents' had their parental rights terminated or children who have been in care for at least two years with no or partial rights terminated.

4. Community-Level Initiatives

The Travis County Collaborative for Children (TCCC)

Led by Texas Christian University's (TCU) Karyn Purvis Institute of Child Development (KPICD), the TCCC implemented system-wide changes to the way children in Travis County are cared for during and after their time in state custody. TCCC's goal is to accelerate healing and speed to permanency for children in foster care utilizing KPICD's research-based Trust-Based Relational Intervention (TBRI®) principles and practices.

Mental Health Connection Trauma Implementation Team

In Tarrant County, originally formed in 2011 to bring Trauma-Focused Cognitive Behavioral Therapy to the community. The Mental Health Connection launched a public awareness campaign in May 2013 called "Recognize Trauma." The organization contains many committees including several with trauma-informed goals.

The Trauma-Informed Care Consortium of Central Texas (TICC)

Established in 2013 by St. David's Foundation and Austin Child Guidance Center, the TICC brings together professional organizations quarterly to network, share information, and coordinate trainings for mental health clinicians, school personnel, medical /nursing professionals, law enforcement, and juvenile justice professionals.