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Vol. 10, No. 3
June 2005

Posttraumatic Stress Disorder

Researchers recently examined outcomes for 659 young adults who had been placed in family foster care as children. One of the most remarkable things they discovered was that one in four (25.2%) of these foster care “alumni” had experienced posttraumatic stress disorder (PTSD) within the previous 12 months (Pecora et al., 2005). This rate of PTSD is nearly double that of US war veterans.

People who think of PTSD as something caused only by the trauma and terror of military combat will probably be shocked by this finding. However, if you work in child welfare, shock is probably not your reaction. You know all too well the effects abuse, neglect, and placement instability can have on children. And yet the implications of this finding for your work are huge.

As you will learn in this issue, PTSD significantly undermines a child’s well-being. Left untreated, it can put children at risk for school difficulties, attachment problems, additional psychological disorders, substance abuse, and physical illness. When the children grow up, PTSD can interfere with economic self-sufficiency. The trauma experienced by children can also profoundly affect child welfare workers.

Family support and child welfare workers and their agencies must be able to recognize the signs of PTSD and they must be prepared to respond in an appropriate and timely way when they come across it. The health and well-being of children—perhaps their very futures—depends on it.


PTSD and Children in the Child Welfare System

How Children and Adolescents React to Trauma

Responding to a Child’s Acute PTSD Reaction

Effective Treatment for PTSD

A Child Welfare Response to Traumatized Children

Strategies for Agencies and Workers

Preventing PTSD in Children

Traumatic Stress and Child Welfare Workers

Assessing Worker Distress

Ways Supervisors Can Help Workers Deal with Secondary Trauma

References for this Issue

Click here to read or print the entire issue as a pdf file

Additional resources related to this topic:

  • Focal Point (Winter 2007). The Portland, Oregon Research and Training Center's Winter 2007 edition of "Focal Point" focuses on child traumatic stress, particularly as experienced by children involved in the child welfare system. The causes and effects of traumatic stress are discussed, as are evidence-based treatments and prevention strategies.

  • Child Welfare Learning Resources Related to Traumatic Stress. The June 2005 issue (vol. 6, no. 3) of the newsletter Training Matters.

  • PTSD and Children in Foster Care, essay by the Child Welfare Institute's Tom Morton which includes the following important points: "child welfare agencies should consider placement as a possible precipitating trauma for PTSD in children and reconsider how caseworkers and foster parents view some emotional and behavioral issues of children in foster care. Equally importantly, PTSD is a possibility for parents following removal of a child."

  • A Gift from Within, an international nonprofit organization dedicated to those who suffer post-traumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals.  Educational materials include videotapes, books, and articles for both professionals and those experiencing PTSD.

  • Working with Traumatized Children. The understanding and treatment of traumatized children in out-of-home care is the focus of a new book, Working with Traumatized Children in Child Welfare. The book provides a framework for understanding childhood separation, loss, and trauma, as well as a variety of helping interventions that focus on specific populations or treatments. The book is divided into three main sections:
    • Early chapters examine the impact of trauma on the child welfare population, including principles of neurodevelopment and parental and social conditions that contribute to childhood trauma.
    • Chapters on treatment cover ethnically sensitive practice, children with disabilities, animal-assisted therapy, adolescent mothers, and eye-movement desensitization.
    • A final section of the book discusses proposals for improved collaboration between the child welfare and mental health systems.

    Working with Traumatized Children in Child Welfare was edited by N. B. Webb, and contributing authors included a number of experts in child welfare and mental health. It was published by Guilford Publications and is available through their website: <>