Trauma-informed care for children involved with the child welfare system: A meta-analysis

There has been a burgeoning development of trauma-informed care (TIC) interventions for children involved with the child welfare system. A quantitative synthesis of these interventions' effects on child wellbeing is warranted for the advancement of evidence-based practices.

We conducted a systematic review and meta-analysis to estimate TIC interventions' pooled effect on the wellbeing of children involved with the child welfare system, while examining factors that may moderate the effect.

The search and review yielded 15 eligible studies. We first estimated the interventions' pooled effect based on a compound child wellbeing indicator, and then on three specific child wellbeing indicators: posttraumatic stress disorder (PTSD) symptom reduction, behavioral problem reduction, and other psychological wellbeing improvement. We further conducted subgroup meta-analyses to evaluate factors that may moderate the effect.

TIC interventions had a moderate effect as shown through the compound child wellbeing indicator (SMD = 0.47, 95% CI = [0.27, 0.67]) as well as the three specific indicators (SMD = 0.37 to 0.52, 95% CI = [0.02, 0.88]). Subgroup meta-analyses indicated that the intervention effects varied but generally remained at a moderate level across study and intervention characteristics.

The findings suggest that TIC interventions for children involved with the child welfare system are promising, but the effect may vary by intervention strategies and other factors. Implications for practices and research are discussed.