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Policy PointsIn order to achieve successful operationalization of trauma‐informed care (TIC), TIC policies must include conceptual clarity regarding the definition of both trauma and TIC. Furthermore, TIC requires clear and cohesive policies that address operational factors such as clearly delineated roles of service providers, protocol for positive trauma screens, necessary financial infrastructure, and mechanisms of intersectoral collaboration.Additionally, policy procedures need to be considered for how TIC is provided at the program and service level as well as what TIC means at the organizational, system, and intersectoral level. Context: Increased recognition of the epidemiology of trauma and its impact on individuals within and across human service delivery systems has contributed to the development of trauma‐informed care (TIC). How TIC can be conceptualized and implemented, however, remains unclear. This study seeks to review and analyze the TIC literature from within and across systems of care and to generate a conceptual framework regarding TIC. Methods: Our study followed a critical interpretive synthesis methodology. We searched multiple databases (Campbell Collaboration, Econlit, Health Systems Evidence, Embase, ERIC, HealthSTAR, IPSA, JSTOR, Medline, PsychINFO, Social Sciences Abstracts, Sociological Abstracts and Web of Science),as well as relevant gray literature and information‐rich websites. We used a coding tool, adapted to the TIC literature, for data extraction. Findings: Electronic database searches yielded 2,439 results and after inclusion/exclusion criteria were applied, a purposive sample of 98 information‐rich articles was generated. Conceptual clarity and definitional understanding of TIC is lacking in the literature, which has led to poor operationalization of TIC. Additionally, infrastructural and ideological barriers, such as insufficient funding and service provider "buy‐in," have hindered TIC implementation. The resulting conceptual framework defines trauma and depicts critical elements of vertical TIC, including the bidirectional relationship between the trauma‐affected individual and the system, and horizontal TIC, which requires intersectoral collaboration, an established referral network, and standardized TIC language. Conclusions: Successful operationalization of TIC requires policies that address current gaps in systems arrangements, such as the lack of funding structures for TIC, and political factors, such as the role of policy legacies. The emergent conceptual framework acknowledges critical factors affecting operationalization. [ABSTRACT FROM AUTHOR]

While research on the biological/genetic approach to trauma transmission has become increasingly abundant over the past 15 years, this research has been primarily limited to scientific research journals and has not yet significantly appeared in practice journals, graduate programs, clinical settings, or policy decisions. This paper aims to develop a bridge across disciplines, integrating a review of biological science literature with mental health literature to provide a multidisciplinary overview of the role of epigenetic mechanisms in the transmission of complex trauma. Such a multidisciplinary overview is important in allowing professionals across disciplines to approach their work with a more complete understanding of the way in which ecological systems shape trauma transmission and healing. While encouraging collaboration between researchers and providers across fields, this paper argues that to heal the person, one must first work to heal the environment. [ABSTRACT FROM AUTHOR]

Objective: Data from electroencephalograms (EEGs), including data from visual evoked-potential studies, were analyzed to assess their association with a specific type of explosive behavior in children and adolescents. Methods: Data for 326 children and adolescents treated in a psychiatric clinic were examined. Eighty-two percent exhibited behavior consistent with intermittent explosive disorder, although diagnosis was not an inclusion criterion for the study. The presence of explosive behaviors was indicated by reports from the legal system, schools, parents, health care workers, and psychiatric intake interviews. A quantitative EEG and a series of pattern-reversal evoked-potential studies were administered to each patient. In these studies, children are shown a rapidly reversing checkerboard pattern or rapid flashes of light, and their brain waves (evoked potentials) are measured. Results: Logistic regression indicated that patients who exhibited explosive behaviors were significantly more likely to produce high-amplitude P100 wave forms in the evoked-potential studies than patients who did not exhibit explosive behaviors. Forty-six percent of those with explosive behaviors met the clinically defined electrophysiological criteria for the high-amplitude P100 wave forms. Conclusions: The use of visual evoked-potential studies helped us classify a large subset of youths who exhibited out-of-control explosive behaviors. The findings suggest that a subgroup of individuals exhibiting explosive behaviors may have a predisposition for violent or explosive behavior that is an innate characteristic of their central nervous system. An understanding of the etiology of explosive behaviors permits the use of more appropriate intervention and treatment strategies. [ABSTRACT FROM AUTHOR]

Long-term residential treatment of children is determined by the depth of the sickness, the requirements of ego growth, and the nature of the treatment process. Psychological and fiscal anxieties sometimes interfere with the assessment of children's needs. [ABSTRACT FROM AUTHOR]

A policy & practice profile of human service leader Susan Dreyfus Susan Dreyfus, former secretary of the Washington State Department of Social and Health Services, has been fortunate to achieve [...]

Name: Dr. Raquel Hatter Title: Commissioner, Tennessee Department of Human Services Years of Service: With 22 years of service to children and families, I have served in many roles, including [...]

Raquel Hatter has been named commissioner of the Tennessee Department of Human Services. She replaces Virginia Lodge. Hatter served as president and chief executive of Family and Children's Service for [...]