Evidence-Based Responses
to Childhood Trauma

Every funder, whether institutional or individual, wants a strong return on investment – a significant and concrete improvement in the community or cause they support. The effect of a gift or grant should be more than the sum of services it funds. It should leverage real social change.

Investing in evidence-based responses to childhood trauma offers one of the best opportunities to have that kind of powerful impact, not only in the lives of children but also in the health and well-being of entire communities.

Childhood trauma is a public health problem, affecting at least a quarter of children in the U.S. It is a contributing factor in a wide range of social problems from poor student performance to homelessness to chronic diseases, and its ripple effects produce long-term costs of at least $100 billion every year.

That’s why investments in effective interventions for childhood trauma are so powerful. Through evidence-based treatment or prevention, we put children on the path to health and well-being, and we relieve communities from the long-term, wide-ranging consequences and costs of trauma.

Prevalence & Consequences

In North Carolina each year, there are on average 7,800 substantiated cases of child maltreatment and 5,600 children who enter foster care. But these data do not adequately convey the full scope of childhood trauma in our communities.

Large-scale public health surveys over the course of 20 years have shown consistently that approximately half of all adults had at least one Adverse Childhood Experience (ACE), and 22 to 25 percent had three or more. ACEs include abuse and neglect, as well as a child’s mother being treated violently, substance abuse or mental illness in the home, parental incarceration, or parental separation – all of which have the potential to traumatize a child.

There are approximately 2.3 million children in North Carolina. Twenty-two percent is 506,000 children at risk of three or more Adverse Childhood Experiences.

Not every child who experiences significant adversity will develop Post Traumatic Stress Disorder (PTSD) or related symptoms. Research suggests a 15 percent probability. Still, that means that at least 75,000 children in our state are living with a diagnosable condition that fundamentally undermines their healthy development and well-being. Even for those who do not develop PTSD, their traumatic experience will have consequences that can last a lifetime.

Children who suffer trauma or multiple adverse experiences have much greater risk for a range of negative outcomes: difficulty in school, substance abuse, problem sexual behavior, juvenile offenses, poor work performance as an adult, unemployment, incarceration, mental illness, and even chronic illness. For instance:

• Teens with 4 or more Adverse Childhood Experiences have higher resting heart rates, body mass index, and rates of obesity.
• A single trauma increases by two to three times the likelihood of using alcohol by age 14.
• 93 percent of juvenile offenders report at least one childhood trauma.
• 60 percent of homelessness in women can be attributed to childhood adversity; 45 percent in men.
• Adverse Childhood Experiences are highly correlated with seven of the ten leading causes of death in the US.

These preventable outcomes are tragic for the individuals involved, but they also come at a high cost for the communities they live in. The Centers for Disease Control and Prevention estimates that the lifetime cost for a single incident of child maltreatment ranges from $98,000 to $210,000, based on expenses in mental health, healthcare, education, and justice systems, as well as lost productivity as an adult. This means that, for every 100 children who experience maltreatment, their community assumes a long-term cost burden of at least $100 million.

Strategic Framework

The good news is that childhood trauma is both treatable and preventable.

Hope and healing are possible even for children who have endured terrible adversity. And every family can create a safe, healthy home with the right support.

CCFH responds to the reality of childhood trauma with highly effective clinical services and in-home supports for individual children and families. But we also aim for a larger, more systemic impact: improving the way mental health agencies, social services, schools, and other systems throughout North Carolina respond to the needs of traumatized children by training others in the evidence-based practices we use.

So, our mission is to define, practice, and teach the highest standards of care in treating and preventing childhood trauma.

We also use this threefold strategic framework to describe our work:

• Treating the effects of childhood trauma
• Preventing child maltreatment
• Transforming systems to be trauma-informed

Evidence-based Practices

Evidence-based practice is the standard at CCFH. When we commit ourselves to doing something about childhood trauma, we commit ourselves to doing something proven to work.

A practice is evidence-based when it incorporates the best research evidence with the best clinical experience and is consistent with the client’s or family’s values. This is the definition used by the California Evidence-based Clearinghouse for Child Welfare, which rates individual models and programs based on level of research support.

The majority of models and programs used by CCFH receive the highest ratings of 1 (well supported by research) or 2 (supported by research) on the CEBC Scientific Rating Scale.

Reach & Impact

Our clinical services and prevention programs primarily serve our local communities, reaching approximately 2,500 children and their families every year.

Our training and systemic change efforts reach more than 3,500 child-serving professionals throughout North Carolina and beyond each year, including therapists, social workers, teachers, and healthcare professionals.