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26 CW360 o Trauma-Informed Child Welfare Practice • Winter 2013Homeless Youth Emerging from the Child Welfare SystemArlene Schneir, MPHPracticeThe Hollywood Homeless Youth Partnership(HHYP), a collaborative of eight homelessyouth serving agencies in Hollywood,California, has been involved as a center withthe National Child Traumatic Stress Networksince 2005. As a result of our work with theNCTSN, we believe that trauma-informedpractices and evidence-based trauma focusedtreatment approaches can be more effective inhelping youth who have experienced traumaand abuse understand their experiences,develop new and healthier coping strategies,create and sustain positive attachments withcaring adults, and healthy relationships withpeers, and promote post-traumatic growth.Most importantly, we strongly believethat early and on-going trauma-focusedintervention with these young people can helpprevent them from transitioning from ourchild welfare system into youth homelessness.Unaccompanied homeless youth are foundin every urban center in the U.S. and inmany smaller cities and rural communities.Nationally, former foster care children andyouth are disproportionately represented inthe homeless population (National Alliance toEnd Homelessness, 2006). In 2007 and 2008,the HHYP conducted a multi-method needsassessment with unaccompanied homelessyouth ages 12 – 25 to better understandtheir needs and experiences. The resultingreport, “No Way Home: Understanding theNeeds and Experiences of Homeless Youthin Hollywood” (Rabinovitz, Desai, Schneir,& Clark, 2010), included rich informationabout the characteristics of homeless youth inthis community that can be useful for childwelfare systems and other public and privateinstitutions that serve these young people.Approximately half (48%) of the youthsurveyed (n=389) reported previous or currentinvolvement with the child protective servicessystem (CPS); forty percent of youth reportedhaving been removed from their homes byCPS. The mean age when youth reportedhaving been removed by CPS was 9.3 yearsold. Almost all (95%) of the youth who hadbeen removed from home had been placedin a group home at some time, and close toone-third of the youth reported they hadbeen in 6 or more group homes. Clearly, ourchild welfare system has not been effective infinding these children and youth the safe andpermanent housing they require for healthydevelopment.As part of our analysis, we compared thehomeless youth in our survey who had beenremoved from home by CPS with those whohad not and found that youth who had beenremoved from home by CPS had pooreroutcomes than their peers. Not surprisingly,youth who had been removed from homeHomeless youth who had been removed from home complained mostabout the multitude of placements and how that interfered with theirability to connect with peers and caring adults.were more likely to report all types of abuseand neglect. These youth also reportedmore episodes of homelessness (8.1 vs. 5.3);were more likely to be engaged in the streeteconomy (panhandling, shoplifting, tradingsex, selling drugs, and/or pimping) (47% vs.36%); and were more likely to have spent atleast one night on the street in a place notmeant for human habitation within the lastmonth (59% vs. 45%).In regard to mental health issues, youthwho had been removed from home by CPSreported more psychiatric hospitalization andwere more likely to report being diagnosedwith a conduct disorder, bipolar disorder, orschizophrenia. They were also more likelyto report self-injurious behavior. In regardto educational issues, youth who had beenremoved from home by CPS were also morelikely to have been diagnosed with learningproblems and enrolled in special education.In individual interviews and focus groups,homeless youth who had been removed fromhome complained most about the multitudeof placements and how that interfered withtheir ability to connect with peers and caringadults. Youth also reported they were oftenmoved from one placement to anotherwithout any warning or explanation. Inaddition, youth had many complaints aboutthe mental health services they received whenthey were involved in the child protectivesystem. They felt they were over-diagnosed,labeled, and medicated. As a result, many ofthese youth were reluctant to access mentalhealth services even after their involvementwith CPS ended.Over the past two decades, the federalgovernment and many state child protectionagencies have intensified their efforts toensure that child welfare services resultin positive outcomes for children andfamilies. However, there is clearly stillwork to be done. Based on our work withyouth experiencing homelessness, we areparticularly interested in efforts to supportpermanency for children and youth in thefoster care system. We applaud new initiativesthat make this possible, particularly for gay,lesbian, bisexual, and gender non-conformingchildren and youth.Arlene Schneir, MPH, is AssociateDirector of the Division of AdolescentMedicine at Children’s Hospital inLos Angeles. She can be reached ataschneir@chla.usc.edu.
CW360 o Trauma-Informed Child Welfare Practice • Winter 2013 27Trauma-Informed Care Using the 3-5-7 ModelDarla L. Henry, PhD, MSW, and Amelia Franck Meyer, MS, MSW, APSW, LISWAlthough there has been an increasing focuson “trauma-informed care” for children inout-of-home care, for many, it has not beenclear exactly what “trauma-informed care”means on the practice level. For example,“What do I do differently in my day-to-dayinteractions with the youth?” “What do fosterparents do differently in the home?” UntilAnu Family Services (www.anufs.org) becameaware of the 3-5-7 Model © , the answersto these questions about the practice-levelchanges needed to address trauma were notas clear. The 3-5-7 Model © , in which alltreatment foster parents and social workersare trained at Anu, helped to concretize howto address trauma for youth in out of homecare. The 3-5-7 Model © helped to give anew perspective to the work: trauma is theexperiences that have happened to theseyouth, losses are what they experience as aresult of these multiple and complex traumas,and grieving is what social workers and fosterparents help them do to heal their losses andtrauma. Using loss as a lens by which to viewtrauma helps social workers, therapists andfoster parents to understand what needs tohappen next.The 3-5-7 Model © is a promising practicethat supports the work of children, youthand families in grieving their losses andrebuilding their relationships. The 3-5-7Model © is a strengths-based approach thatempowers children and youth to engagein activities that encourage expressions ofhurt related to losses and to give meaning tosignificant relationships towards developingpermanent connections. It supports deepertherapeutic work around the traumas ofabuse, abandonment and neglect experiencesthat is or may be provided by other clinicalprofessionals. As individuals begin to reconciletheir grief, they may more readily enter intodeeper, intensive therapies, if needed.The 3-5-7 Model © incorporates threetasks, five conceptual questions and seveninterpersonal skill elements to support thiswork. The three (3) tasks, clarification,integration and actualization, guide theactivities that support the work of grievingand relationship building. Losses will beclarified, relationships will be integrated, andpermanent connections will be actualized.Clarification means to identify and makesense out of the events of the one’s life, toprovide a factual base for understandingwhat is real and what is not real. Integrationis the process by which one develops theability to understand their connectionsand membership in numerous families.Actualization is the visualization ofpermanency, that is, the sense of feeling safeand of belonging, claiming an identity, andestablishing a place within family or otherpermanent relationship. Actualization is wellbeing.It is the ability of the child or youth tobegin to see a possible permanent future witha family, parent, or guardian as the tasks ofUsing loss as a lens by which to view trauma helps social workers,therapists and foster parents to understand what needs to happen next.clarification and integration are occurring andevolving.The five (5) conceptual questions, who amI, what happened to me, where am I going,how will I get there, and when will I know Ibelong, support the work of the three tasks.The seven (7) interpersonal abilitiesguide the efforts of professionals, counselorsand families as they support the grief work.These abilities are: engagement and listeningskills, recognizing the pain reflected inbehaviors, affirming and responding to thesebehaviors from a grief perspective, remainingpresent to these expressions of grief,creating opportunities for the perception ofsafety within the helping relationship, andrecognizing that grief work and relationshipbuilding can be done only by those who haveexperienced the loss.The 3-5-7 Model © provides tools, basedon theoretical foundations, to support thework of the child or youth. For example:Start the activity with the child byexplaining that you are going to play a specialkind of basketball, which will help them discusshappy and sad feelings. When the child throwsa ball through the hoop, they select a card froma “happy face” pile. When the child misses thehoop, they select a card from a “sad face” pile.They share their feelings, or not, at a pace thatis safe and comfortable for them (The 3-5-7Model © Workbook, p.16, 2012 Edition). Thisis a safe way for the child to identify and expressfeelings and typifies the task of clarification bysupporting them in telling the story of events thathave happened to them. Questions related toidentity and grieving are captured in this work.Through learning the techniques andtheories of the 3-5-7 Model © , workersand families become knowledgeable andcomfortable in exploring the hurts of thosethey parent and work with, learning patienceto support the expressions of their pain. Asa practice for relational work, the use of thismodel has shown that children and youthdo their work in grieving losses and are ableto move forward towards permanency inrelationships where they feel safe and secure.Darla L. Henry, PhD, MSW, MARS, isthe author of the 3-5-7 Model©, 3-5-7Model© LLC. She can be reached atdhenry@darlahenry.org.Amelia Franck Meyer, MS, MSW, APSW,LISW, is the CEO of Anu Family Services.She can be reached at afranckmeyer@anufs.org.Practice
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