Child Welfare Trauma Referral Tool

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					Please provide us with feedback on the CWT by faxing your evaluation to (858) 966-7524, Attn: Robyn Igelman, PhD, Chadwick Center for
Children & Families
                                                                                  Date: ____________________
                                            Child Welfare Trauma Referral Tool (CWT)
                                                         Evaluation Form

Position in your agency:  Caseworker              Supervisor         Administrator           Other:_____________

Years of Experience in child welfare field:  < 1              1-3       4-5       6-9        10-14        15-19      20+

Please check the response that matches your experience using the Child Welfare Trauma Referral Tool (CWT):
                                              Strongly Disagree       Unsure    Agree   Strongly        Not
                                              Disagree                                   Agree       Applicable
 1. The directions for using the CWT were
                                                                                                    
 easy to understand.
 2. I was able to identify my client’s trauma
                                                                                                    
 types using the CWT:
 3. The CWT included the trauma type(s)
                                                                                                    
 experienced by my client.
 4. I found the Age(s) Experienced
 checkboxes helpful in understanding my                                                             
 client’s traumatic history.
 5.The CWT helped me identify the following in my client:
       a. Traumatic Stress Reactions                                                                
       b. Attachment Difficulties                                                                   
      c. Behaviors Requiring Immediate
                                                                                                    
         Stabilization
      d. Difficulties regulating emotion                                                            
      e. Difficulties regulating behaviors                                                          
 6. The CWT helped me link my client’s
                                                                                                    
 experiences to their reactions.
      a. The Referral Flowchart was easy to
                                                                                                    
           read and understand
      b. The Referral Flowchart helped me
                                                                                                    
           determine referral type.
      c. The Referral Guidelines were easy
                                                                                                    
           to read and understand
      d. The Referral Guidelines helped me
                                                                                                    
           determine referral type.
 7. I am more likely to make a trauma
                                                                                                    
 referral as a result of the CWT.
 8. The CWT helped me understand my
                                                                                                    
 client better.

9. Referral Outcome for Current Client:
            a. Trauma Referral Made?                                   Yes (List:___________)             No
            b. Referral Made to a Specialized Program?                 Yes (List:___________)             No
            c. General Mental Health Referral Made?                    Yes (List:___________)             No

10. In your experience, what percentage of your total caseload would merit a trauma referral? ______

11. Other feedback: ______________________________________________________________

				
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