Foster Parents


Trauma is defined as an experience that is perceived as life-threatening or a severe threat to a person's body. It can include:

  • Physical or sexual abuse
  • Car accidents
  • Life-threatening injuries
  • Scary medical procedures
  • Disasters
  • Animal attacks
  • Witnessing another person being threatened, harmed, or killed


Posttraumatic Stress Disorder (PTSD) is the core psychological response following a traumatic event. The Diagnostic and Statistical Manual of Mental Disorders 5e (DSM-V) lists four major symptom clusters:

  • Re-experiencing symptoms
  • Increased arousal symptoms
  • Avoidance symptoms
  • Negative alterations in cognitions and mood symptoms
Click on the video below to learn more about the 20 different PTSD symptoms.


National Statistics

In the United States, PTSD symptoms are prevalent in 19.2% of children referred to child welfare for investigations and ultimately placed in foster care (Kolko et al., 2010).
One study found that 25% of foster care alumni suffer from PTSD (Pecora et al., 2005).

Louisiana Statistics

The Louisiana Child Welfare Trauma Project found that PTSD is highly prevalent in the Louisiana child welfare system. Depending on the age group, 7% to 37% of the demographic are likely to have PTSD.

Our project has collected data on PTSD plus other emotional and behavioral problems on over 10,000 youths throughout Louisiana. Use our interactive graphs to learn more about the project's findings.


Trauma-Focused Screen

The TBH is used to assess whether a child has PTSD and its co-morbid disorders: ADHD, internalizing behaviors (INT), or externalizing behaviors (EXT).

Two Versions

The TBH has two versions:
(1) The Caregiver Version (all children)
(2) The Child Version (7-18 year-olds only)

Research shows that children and caregivers endorse different types of symptoms. The two versions therefore provide a more accurate assessment.

Administering the TBH

There may be times that you have to administer the TBH as an interview (for example, if your child cannot read or understand the questions, or if their vision is impaired). Administering the TBH sensitively can seem daunting. Fortunately, we have resources throughout our website to help you!

Joint Score

The TBH uses the Caregiver score and the Child score to create a Joint Score, which ultimately determines whether or not a child needs a referral for a specific disorder. 

Interpreting Scores

The TBH not only informs you whether your child should be referred to a therapist, but tells you what kind of specialized treatment you should seek. For example, if your child receives a high joint score for PTSD, you should seek a therapist who specializes in PTSD treatment.

If you would like to access the free, hand-scoring versions of the TBH, please click here.


Cognitive-Behavioral Therapy

Research supports the use of Cognitive-Behavioral Therapy (CBT) as a good method to help children recover from trauma. CBT for PTSD uses structured therapy sessions to emphasize behavioral exposures and anxiety management training.

Finding a Provider

We trained 334 licensed clinicians across Louisiana to provide cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD). For a list of providers who have received our CBT for PTSD treatment training, click Providers.


Are you concerned that you may have PTSD? The following assessment screens may provide you better direction and insight into what resources are available. Please note that a diagnosis can only be given by a licensed clinician.

Life Events Checklist (LEC-5)
PTSD Checklist for DSM-5 (PCL-5)
Zung's Self-Rating Anxiety Scale
The Center for Epidemiologic Studies Depression Scale Revised


Kolko, D. J., Hurlburt, M. S., Jinjin, Z., Barth, R. P., Leslie, L. K., & Burns, B. J. (2010). Posttraumatic Stress symptoms in children and adolescents referred for child welfare investigation. Child Maltreatment, 15(1), 48-63.

Miron Murphy, Devi. (2018). Addressing the needs of traumatized children in foster care [Powerpoint slides].

Pecora, P.J., Kessler, R.C., Williams, J., O’Brien, K., Downs, A.C., English, D., Holmes, K. (2005). Improving family foster care: Findings from the Northwest Foster Care Alumni Study.