Why This Work Was Needed
In the early 2010s, child welfare systems across the country began to recognize that keeping children safe was not enough. Too often, services focused narrowly on safety, permanency, and compliance. They missed the deeper needs families brought with them: trauma, instability, and overwhelming stress.
At the same time, a memo from the Administration on Children, Youth and Families (ACYF) called for a shift toward well-being, to operationalize the emerging national focus on improve child functioning. In Wisconsin, a small group of changemakers saw an opportunity to act. Title IV-E Social Work students, trained in Parent-Child Interaction Therapy (PCIT), were returning to their employer with no place to apply their skills. Case managers saw families struggling to meet basic needs. Referral systems to trauma responsive interventions were inconsistent, and supports were scattered.
The team began by expanding services and testing new tools. Over time, they realized those efforts pointed to a larger question:
What would it take to deliver trauma-responsive care from within the system, not outside of it?
That question marked the beginning of the Clinical Services Integration (CSI) initiative. What started as program implementation grew into a broader strategy to change how systems support families.
What we did
CSI brought together public and private agencies, therapists, and evaluators to test whether trauma-responsive care could be embedded into the daily work of systems. The initiative started with implementation and adaptation of two evidence-based trauma treatments: Parent-Child Interaction Therapy (PCIT) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). These services were delivered in homes, schools, and community settings to reduce barriers and build trust.
To support earlier intervention, caseworkers began using trauma screening tools and Well-Being Assessments. Most of the data collected on child welfare at the time focused on children, with very little population level data about the parents with children entering foster care. These tools helped teams identify caregiver stress, economic hardship, and other factors that affect family stability. They also shifted how staff talked about safety and risk.
In 2019, the Trauma and Recovery Project (TARP) expanded the work. TARP provided funding, training, and learning infrastructure that helped partners reflect on how services were delivered, who accessed them, and where gaps persisted. The project also brought in Mobility Mentoring, a coaching model that focused on economic mobility by helping caregivers set and achieve goals. building stability.
Throughout the initiative, ICFW embedded evaluation and learning. After Action Reviews (PDF) gave staff space to reflect on what was working. Cross-team discussions helped identify shared problems and test new solutions. Supervisors used tools that supported coaching and adaptation.
These activities were not separate projects. They were connected pieces of a strategy to align services, shift practice, and build systems that respond to family needs.
The Strategic Turn
As the work expanded, teams began to see patterns across programs. They were not just implementing trauma therapies. They were shifting how systems defined success, supported staff, and responded to family needs.
Caseworkers and clinicians started using shared language. Supervisors adjusted expectations and gave staff space to reflect and adapt. Leaders asked different questions in meetings. They focused less on compliance and more on what families were experiencing.
The team named this shift Clinical Services Integration. It was not a single program or toolkit. It was a strategy for aligning services, decision-making, and infrastructure around family well-being.
Strategic learning was central. Every activity, from therapy delivery to dashboard design, became an opportunity to test, reflect, and adjust. ICFW used tools like After Action Reviews, outcome harvesting, learning logs, and Communities of Practice (CoPs) to connect learning across levels.
This approach helped staff see themselves as part of a broader system. It also made change possible inside agencies that were under pressure to do more with less.
What Changed
CSI led to visible shifts in how staff, agencies, and systems operated. These signals of change were not tied to any single program. They reflected new ways of thinking, working, and measuring progress.
Practice shifted.
Caseworkers used trauma screening tools and Well-Being Assessments to guide decisions. Therapists delivered evidence-based interventions with fidelity in real-world settings. Mobility Mentoring gave staff new ways to engage and support family economic stability.
Measurement improved.
Teams moved from tracking services to measuring outcomes. Dashboards showed progress in family well-being over time. Supervisors used data to support staff and adjust strategies.
Mindsets shifted.
Staff saw themselves as part of a larger system. They talked about alignment, adaptation, and shared responsibility. Partners brought evaluation questions into their planning.
Tools spread.
After Action Reviews became a routine part of project work. Well-Being Assessments and coaching tools were adapted by other teams. Supervisors integrated reflective learning into practice.
These shifts did not happen all at once. They grew through steady use of shared tools, routines, and partnerships. The result was a more responsive system—one that could learn and adjust in real time.
Why It Matters Now / What We Offer
Public systems are under pressure. Family needs are rising. Resources are shrinking. Agencies are expected to improve outcomes without changing how services are structured or delivered.
CSI shows that another approach is possible. When systems build in time to reflect, adapt, and align, they become more responsive. When partners work from a shared definition of well-being, they make better decisions. When learning is embedded, change lasts.
This work laid the foundation for how ICFW supports changemakers today. We help public systems, community organizations, and funders:
- Align programs, practices, and data around well-being
- Embed evaluation and reflection into daily work
- Adapt evidence-based models for complex settings
- Build networks that support shared learning and action
If you want support integrating these approaches into your work, ICFW offers consulting, coaching, and tools grounded in what we learned through CSI.
What Partners Said
Shifting Practice
“We stopped trying to fix families and started thinking about what we were offering them.”
— Facilitated AAR Discussion
“It made us reflect on whether we were helping families meet their goals or meet ours.”
— AAR: Selecting EBIs for Child Welfare
“We finally had language to talk about what we were seeing every day.”
— Outcome Harvest Summary
“It wasn’t just about learning the model. It was about learning how to serve families differently.”
— AAR: In-Home Therapy
Learning and Supervision
“The After Action Reviews helped us slow down and figure out what was actually working.”
— Facilitated AAR Discussion
“This gave us the structure to reflect without feeling like we failed.”
— Trauma Therapy Learning Log
“We weren’t having those reflective conversations before. Now they’re expected.”
— AAR Summary (Compiled)
System Alignment
“We started asking different questions in supervision. That changed everything.”
— Outcome Harvest Summary
“When the work is aligned, people feel more supported. We saw it happen.”
— AAR Compilation
“It made us ask, what’s the system we’re building toward, not just the one we’re reacting to?”
— Facilitated AAR Discussion
Frequently Asked Questions
1. What does “trauma-responsive” mean in public systems?
Trauma-responsive systems do more than acknowledge trauma. They change how services are structured to support healing. This includes decision-making, staff roles, and how outcomes are tracked.
2. What is the difference between trauma-informed and trauma-responsive care?
Trauma-informed care helps staff understand how trauma affects families. Trauma-responsive care takes that understanding and applies it to service delivery, supervision, and system design.
3. How does Clinical Services Integration work?
CSI helps align services, supervision, and data around family well-being. It uses shared tools such as trauma screenings, reflective supervision, and After Action Reviews to support continuous improvement.
4. What tools or models were used in CSI?
CSI included Parent-Child Interaction Therapy (PCIT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Mobility Mentoring. It also used Well-Being Assessments, shared dashboards, and trauma screening tools.
5. Can other systems use this approach?
Yes. The same strategies can be adapted for education, behavioral health, housing, or other service systems that work with families.
6. Does ICFW offer training or technical assistance?
Yes. ICFW provides consulting, coaching, and implementation support based on what we learned through CSI. Contact us to learn more.