Childhood Trauma
Task Force 2024
Annual Report
A Report of the Childhood Trauma Task Force
DECEMBER 2024 | HTTPS://WWW.MASS.GOV/LISTS/CHILDHOOD-TRAUMA-TASK-FORCE-CTTF
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 About the Childhood Trauma Task Force
The Childhood Trauma Task Force (CTTF) was established by An Act Relative to Criminal
Justice Reform (2018) in M.G.L. Chapter 18C, Section 14. The CTTF, which is chaired by the
Child Advocate and is made up of representatives from a broad spectrum of stakeholders
involved in the juvenile justice and other child-serving systems, was tasked by the
Legislature with determining how the Commonwealth can better identify and provide
services to children who have experienced trauma, with the goal of preventing future
juvenile justice system involvement.
The Legislature created the CTTF as a permanent entity, recognizing the complexity and
scale of the group’s assignment. Learn more about the CTTF here:
https://www.mass.gov/lists/childhood-trauma-task-force-cttf
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Table of Contents
Introduction .......................................................................................................................... 6
Section 1: Towards a Trauma-Informed and Responsive Commonwealth ................................ 9
Childhood Trauma Task Force Work-to-Date............................................................................... 9
Center on Child Wellbeing & Trauma Work in 2024 ................................................................. 11
Section 2: CTTF 2024-2025 Work Plan Focused on State Agencies’ Trauma Training
Requirements and Opportunities ......................................................................................... 17
Methodology ............................................................................................................................. 18
Massachusetts State Agency Interviews ................................................................................... 19
Massachusetts Training Policies and Procedures ...................................................................... 19
National Scan of Other Jurisdictions’ Child-Serving Agencies’ Training Requirements ............ 19
Looking Ahead: CTTF Work in 2025 ...................................................................................... 26
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Members of the Childhood Trauma Task Force
Member Name Appointing Organization
Maria Mossaides Child Advocate, Chair
Representative Tram Nguyen House of Representatives (Speaker of the
House Appointee)
Vacant House of Representatives (Minority Leader
Appointee)
Senator Adam Gomez Senate (Senate President Appointee)
Senator Patrick O’Connor Senate (Minority Leader Appointee)
Thomas Capasso* Juvenile Court
Rachel Wallack
James Quinn Massachusetts Probation Service
Elizabeth Schatzel-Murphy Department of Youth Services
Laura Brody Department of Children and Families
Andrea Goncalves-Oliveira Department of Mental Health
Keesha LaTulipee Department of Public Health
Stacy Cabral Executive Office of Education
Claudia Dunne Committee for Public Counsel Services
Kate Lowenstein Citizens for Juvenile Justice
Mia Alvarado Children’s League of Massachusetts
Dawn Christie Parent of a child who has been subject to
juvenile court jurisdiction
* Abstained from voting on this report
The Childhood Trauma Task Force is a committee of the Juvenile Justice Policy and Data Board.
The CTTF is staffed by the Office of the Child Advocate:
Audrey Smolkin, Executive Director of the Center on Child Wellbeing and Trauma
Joy Cohen, Deputy Director of the Center on Child Wellbeing and Trauma
Daisy Perez, Senior Policy & Implementation Manager
Alix Rivière, PhD, Senior Policy and Research Analyst
Kerin Miller, Policy and Research Analyst
Arianna Turner, Project and External Affairs Coordinator
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Guide to Acronyms
Acronym Definition
ACE Adverse childhood event
CCWT Center for Child Wellbeing and Trauma
CTTF Childhood Trauma Task Force
DCF Department of Children and Families
DMH Department of Mental Health
DPH Department of Public Health
DTA Department of Transitional Assistance
DYS Department of Youth Services
EEC Department of Early Education and Care
EOHHS Executive Office of Health and Human Services
EOHLC Executive Office of Housing and Livable Communities
JJPAD Juvenile Justice Policy and Data Board
OCA Office of the Child Advocate
TIR Trauma-informed and responsive
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Introduction
The Childhood Trauma Task Force (CTTF) was tasked by the Legislature with determining how
the Commonwealth can better identify and provide services to children who have experienced
trauma, with the goal of preventing future juvenile justice system involvement. As Section 1 of
this report describes, the CTTF has fulfilled much of its mandate and continues to meet
quarterly to understand the landscape of trauma-responsive services for children and families
and develop recommendations to improve our systems of support.
This annual report provides information on the prevalence of trauma in Massachusetts, trauma-
responsive services established across the Commonwealth, and the CTTF’s Work Plan for 2024-
2025. This report also lays out the work of the Center on Child Wellbeing & Trauma, established
in 2021 as a result of CTTF recommendations to the Legislature.
Over a third of Massachusetts children (36%) experience at least one adverse childhood
experience (ACE), including violence in their home or community, maltreatment, and
discrimination.1 Adverse childhood experiences are linked to childhood trauma, which is
correlated with negative life outcomes. Not all children in Massachusetts experience ACEs at the
same rate. For children living in households with income below the federal poverty level, the
rate of experiencing at least one ACE is 63%. Additionally, close to half (48%) of Black non-
Hispanic children and Hispanic children (54%) experience at least one ACE, compared to 30% of
white children.
This disproportionate experience of trauma is an early source of systemic inequity, the impact of
which is seen in educational, healthcare, judicial, and social service systems. Experiencing
trauma can negatively impact children’s capacity to regulate their emotions and can lead to
significant behavioral health issues. This, in turn, can lead to professionals using disciplinary
actions to respond to these challenging behaviors. For example, in 2021-2022, Black students
were suspended at rates nearly 2.5 times higher than their white peers, and Latino students
were suspended at twice the rate of white students.2 Additionally, in FY23 Black youth in
Massachusetts were close to five times more likely to experience an arrest than white youth.3
That year, Hispanic youth were close to three times more likely to experience an arrest than
white youth.4
1 Data Resource Center for Child and Adolescent Health. (2020). Indicator 6.13: Adverse childhood experiences—Massachusetts.
The Child & Adolescent Health Measurement Initiative. https://www.childhealthdata.org/browse/survey/results?q=8755&r=23
2 Massachusetts Department of Elementary and Secondary Education. (2023, February). Guidance on Updated Expectations for
School and District Leaders Related to Student Discipline per G.L. c. 71, s. 37H ¾ (b), as amended by Chapter 177 of the Acts of
2022, An Act Addressing Barriers to Care for Mental Health.
3 Massachusetts Juvenile Justice Policy and Data Board. (2023). Massachusetts Juvenile Justice System.
https://www.mass.gov/doc/jjpad-2023-annual-report/download
4 Ibid.
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Many of the adults who care for children also experience trauma and other mental health
issues, which detracts from their ability to support the children they care for. In the summer of
2024, the U.S. Surgeon General issued a warning on parental stress: nationally, 41% of parents
report that “most days they are so stressed they cannot function”, and 48% say that “most days
their stress is completely overwhelming” compared to non-parents with the same responses
(20% and 26%, respectively).5 Professionals working with children and families are also
experiencing high levels of stress. For example, nationally, over 50% of behavioral health
providers and 45% of early childhood educators report experiencing burnout.6
These data paint a bleak picture of the behavioral health challenges faced by children,
caregivers, and child-serving professionals in Massachusetts and across the nation. They also
highlight the importance of the investments some jurisdictions are making to track and
understand the state of families’ wellbeing as well as the need for more work in this space. Of
note, in 2023, the Massachusetts Department of Public Health (DPH) released its Positive and
Adverse Childhood Experiences Data Dashboard to help professionals and the public understand
trends over time and by population group. Massachusetts now also tracks behavioral health
service utilization and outcomes through multiple dashboards.7
In the aggregate, increased attention to data on child wellbeing has helped the Commonwealth
create policies and programs that can better meet the needs of children who experience
trauma. In the past few years, Massachusetts has greatly invested in supporting children who
experience trauma and face behavioral health challenges. Since 2022, the Commonwealth has
established:
• A Roadmap for Behavioral Health Reform, a multi-year initiative to increase access to
effective treatment and improve health equity.
• A statewide Behavioral Health Help Line to more effectively connect individuals across
the age range with needed services in their communities.
• A new Office of Behavioral Health Promotion within the Executive Office of Health and
Human Services (EOHHS) to develop and implement a comprehensive plan to strengthen
community and state-level health promotion programming and infrastructure.8
5 The U.S. Surgeon General's Advisory on the Mental Health & Well-Being of Parents. (2024). Parents Under Pressure.
https://www.hhs.gov/sites/default/files/parents-under-pressure.pdf
6 Substance Abuse and Mental Health Services Administration. (2022). Addressing Burnout in the Behavioral Health Workforce
through Organizational Strategies. https://store.samhsa.gov/sites/default/files/pep22-06-02-005.pdf ; K-12 DIVE. (2022). 45% of
early childhood educators report high burnout, stress. https://www.k12dive.com/news/early-childhood-educators-experiencing-
high-burnout-stress/633709/
7 Statistical data dashboards to track service utilization and outcomes include the Massachusetts Behavioral Health Dashboard
and the Behavioral Health Helpline (BHHL) Dashboard. See: https://www.chiamass.gov/behavioral-health-in-massachusetts and
https://www.mass.gov/info-details/behavioral-health-help-line-dashboard
8 Chapter 177 of the Acts of 2022. (2022). An Act Addressing Barriers to Care for Mental Health.
https://malegislature.gov/Laws/SessionLaws/Acts/2022/Chapter177
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 • A Complex Case Resolution interagency team to address the urgent needs of children
who receive state services and face complex behavioral health challenges.9
• New and innovative programs for children and families, such as Community Behavioral
Health Centers, Youth Community Crisis Stabilization, and MCPAP for Moms.10
The CTTF recognizes the great investments that the Commonwealth has made in providing
therapeutic services for children and families who experience trauma and need support. And
yet, there is still more work to do to ensure that children who experience trauma are effectively
identified and provided with quality, community-based, and trauma-responsive supports.
Of note, while the Commonwealth has made incredible investments in behavioral health
services, children who experience trauma interact daily with systems and services that are not
necessarily trauma-informed and might in fact re-traumatize them. For Massachusetts to
become a trauma-informed and responsive state, we need to continue to train our professionals
in trauma-responsive care, change policies and procedures to avoid re-traumatization, and
create a shared culture that acknowledges and responds to the needs of families who
experience trauma and structural inequity.
In 2024, the CTTF continued its legislative mandate to determine how the Commonwealth can
better identify and provide services to youth who have experienced trauma. This report
summarizes the work of the CTTF and the Office of the Child Advocate’s (OCA) Center on Child
Wellbeing & Trauma (CCWT) in 2024. The current work of the CTTF in 2024 as well as planned
work in 2025 will inform findings and recommendations in future reports to the Legislature.
9 Code of Massachusetts Regulations. (2024). 101 CMR 27.00: Interagency review of complex cases.
https://www.mass.gov/regulations/101-CMR-2700-interagency-review-of-complex-cases-0
10 Executive Office of Health and Human Services. Community Behavioral Health Centers. https://www.mass.gov/community-
behavioral-health-centers ; Executive Office of Health and Human Services. Youth CCS programs and addresses.
https://www.mass.gov/info-details/community-crisis-stabilization#youth-ccs-programs-and-addresses- ; MCPAP for Moms.
https://www.mcpapformoms.org/
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Section 1: Towards a Trauma-Informed and Responsive
Commonwealth
Childhood Trauma Task Force Work-to-Date
Since its inception in 2019, the CTTF has fulfilled much of its legislative mandate. After studying
the landscape of trauma-focused programs and initiatives in Massachusetts and realizing the
term “trauma-informed” and “trauma-responsive” held various meanings for professionals, the
CTTF developed a Framework for Trauma-Informed and Responsive Organizations. This 20-page
framework, published in 2020, provides child-serving organizations with guiding principles of
trauma-informed and responsive (TIR) policies and practices as well as organizational domains
in which these principles can be applied. In all its work, the CTTF has adopted the Framework’s
guiding principles of safety; trust and transparency; healthy relationships; empowerment, voice,
and choice; and equity. The CTTF’s 2020 report, From Aspiration to Implementation, provides
recommendations for how to implement the Framework, including a recommendation to
establish a Center on Child Wellbeing & Trauma to support organizations in their efforts to
become TIR.
Following this work, the CTTF dedicated two years to conducting a large-scale study of trauma
identification mechanisms for child-serving organizations. In doing so, the CTTF researched the
benefits and limitations of screening and other means of identifying childhood trauma (e.g.,
observation, conversation) across child-serving sectors, including pediatric primary care,
education, early childhood, child welfare, and juvenile justice. The complexity of this topic led to
an Interim Report on Trauma Screening and Referral Practices (2021), which provided the
background for the CTTF’s recommendations for providers and the state in 2022. Identifying
Childhood Trauma: Recommendations on Trauma Identification Practices in Child-Serving
Organizations presented ways in which individual providers and organizations across child-
serving sectors could implement a trauma identification process.
The CTTF’s report Identifying Childhood Trauma also discussed a critical component of trauma-
responsive identification practices, namely, the importance of following up with families who
have referrals and connecting them to needed supports. Because of this, the 2022 annual
report, like previous CTTF reports, recommended the state increase the availability of services
needed for children to recover from trauma.
In 2023, the CTTF continued to learn about trauma supports for children in Massachusetts. In
doing so, members focused on three areas:
1. The current landscape of trauma supports for very young children, students in K-12, and
youth involved with the juvenile justice system. Between August and December 2023,
members heard panel presentations from community-based providers and state
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 agencies working in early education and care, K-12 systems, and juvenile justice (see
CTTF’s 2023 Annual Report).
2. Childhood trauma training requirements for child-serving professionals working with
state agencies (either as employees or contracted providers). To understand what the
Commonwealth expects professionals who work with child-serving state agencies to
know about childhood trauma, the CTTF began researching training requirements in
agencies’ policies, regulations, contracts, and licensing. This work is discussed in Section
2; it is ongoing and will continue into 2025.
3. Tracking the availability and type of trauma-focused services for children and families.
For our state to support children and understand gaps in trauma-focused services, it is
critical to have a structured repository of all available trauma services. The CTTF 2023
Annual Report highlighted Massachusetts’ lack of a statewide single repository of all
available trauma