The grief and the sadness over the events of September 11 have affected many people with shocking immediacy. Whereas the events themselves brought the country to a brief standstill, these events were really only the beginning of what we must now understand and confront if we are to continue to make progress and improvements in the child welfare system.

A broad range of consequences flow from that day magnifying other social and economic trends. The events themselves and the rippling aftershocks will produce substantial effects in child welfare. These effects may be difficult to document, but they do require a response.

In this issue of Best Practice/Next Practice we have set ourselves a challenging task: connecting the effects of September 11 to child welfare populations and presenting strategies to improve practice with families affected by trauma.

Personal loss

How can we look at the scope of the events of September 11? On one level there was a numbing personal experience of the events. At the epicenter, thousands lost their lives. Thousands more lost close family members. Many thousands more lost friends, colleagues, neighbors, and acquaintances. Within these expanding ripples, news and stories about the events made the experience a strangely personal one for people around the world. People were connected as they witnessed the events unfolding in live television coverage. At this level of personal experience, the events had serious consequences, inflicting trauma that interrupted everyday life. Insecurity, uncertainty, and fear traveled alongside virtually all families as they sought, under the increased stress, to do their work and care for each other.

The significance of this stress is heightened among a child welfare population that is already vulnerable. For some of the most disenfranchised families-those whose lives are too distressed to even notice the national tragedy-the aftershocks may prove to be even more powerful.

The extent of this trauma has been documented. Research conducted by the Rand Corporation and published in the New England Journal of Medicine states that close to half of American adults-44 percent-reported having one or more substantial symptoms of stress in the hours and days following the September 11 terrorist attacks; nine out of ten adults had stress reactions to some degree. Among children five years old or older, more than a third displayed one or more stress symptoms and almost half expressed worry about their own safety or the safety of loved ones.

Economic aftershocks

The events of September 11 also contributed to a series of economic aftershocks. For example, in the days following September 11, the closure of Reagan National Airport directly affected numerous airline and airport staff. With no passengers coming to the airport, the local taxis, hotels, and restaurants saw a drastic decrease in their business. That in turn created a bout of layoffs among hotel staff. At the same time, local distributors who supplied the airport, hotels, and restaurants saw a decrease in their business, and they in turn decreased the work for their staff and orders to their suppliers. And a myriad of other service and tourism industries in the Washington and New York areas and elsewhere have been affected with layoffs, decreased salaries, or shortened workweeks. Now we are in a recession, and the effects tied to these economic aftershocks are proliferating.

With decreasing incomes many people cannot locate affordable housing. The New York Times recently reported cities around the country are experiencing a new and sudden wave of homelessness. Shelters are overflowing, and more people this year-many families with children-are sleeping on floors in social service centers, living in cars, or spending nights on the streets. "In New York, Boston, and other cities, homelessness is at record levels ....A survey by the U.S. Conference of Mayors released [in December] found that requests for emergency shelter in 27 cities had increased an average of 13 percent over last year."

Effects on child welfare

In part, our existing knowledge frames many of the implications of this for child welfare. We know economic dislocation exacerbates family stress. We know that the child welfare population is drawn disproportionately from the ranks of those who are poor, with the highest correlations between poverty and serious and chronic neglect. We know also that the increased incidence of stress on families contributes to family violence-in the forms of domestic violence and child abuse-as resources and self-esteem erode under the forces of scarcity. Newspapers across the country, including the Boston Globe and Washington Post, are already reporting a rise in crime and violence.
We also know that the largest growth in the economy in recent years has been among lower-paying jobs with few benefits and little room for savings. This has been the economic force nudging forward the lower numbers of children in poverty by expanding the numbers of families able to earn a subsistence wage from the service economy. Under these circumstances, we would be well advised to anticipate the ways in which this population of families, struggling for subsistence in a shrinking economy, may need increased resources for family support to handle the increased stress of the loss of a job or growing unemployment around them.

At the same time, we face the effects of untested linkages in child and family policy. In the first days after the passage of welfare reform legislation, some observers became concerned that transitioning people off of welfare would degrade conditions for children and lead to an increased reliance on Title IV-E funds-the remaining entitlement program supporting children's well-being. The early years of welfare reform saw a "truce" in this debate, as a booming economy absorbed working mothers, and critics were confounded by the fact that the baseline at which states' Temporary Assistance for Needy Families (TANF) grants were set produced the unexpected state debate over how to use the TANF surplus.

This will change in the aftermath of September 11. The boundary around the child welfare population that exists as a standard of minimally acceptable safety and well-being can shift. The combination of economic recession and welfare time limits could add up to drastically increased strains on child welfare systems whose capacities are pushed to their limits already.

State funding for child welfare

The accumulation of stress factors in the wake of September 11 extends to state budgets as well. Memories of the TANF surplus are fading fast. States now find themselves having to spend millions of dollars on internal security to respond to residents' fears and potential dangers from terrorists. At the same time, significant budget cuts are soon to be enacted. These cuts include significant lay-offs of child welfare and social services staff. Discussions with state child welfare staff in every region confirm this trend. At the same time, as state child welfare departments struggle with budget cuts, the federal review process, the Child and Family Services Review (CFSR), continues to challenge state systems with its call for systemic change and family-centered best practice. Everyone involved must respond by reaching for new reserves of hard work and commitment. It is no easy task.

Bracing for the aftershock

The effects of September 11 are cumulative, and they are building. The truth is that we cannot trace people's behavioral responses to traumatic events back to a single incident, nor can we say definitively what triggers the symptoms of post-traumatic stress disorder. We can, however, be aware of and prepared for effects most likely connected to recent traumatic events.

These effects can include the following:

* Personal feelings of insecurity expressed as fear of going to work or school, of being left alone, or of being away from parents. In parents, role conflict intensifies. In children, relatively simple fears can complicate daily routines, which can add stress to parenting.

* Recent assessments of mental health in child welfare find that mental health issues affect both children and caretakers in child welfare in many complex ways. They are both cause and effect of child welfare involvement, and effective assessment and treatment is elusive. Exacerbated by September 11 and its aftershocks, we should be prepared to identify persistent mental health side effects and mobilize innovative supports to address them.

* Substance abuse and other negative health habits rise in reaction to trauma. When upwards of 80 percent of child welfare cases involve substance abuse, this is a serious concern.

* Child welfare workers are vulnerable to multiple issues generated by the trauma. Practice in an atmosphere of fear and fatigue can undercut more clinically sophisticated family-centered approaches.

Perhaps our greatest concern should be reserved for those families and children involved in child welfare untouched by our current situation. The most disenfranchised populations in child welfare live lives in which the trauma of September 11 and its aftershocks become a part of a deadening routine. What does this mean for long-term policy and development? Does it point towards better understanding of our responsibilities?

The articles in this section can help us be aware of and prepared for effects most likely connected to both previous and the recent traumatic events. We begin our discussion close to the epicenter of the recent events and expand our focus. In "Braced for the Storm," we interviewed agency staff in New York City, some only blocks from Ground Zero, to see how they dealt with and continue to face the demands placed on their services and staff.

In "Foster Families and Agencies Respond," foster parents discuss the behavioral changes in the children in their care following September 11. How have some local agencies responded to their own needs as well as those of child welfare workers?

"Reaching out to Children" describes the symptoms of post-traumatic stress disorder in children, explains the mental health needs of children in the child welfare system, and provides suggestions for families and caregivers.

Child welfare workers are vulnerable to trauma. They need support from administrators and supervisors. In "The Importance of Helping the Helper," Roger Friedman explains the prevalence and impact of traumatic stress on child welfare staff and describes secondary traumatic stress. He explains how individuals and agencies can successfully cope with these challenges.

A state of alert

We need to see the extended and indirect effects tied to September 11 to honestly take the measure of the events. We need to see the fabric of relationships connecting these events, and connecting us all to these events and their consequences. But what, in the end, should we learn?
We are not in a state of alarm. But we are, as advised, in a heightened state of alert. As time goes on, and we continue to deal with the rippling effects of September 11, we also need to create a heightened state of humanity within the complex world of child welfare and elsewhere. We have to recognize the fact that people live with the effects of trauma everyday-in a way in which September 11 only makes us more aware-and this is a potent argument for making policy and practice dealing with families as humane and as family-centered as possible.