Examining Trauma-Informed Care Training and Interventions for Foster Caregivers: A Systematic Review

Background: Trauma-Informed Care (TIC) emphasizes understanding the impact of trauma, recognizing trauma-related behaviors, and responding in ways that promote safety, healing, and emotional regulation. Research suggests that trauma-informed caregiving can improve child emotional regulation, strengthen caregiver–child relationships, and reduce placement disruptions within the child welfare system. Despite growing recognition of its importance, the implementation of trauma-informed practices among foster caregivers remains inconsistent due to variability in training requirements, limited practical skill-building, and insufficient systemic support. The primary purpose of this systematic review was to (a) identify TIC trainings, supports, or interventions for relative and non-relative foster caregivers; (b) summarize and critique how TIC components are integrated within these trainings; and (c) examine study and methodological characteristics to assess the strength of evidence supporting these trainings.

Methods: The development of this systematic review was guided by the steps laid out in the PRISMA 2020 Checklist (Page et al., 2021). We included peer-reviewed empirical studies examining TIC trainings, supports, or interventions for relative and non-relative caregivers. Database searches were conducted in April 2025 using Academic Search Complete, SocINDEX, and PsycINFO. A Boolean search strategy included terms such as “foster parent,” “foster caregiver,” “training,” “intervention,” and “trauma-informed care.”

Results: Following import into Covidence, a total of 713 unduplicated articles were included for title/abstract screening, and 129 articles were narrowed down for full text review. Following full-text review, 109 articles remained. Articles included multiple different types of trainings primarily focused on enhancing behavioral outcomes of children (e.g., behavioral parenting interventions), attachment-focused outcomes, or providing psychoeducational content to caregivers. Training content showed overlap in key areas (e.g., trauma education, regulation, relationships) but lacked consistency in structure and implementation, limiting comparability across programs. There was substantial variability in how TIC was defined and integrated, with some programs explicitly grounded in TIC frameworks and others demonstrating only implicit alignment. Studies generally showed positive short-term outcomes, but the vast majority of studies were limited in rigor (cross-sectional, pre-test/post-test, or only included one follow-up).

Conclusions/Implications: There is growing evidence and overwhelming support for TIC training, but there is a relative lack of clarity on specifically how TIC drives improved outcomes for foster caregivers and children. It seems that improved outcomes in some of the articles may be based more upon the theoretical orientation of the training program or model (e.g., changes in child outcomes may be due to behavioral parenting changes) rather than the specific components of TIC. The authors are not indicating that TIC is ineffective or unhelpful, but that there needs to be more evaluation of how specific TIC components are being assessed and how they drive the intended or expected improvements for children, caregivers, and the child welfare system. Future research should include evaluate caregiver and child outcomes to better understand whether skills are maintained across different children/placement situations, as well as what factors or support are needed to sustain TIC knowledge and skills. Training programs should clearly define and operationalize TIC components in training, and ensure feasibility within current foster home or community environments.