Misunderstood or unaddressed, trauma can set a child’s life on a trajectory that perpetuates that pain, says Patrice Penney, a clinical professor in the College of Social Work.

“Because there may not be another pathway open to them, the effects of childhood trauma may lead to substance use, criminal behavior and incarceration, mental health difficulties, homelessness, or generational poverty,” Penney says. “They've probably not done well in school because your thinking brain doesn't work very well when you're in survival mode. These are kids who are vulnerable to more trauma.”

While one-time events such as a car accident or natural disaster can be traumatic, she says most children will recover if they have a responsive caregiver. However, repetitive and cumulative experiences such as chronic poverty, abandonment, food insecurity, neglect, and abuse can set children on a challenging path that puts them at risk.

Penney developed her focus on the social determinants of childhood and family trauma while directing a community mental health program for low-income families in Chicago. When she and her husband took an opportunity to work in Kenya, she applied her passion for working with children at risk to better understand trauma and loss in an African context. When they moved in 2003, the plan was to work there for a year. They stayed for 10.

During that time, Penney taught and developed university courses for trauma-informed practice, developed a counseling certificate program, and helped build an undergraduate psychology program. Her compassion for children in difficult family or social situations tugged at her, so she began not only delving into the limited research available on child welfare in Africa, but also doing her own inquiry.

“I began going to orphanages and street child projects, talking with cultural informants who were already working with children at risk – whether they were social workers, whether they did or didn’t have training,” she says. “What I learned is that many factors and barriers were impacting children and that about 50 percent of children in that context were at risk in some way.”

Among those complex challenges were poverty and unemployment, abuse and neglect, civil unrest, refugee status, illnesses such as HIV/AIDS and malaria, and economic obstacles to secondary education. If the parents in poverty were ill, the children often became responsible for the household, caring for the parents, being forced into child labor, begging, or criminal activity.

“Without a robust child welfare or foster care system, these kids either are going to stay in the community and be child-headed households, or they may be placed in an orphanage, which may or may not be a better circumstance for them,” Penney says.

She observed that caregivers and agencies were aware that children who had suffered under stressful and often abusive conditions needed help, but they didn’t have the training to provide it. When she was approached about counseling children herself, she  realized that wasn’t the best way to have an impact.

“I'm white. I'm American. I don't have the language, and I don't have the culture even though I was trying to be a student of both. Also, there were plenty of people on the ground trying to do this work,” Penney says. “I felt I could better use my experience to train caregivers. If I'm providing services, I could work with at most 30-40 children at a time, but if I'm training, I can multiply that to hundreds or thousands of children reached.”

She recognized the importance of directly training the caregivers – called mamas and babas – who were already on the frontlines in both community-based organizations and in residential settings. The workers were often low paid, undereducated, and living in poverty themselves.

“Some were large international orphanages that had American or European sponsorship. You would think those would be well run and well equipped, but there often were terrible conditions,” Penney says. “Sometimes it was a mom-and-pop operation, people who had big hearts who were trying to care for 10 kids in their home. They were rural; they were urban. They were well funded; they were poorly funded – the whole gamut.”

She developed a curriculum to help caregivers – who had mainly been trained to provide basic needs such as food and education – understand the range and scale of the trauma children may have experienced. It focuses on caregiving that is nurturing and responsive, centered on the stories of the children in care in these African contexts she learned in collaboration with local caregivers and organizations.

“My focus is trying to bring trauma-informed caregiving with an understanding of what's required for helping kids rebuild their sense of trust, safety and empowerment, so we can change the trajectory to allow them to thrive,” Penney says.

What she often found was that the caregivers themselves needed the same nurture and support because they had endured many of the same childhood experiences.

Penney has now provided training in 11 African countries and has been approached with a potential opportunity to adapt it for India. She estimates she’s trained more than 1,500 people – caregivers, teachers, administrators, law enforcement, church leaders and national and international organizations – whose reach is potentially hundreds of thousands of children and families.

“I will train anybody because I want people to understand not only what child developmental trauma looks like and how it affects kids across the lifespan, but I also want them to understand that nurturing caregiving is the key to healing,” Penney says.

Penney’s materials have been translated into French and Kiswahili, and she has developed mini modules that can be used as refreshers for those who have taken the training. She started an international nonprofit in 2014 ICARA (Initiative for Children at Risk in Africa) to provide information and facilitate training.

The love Penney developed for African culture and people has now spanned 25 years, and she brings some of that experience into the social work classroom at the University of South Carolina. She has also taken several students to Africa post-graduation to help with training with ICARA.

“Most of my students are going to work in an American context. The training has important implications for foster care and kinship care in the U.S. – caregivers are the most critical piece to helping kids recover from developmental trauma,” she says. “I do a lot of work with foster and kinship caregivers and child welfare organizations in South Carolina and across the Southeast.”

Penney is now focused on training African trainers to carry the initiative forward as well as continue to develop curricula.