(Refiles this Feb 14 story to correct name of program in paragraph two; changes “Trauma” to “Temporary”.)

(Reuters Health) - A federal assistance program designed to move low-income families toward financial independence comes up short – but results might improve if families also receive support that helps them deal with traumatic experiences, a new study suggests.

The Temporary Assistance for Needy Families program (TANF), part of the Department of Health and Human Service’s Office of Family Assistance, is intended to help poverty-stricken recipients gain employment skills, secure jobs and adequate income so they can slowly become self-sufficient. Past or current physical or emotional distress are also entry criteria.

But years of study have shown the TANF program falls short of helping people enter the workforce and stay there.

To explore potential improvements, researchers conducted a study in which 103 caregivers of small children were assigned to three separate groups.

As reported in the Journal of Child and Family Studies, all three groups received standard TANF programming, consisting of 20 hours per week of supervised job training and job search activities.

One group also received assistance in opening a credit union savings account where their savings were matched, plus 28 weeks of financial education about entrepreneurial activities, retirement and reducing debt.

Another group received those same extra resources but in addition was invited to participate in a 28-week self-empowerment group to help people deal with trauma.

Examples of “trauma” include a work-limiting health condition, exposure to violence and adversity in the home, and physical, emotional and sexual abuse. These problems are common among TANF participants, and most families in the program have at least one household member in prison, according to the researchers.

Fifteen months later, the group that received the trauma support had improved scores in self-efficacy, while the group that TANF-only group had a significant decline in self-efficacy scores.

Participants who received the extra financial counseling but not the self-empowerment program had no change in self-efficacy scores.

Depressive symptoms also improved for the group that received all of the interventions, but remained unchanged in the other two groups.

“This is important, as even minor declines in depressive symptoms signals reduction in stress and better employment outcomes,” study coauthor Mariana Chilton, from the Dornsife School of Public Health at Drexel University in Philadelphia, told Reuters Health by email.

Ultimately, the TANF-only participants were the only group to experienced increased employment 12 months after the study started. According to Chilton, this is largely a consequence of the goal of the standard TANF program, which has a strong focus on helping recipients to secure employment as quickly as possible – but whether recipients will sustain such employment and secure financial independence, which is the ultimate goal, is unclear.

Economic hardship, however - defined as food, housing or energy insecurity - declined significantly only in the full-intervention group. This group experienced a significant increase in earnings by the end of the study, while hourly earnings in the control and partial intervention groups remained unchanged.

The problem with TANF, Chilton and coauthor Sandra Bloom say, is that it doesn’t address past and current exposure to trauma as a barrier into the workforce.

“Trauma-informed program approaches consider, ‘what has happened’ to a person as opposed to ‘what is wrong with them,’ to better support people in their recovery,” Bloom said in an email.

The programming, Chilton adds, avoids punishing people for coping behavior, de-escalates potential conflict and creates avenues for recovery from trauma in a more caring and informed way.

“If a person has unaddressed or unrecognized behavioral health issues, and doesn’t get time to work on their own sense of well-being, to acknowledge their emotions and learn to manage them or develop a sense of their own goals - as opposed to goals of the employment and training program - they won’t perform well on the job,” she said.

SOURCE: bit.ly/2ss6xuV Journal of Child and Family Studies, online January 1, 2018.