Complex trauma is a significant public health problem in the United States (U.S.), occurring in families with chronic and compounding exposures to traumatic stressors like substance misuse, intimate partner violence (IPV) and child maltreatment (Cook et al., 2017). Yet, few programs exist to treat their intersection, challenging our ability to respond effectively and restore positive trajectories for children and families. In this context, there is a need for innovative approaches to treat these intersecting phenomena. In this conceptual paper, we identify three innovative programs that offer integrative approaches to these intersecting challenges. We analyze common elements among these programs, offering a theoretical foundation for fundamental elements of transformative services. Finally, we consider how the Families First Prevention Act could be leveraged for states to adopt and implement these programs. The goal of this conceptual paper is to advance empirical and practical discussions regarding programmatic and policy options for more effectively responding to substance misuse, and IPV in families, and the associated traumas incurred by maltreated children and their caregivers.

复杂创伤是美国 (US) 的一个重大公共卫生问题，发生在长期和复合暴露于创伤性压力源的家庭中，例如物质滥用、亲密伴侣暴力 (IPV) 和虐待儿童（Cook 等人，2017 年）。然而，很少有项目可以处理它们的交叉点，这对我们有效应对和为儿童和家庭恢复积极轨迹的能力提出了挑战。在这种情况下，需要采用创新方法来处理这些交叉现象。在这篇概念性论文中，我们确定了三个创新计划，为这些交叉挑战提供综合方法。我们分析了这些程序之间的共同要素，为变革性服务的基本要素提供了理论基础。最后，我们考虑如何利用《家庭优先预防法》让各州采用和实施这些计划。本概念性文件的目标是推进有关计划和政策选择的实证和实践讨论，以更有效地应对物质滥用和家庭中的 IPV，以及受虐待儿童及其照顾者造成的相关创伤。