Trauma Informed Services The Evolution of a Concept Maxine Harris Ph.D. July, 2004

What Is A Trauma-Informed Service System? A human services or health care system whose primary mission is altered by virtue of knowledge about trauma and the impact it has on the lives of consumers receiving services

Why Trauma? The Extent of the Problem 60-75% of women in treatment for drug or alcohol abuse 43-81% of adult psychiatric inpatients 22-54% of women receiving outpatient mental health services 50-70% of women in domestic violence shelters

INFORM: to educate and make. knowledgeable about INFORM: to educate and make knowledgeable about (Harris and Fallot, 2000) Basic education for staff about trauma and its relationship to mental health symptoms and substance abuse Consumer awareness campaign Standard assessment of trauma and PTSD symptoms

INFORM: to educate (cont) Trauma skills assessment as part of an employment interview for all clinical staff Trauma champions within the agency Elimination of overtly abusive practices Administrative support for training and treatment innovations

INFORM: to give character to (Elliot, Bjelajac, et. al., 2004) Services should maximize consumer safety, choice and empowerment Eliminate practices that have the potential to re-victimize Collaborate in all aspects of treatment Provide needed emotional and practical support to facilitate recovery Maximize choice and consumer control Emphasize consumer strengths Acknowledge and respect the role of culture

INFORM: to be the formative principle of A paradigm shift in assessment, diagnosis, and treatment that identifies trauma as the core event Wider use of trauma-related diagnoses Identification of trauma-related skill deficits Self-awareness, self-soothing, accurate labeling Treatment to address trauma and the related skill deficits specifically Appreciation of the impact trauma dynamics have on all relationships Betrayal, power, blame and trust

Choosing a Definition Assess the needs and values of the organization Assess the resources available Assess the potential opposition Consider staging the transformation