1. Organizational Trauma-Informed Care
Whitney Walsh M.S.

2. What is trauma? Derived from Greek word for wound Types:
Emotional/Physical response when resources are not enough to cope with external threat
Types:
Physical/sexual abuse
Neglect
Witnessing violence
Bullying
Community-based violence
War/terrorism
Natural Disaster

3. Where is this population?
Treatment centers
Mental health
Substance abuse
Hospitals
Medical
Psychiatric
Foster care systems
Soup kitchens
Homeless shelters
Therapeutic practices
Faith-based groups
Community

4. Importance of language
Changing language as key component of the trauma-informed care movement
Victim
Negative connotation, evokes pity
Survivor
Empowering, more positive connotation
SAMHSA and The National Council on Behavioral Health
Survivor and individual with lived experience

5. Examples of non-Trauma-informed care
Long list of invasive initial questions
Staff who are intended to gather information rather than provide services
“The unit”, conditions, close proximities
Seclusions and restraints in psychiatric hospitals
Office settings in which door is closed behind patient and he/she cannot see who is entering the room
Male staff member completing overnight rounds on wing with female sexual abuse survivor
Human trafficking prosecution of children

6. Need for trauma-informed care
Patient:
Loss of trust
Higher self-harm
Less engagement in treatment
More distressed, for longer
Staff:
Higher injury from assault
Stress, secondary trauma
Staff turnover and low morale
Little attention on supervision
Treatment models are
less effective

7. What is trauma-informed care?
Substance Abuse and Mental Health Services Administration
SAMHSA
Realizes widespread impact of trauma
Understand paths for recovery
Recognizes signs and symptoms
Responds by integrating knowledge into policies, practices, etc.
Actively resists retraumatization in staff and survivors

8. Principles of ti organizations
Safety
Feeling physically and psychologically safe
Trustworthiness and Transparency
Goal of building and maintaining trust
Peer support and Mutual Self-help
Collaboration and Mutuality
Reducing power differences, meaningful sharing, everyone has role
Empowerment, voice, and choice
Individual’s strengths recognized, emphasis on choice
Cultural, historical, and gender issues
Moves past cultural bias, offers gender responsive services, addresses historical trauma

9. Samhsa’s strategies
1. Establishing organizational commitment to trauma-informed care
2. Develop a strategic plan using trauma-informed principles
3. Update the mission, vision, and value statements of the organization
4. Assign a trauma-aware senior staff member to oversee the process
5. Establish an oversight committee that will provide feedback throughout the course of the change process
6. Complete a self-assessment
7. Creating an implementation plan with which to move forward

10. Cont’d
8. Initial review of policies and procedures to assess potential for retraumatization
9. Make a disaster plan, less reactive
10. Create and implement a universal screening process
11. Establish culturally competent practices regarding the implementation
12. Utilization of Evidence Based Practices
13. Creating an environment that highlights peer support
14. Strive for continuous feedback and evaluation
15. Carefully assess environmental safety
16. Establish connections with other trauma-informed organizations in the community

11. 4 models Sanctuary Risking Connection THRIVE
Developing Trauma Informed Organizations: A Toolkit (Second Edition)

12. sanctuary Gold standard- full certification
Creating and maintaining nonviolent lives and nonviolent systems of recovery
Changes organizational structure
30 months-3 years
Three phases
Training, Consultation, Independent practice and certification
Re-certification every 3 years
Cost: $165,000 across the 3 years
For more information:

13. Risking Connection
RICH relationships, characterized by respect, information sharing, connection, and hope
Survivors of childhood abuse
Manualized 20-hour program with 5 modules
Module 1: Understanding Trauma is the First Step
Module 2: Using Connections to Develop Treatment Goals with Survivor Clients
Module 3: Keeping a Trauma Framework When Responding to Crises and Life Threatening Behaviors
Module 4: Working with Dissociation and Staying Grounded: Self-Awareness and a Tool for Clients and Helpers
Module 5: Vicarious Traumatization and Integration: Putting it All Together

14. RC cont’d Cost: $8,500 plus trainer travel and training manuals
Intended for smaller organizations up to 70 people
Additional consultation can be purchased
Abbreviated 6-hour version of training available for leadership teams
Those who would benefit from exposure but
don’t need mastery
20-40 people costs $3,750 plus travel
and manuals
For more information:

15. thrive
Individual’s response to and recovery from trauma is rooted in the community response (resiliency)
“family driven, youth guided, and culturally and linguistically competent.”
Strength-based
Highly customizable program
Utilizes web-based Hornby-Zeller Associates, Inc. for assessment support
For more information:

16. Thrive cont’d
Option 1: Agency Preparation for Trauma-Informed Change (90 days)
Review policies, motivate organization
Cost: $6,600 plus travel, up to 50 people
Option 2: Trauma-Informed Agency Assessment (TIAA) (30 set up available for a year)
Self-assessment through Hornby-Zeller
Cost: $4,500 for standard assessment, can be customized
Option 3: Continuous Quality Improvement (CQI) Planning for Organizational Change
Discussion of the self-assessment
Cost: $3,000 plus travel, $900 for additional consultation
Option 4: Sustainability of Community Training and Trauma-Informed Change.

17. Toolkit (2nd edition)
Trauma-informed care begins at foundational level
Designed for policy makers and organization leaders
Women with co-occurring mental health and substance use
Principles for an integrated, trauma-informed service system
Template for Developing a trauma-informed strategic plan
Sample trauma policies
Trauma-Informed Self-Assessments
Staff practice survey
Trauma-Informed Supervision
For more information:

19. Questions?