Trauma Informed Care
Trauma is a near universal experience of individuals with behavioral health problems. According to the U.S. Department of Health and Human Services’ Office on Women’s Health, 55% – 99% of women in substance use treatment and 85% – 95% of women in the public mental health system report a history of trauma, with the abuse most commonly having occurred in childhood. The Adverse Childhood Experiences (ACE) study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. Almost two-thirds of the study participants reported at least one adverse childhood experience of physical or sexual abuse, neglect, or family dysfunction, and more than one of five reported three or more such experiences.
An individual’s experience of trauma impacts every area of human functioning — physical, mental, behavioral, social, and spiritual. The ACE study revealed the economic costs of untreated trauma-related alcohol and drug abuse alone were estimated at $161 billion in 2000. The human costs are incalculable.
Trauma is shrouded in secrecy and denial and is often ignored. When we don’t ask about trauma in behavioral health care, harm is done or abuse is unintentionally recreated by the use of forced medication, seclusion, or restraints.
The good news is trauma is treatable — there are many evidence-based models and promising practices designed for specific populations, types of trauma, and behavioral health manifestations.
Child Focus, Inc. is a Trauma-Informed Care Agency. Our agency has always been involved with the TIC values and principles:
- Safety - Throughout the organization, staff and the people they serve feel physically and psychologically safe.
- Trustworthiness and transparency - Organizational operations and decisions are conducted with transparency and the goal of building and maintaining trust among staff, clients, and family members of those receiving services.
- Peer support and mutual self-help - These are integral to the organizational and service delivery approach and are understood as a key vehicle for building trust, establishing safety, and empowerment.
- Collaboration and mutuality - There is true partnering and leveling of power differences between staff and clients and among organizational staff from direct care staff to administrators. There is recognition that healing happens in relationships and in the meaningful sharing of power and decision-making. The organization recognizes that everyone has a role to play in a trauma-informed approach. One does not have to be a therapist to be therapeutic.
- Empowerment, voice, and choice - Throughout the organization and among the clients served, individuals' strengths are recognized, built on, and validated and new skills developed as necessary. The organization aims to strengthen the staff's, clients', and family members' experience of choice and recognize that every person's experience is unique and requires an individualized approach. This includes a belief in resilience and in the ability of individuals, organizations, and communities to heal and promote recovery from trauma. This builds on what clients, staff, and communities have to offer, rather than responding to perceived deficits.
- Cultural, historical, and gender issues -The organization actively moves past cultural stereotypes and biases (e.g., based on race, ethnicity, sexual orientation, age, geography), offers gender responsive services, leverages the healing value of traditional cultural connections, and recognizes and addresses historical trauma.
In June 2016- CFI was accepted to the Tri-State Trauma Network Trauma-Informed Care Learning Community in Collaboration with National Council for Behavioral Health, a yearlong experience to create culture change within our organization and to create a more trauma-informed system of care throughout our communities. Through the Learning Community we have begun to map out and operationalize a plan for delivering trauma-informed care utilizing the National Council for Behavioral Health’s Seven Domains; early screening and assessment, consumer-driven care and services, nurturing a trauma-informed and responsive workforce, evidence-based and emerging best practices, creating safe environments, community outreach and partnership building, and ongoing performance improvement and evaluation. Addressing trauma helps our organization improve the quality and impact of our behavioral health services, increase safety for all, reduce no-shows, enhance client engagement, and avoid staff burnout and turnover.
Although CFI had already made great strides specific to TIC, it was during the Learning Community that we became more intentional in our TIC approach as an agency and utilized a structured framework guided by the TIC values and principles. Being a TIC agency is an ongoing process, so we continue to move forward in the seven domains as our agency continues to grow and make a difference in the community.