Trauma is a widespread, harmful and costly public health problem. Trauma can be caused by a single event such as a natural disaster or abuse. An individual’s thoughts, feelings, and behaviors are filtered through their experience and perspective. Trauma has no boundaries with regard to age, race, geography or sexual orientation. The need to address trauma is increasingly seen as a key component of effective service delivery in social and human services. In addition, the service system can traumatize individuals again if employees are not educated about the population and individuals your organization serves. It is essential to be intentional about how services are provided to protect clients because re-traumatization can negatively impact a client’s willingness to engage and participate in treatment and support services.
There is still a common definition of trauma-informed care within the industry. Trauma Informed Care (TIC) is an approach based on knowledge of the impact of trauma, aimed at ensuring that environments and services are safe, welcoming and engaging for service recipients and staff. There is a growing consensus in the field that trauma-informed care is a strengths-based framework, one of which is based on understanding the impact of, and responding to, trauma. TIC emphasizes the safety of both providers and survivors and creates opportunities for survivors to rebuild a sense of control and empowerment.
The benefits of having an organizational culture rooted in TIC has many positive effects including improved client engagement, better health outcomes, increased provider and employee wellness, and treatment adherence. The TIC approach is a path to creating safety for clients, an environment that cares and supports employees and creates opportunities for choice, power and control for clients that helps build healing interactions and reduces the possibility of re-traumatization. It allows the organization to increase the quality of services while reducing unnecessary interventions and costs. It also helps reduce negative encounters and events. Overall, research has shown increases in client and family satisfaction as well as job satisfaction among staff when trauma-informed care is used to guide practice.
Implementing a system-wide approach to trauma requires a commitment to change the practices, policies and culture of the entire organization. According to SAMHSA’s concept of the trauma-informed approach, there are four assumptions to focus on:
- Recognize the broad impact of trauma and understand potential pathways to recovery.
- Recognize signs and symptoms of trauma in clients, families, employees, and others involved in the system.
- Response to fully integrate knowledge about trauma into policies, procedures, and practices.
- Active resistance exercise re-shock.
Keep in mind that each organization may be at a different step in the process of culture change, but the first action an agency should consider is to complete an organization-wide assessment, such as the Trauma-Informed Organizational Assessment (TIOA) created by the National Center for Child Trauma Stress (CHS). NCCTS), to evaluate current practices. The results of the assessment may guide your organization to decide where to start when considering focusing on a trauma-informed approach to care. More information can be found here: https://www.nctsn.org/trauma-informed-care/nctsn-trauma-informed-organizational-assessment. To be able to make a complete cultural change, there needs to be a certain governance and leadership of the process.
In short, changing an organization’s framework, lens or approach is labor intensive that requires diligence and focus and may take longer than expected. As discussed throughout this blog post, the benefits are plentiful. An organization that has a framework of trauma-informed care will see success in its clients, staff and the longevity of the agency. Contact a member of our A Team to learn more about this or other risk-serving approaches for your nonprofit or human services organization.
About the author
Toni Malicdem is a senior healthcare safety advocate at Assurance. With over 10 years of experience in the healthcare industry, she is an industry expert and brings this unique perspective to her clients. Tony is responsible for ensuring that clients implement best practices as efficiently and effectively as possible while creating a high quality of life for residents and patients.