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Trauma-Informed Care
Care that is grounded in and directed by a thorough understanding
of the neurological, biological, psychological and social effects of trauma and
violence on humans and is informed by knowledge of the prevalence of these
experiences in persons who receive mental health services.
(NASMHPD, 2004)
Trauma-Informed care represents a change in "mental models" - the underlying
assumptions that determine what we are able to think about.
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Mental Models |
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Organizational Stress as a Barrier to
Trauma-Informed Change |
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Sanctuary Model of Organizational Change |
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Components of the Sanctuary Model |
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Social Legacy of Trauma |
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Trauma Theory |
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Seven
Commitments |
Substance Abuse and Mental Health
Services Administration
Trauma-Informed Systems
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System Integration
that requires coordinating services at the level of agencies and broader
service systems;
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Clinical Integration
that requires coordination of services at the level of individual consumers;
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Specialized Services
requiring the development of face-to-face therapeutic activities intended to
help individual men, women, children, families and communities; and
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C/S/R Integration
which necessitates the incorporation of consumer experiences and
perspectives into intervention design, development and implementation.
Substance Abuse and Mental Health
Services Administration
Trauma-Informed Systems
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State trauma policy or position statement
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Trauma screening and assessment – universal
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Clinical practice guidelines and treatment approaches
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Specialized trauma programs with integrated mental health and
substance abuse services
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Procedures to avoid retraumatization
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Staff trauma awareness, training, competencies, and job
standards
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Linkages with higher education
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Regulations addressing trauma
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Research, needs assessment, quality improvement data
regarding trauma
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Financing mechanisms
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Person-with-lived-experience involvement and rights
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Trauma policies and services that respect culture, religion,
race, ethnicity, gender, age, sexual orientation, and physical disability
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Systems integration, including life-span perspective
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Trauma-informed disaster and terrorism response
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Trauma function and focus in state mental health department
Trauma Specific Services
Promising and evidence-based best practices and services that
directly address an individual’s traumatic experience and sequelae and that
facilitate effective recovery for trauma survivors. (NASMHPD, 2004)
So What Is Trauma-Informed Culture?
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Responding to the needs of traumatized individuals and
families
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But, the ACEs study (and many others) tells us that the
majority of adults will be trauma survivors
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So one thing it means is being sensitive to the reality of
traumatic experience in the lives of most people – children, their parents,
staff, administrators, state officials, police, courts, schools,
politicians, etc.
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Being sensitive to the ways in which trauma has affected
individuals, families, and entire groups
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Being sensitive to the ways in which trauma impacts
organizations and entire systems
What is a
Trauma-Sensitive Culture?
A culture within which it is
understood that most human behavioral pathology is related to overwhelming
experiences of exposure to abusive power, disabling losses and disrupted
attachment, usually beginning in childhood. Therefore behavior on the part of workers and clients,
caregiver and patients, employers and employees, parents and children,
must be understood and responded to within the context of these dynamic
forces.
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less violence including the use of
coercive measures like seclusion and restraint;
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an understanding of the complex
biopsychosocial and developmental impact of trauma and abuse with
implications for response;
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less victim-blaming;
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less punitive and judgmental
responses;
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clearer more consistent boundaries,
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higher expectations,
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linked rights and responsibilities;
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earlier identification of and
confrontation with controlling, abusive, and violent behavior;
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better ability to articulate goals,
create strategies for change, justify need for holistic education;
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a working understanding of
reenactment behavior
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a more democratic environment at
all levels.
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