History of the Sanctuary Model

In 1980, Sandra Bloom, a psychiatrist, Joseph Foderaro, a social worker, and Ruth Ann Ryan, a nurse manager joined with other mental health professionals to create an acute care psychiatric unit in a general hospital north of Philadelphia. Around 1985, the treatment team began to realize that most of the people they were treating in an inpatient setting and in outpatient treatment had survived overwhelmingly stressful and often traumatic experiences, usually beginning in childhood.

From 1985-1991 they developed inpatient and outpatient trauma-informed approaches to the treatment of adults, just as the field of traumatic stress studies itself was developing as a field of knowledge. In 1991, the team formed The Sanctuary, a trauma-specific program for adult survivors. Dr. Silver had written the first chapter on the inpatient treatment of trauma survivors - a program for Vietnam veterans and he had described "sanctuary trauma" - expecting a welcoming and healing environment and finding instead, more trauma. Dr. Bloom and her colleagues sprang off of this concept in their conversations about what it takes to create a truly healing environment for their patients - adult survivors of childhood maltreatment. In doing so, they recognized the continuity between their observations of what benefited their clients and several significant previous movements in psychiatry – Moral Treatment, social psychiatry and the therapeutic community.

The Sanctuary ModelIn 1997, Dr. Bloom published Creating Sanctuary: Toward the Evolution of Sane Societies, describing the journey of this treatment team in learning exactly what it means to create "trauma-informed systems". The program closed in 2001 as a result of the monumental changes in mental health care financing that have subsequently created a mental health care crisis that she has written about extensively and that she and Brian Farragher have documented in Destroying Sanctuary: The Crisis in Human Service Delivery Systems.

During the early 1990's, several other mental health organizations and individuals sought consultation around the emerging Sanctuary Model and included the Program for Traumatic Stress Recovery at Homewood Hospital in Guelph, Canada and Dr. Lyndra Bills who was the first person to implement the model in a state hospital setting. Later, Dr. Maggie Bennington-Davis and her colleague Tim Murphy, then at Salem Hospital in Salem, Oregon consulted with Dr. Bloom and used elements of the Sanctuary Model to eliminate the use of seclusion and restraint.


History: Sanctuary inpatient hospital programs for adults

1980 - 1991 Quakertown Community Hospital, Quakertown, PA
1991 - 1996 Northwestern Institute of Psychiatry. Fort Washington, PA
1996 - 1999 Friends Hospital, Philadelphia, PA
1999 - 2001 Horsham Clinic, Ambler, PA
1999 - 2001 Hampton Hospital, Rancocas, NJ


Late in the 1990's, the Jewish Board of Family and Children's Services of New York contacted Dr. Bloom about the possibility of implementing the Sanctuary Model in several residential treatment programs for children in Hawthorne, New York. As a result, Hawthorne-Cedar Knolls, the Goldsmith Center, and the Linden Hill School all participated in an NIMH research study to demonstrate the effectiveness of the implementation of the Sanctuary Model in children's residential care.

Around the same time, administrators at the Andrus Children's Center contacted Dr. Bloom about creating a trauma-informed culture in their residential program, day treatment center, school, and community organizations in Yonkers, New York. Julia Dyckman Andrus Memorial Center reaches approximately 2500 children and families each year through residential, day treatment, and community-based programs.

In 2005, Andrus Children’s Center and Dr. Sandra L. Bloom partnered to create The Sanctuary Institute a training, education, and technical assistance program designed to help organizations implement the trauma-informed, whole-system organizational approach known as the Sanctuary Model. As of July 2010, over 100 programs nationally and internationally have become a part of the Sanctuary Network.

Moral Treatment

Social Psychiatry

Therapeutic Community

Maxwell Jones

Trauma Studies