Trauma Informed Care Implementation Tool

square bulletTIC Implementation Tool Introduction and Origin

The Trauma Informed Care (TIC) Implementation Tool was created by the Human Services Implementation Lab and Trauma Informed Oregon to assist organizations, systems, and agencies in implementing trauma informed care and tracking their progress. In 2022, the Human Services Implementation Lab and Trauma Informed Oregon tested the tool with six diverse organizations, receiving feedback that helped to improve the tool. The TIC Implementation Tool was developed in response to a growing demand from organizations seeking to evaluate their alignment with trauma informed care and monitor their progress. Organizations can use the tool to conduct independent assessments or receive support and a full audit from the HS Implementation Lab.

How the TIC Implementation Tool was Developed

The tool itself is based on TIO’s 10 years of consultation, the Standards of Practice, training in the field, SAMHSA’s Six Key Principles of Trauma-Informed Care, and on SAMHSA's Ten Impelementation Domains.

SAMHSA’s Six Key Principles of Trauma-Informed Care

  1. Safety
  2. Trustworthiness and Transparency
  3. Peer Support
  4. Collaboration and Mutuality
  5. Empowerment, Voice and Choice
  6. Cultural, Historical, and Gender Issues

SAMHSA's Ten Implementation Domains

  1. Governance and Leadership
  2. Policy
  3. Physical Environment
  4. Engagement and Involvement
  5. Cross Sector Collaboration
  6. Screening, Assessment, Treatment Services
  7. Training and Workforce Development
  8. Progress Monitoring and Quality Assurance
  9. Financing
  10. Evaluation

Five Essential Elements of Trauma Informed Care

TIO’s Standards for Trauma Informed Care are grouped under five key elements:

  1. Organizational Commitment
  2. Training and Education
  3. Policy, Procedure, Practice Review
  4. Feedback and Quality Assurance
  5. Culture and Climate

Each standard can be rated on a scale for 1 to 5, where 1 equals “Organization is unaware of the need for this standard” and 5 equals “Standard is sustainably in place and monitoring for continuous quality improvement occurs regularly”.

Systematically assessing TIC implementation accomplishes two things. First, it documents the extent that the organization is trauma-informed and clearly identifies systemic strengths, weaknesses and gaps. Second, it helps the organization decide on overall goals, and identify and prioritize specific practice changes to make.

TIC Implementation Tool Files

TIC Implementation Tool

A PDF of the TIC Implementation Tool can be useful if you’re using the tool in a group setting to assess your program, clinic, agency or system. Sample reports can also be seen and downloaded from the HS Implementation Lab's website.

TIC Essential Elements

Read Mandy Davis, PhD’s blog to learn more about the TIC Essential Elements. A fifth element, Organizational Commitment, has since been added to this tool to reflect feedback from piloting this tool with organizations throughout Oregon.

Consultation

If you are interested in support with formulating a plan after your TIC Implementation report, contact us. For assessment support, you can go directly to HS Implementation Lab’s website.

square bulletHow to Use the TIC Implementation Tool

There are multiple ways to approach this tool. For consultation and assessment support, contact the HS Implementation Lab for full scope of options and price quotes.

square bullet Resources by Essential Element

You will see various resources below each TIC Essential Element. These resources are a compilation of TIO material and external material that offer insights and tips to consider when planning around the TIC Essential Elements. Please note that external material has not been vetted by TIO and is included to encourage exploration of other perspectives and knowledge outside of TIO. The navigation links below will jump to a specific section of resources.

Element #1: Organizational Commitment

Organizational commitment is demonstrated through dedicated support for a trauma-informed infrastructure that includes specific funding and employee time for implementing trauma-informed care. Organizations acknowledge that an understanding of the impact of trauma is central to effective service delivery and make operational decisions accordingly. Organizational commitment is evident within all four domains outlined in SAMHSA’s TIC Guidance: (1) Governance and Leadership, (2) Policy, (3) Financing, and (4) Engagement and Involvement. Leadership collaborates with other organizations to create a trauma-informed community that follows the principles of trauma-informed care across sectors.

Element #2: Culture and Climate

Culture and climate is the cohesive narrative, the glue, that holds a trauma-informed community together. It is the embodiment of all that is seen, heard, done, and experienced in spaces and settings. Trauma-informed practices and settings demonstrate an understanding of the impact of trauma and toxic stress on the body (both individual and organizational) and the power of relationship and belonging. This understanding appears in the language used, protocols that are followed, and behaviors that are witnessed.

Element #3: Training and Education

The professional development plan for staff is demonstrated by staff competency and skills, as well as how the principles and values of trauma-informed care are applied in the training methodology. The plan’s goal is staff embodiment of the content shared. Training is paired with educational opportunities that promote competence (knowledge) and confidence (skill) to apply to trauma informed approaches (TIA). This learning is done at a reasonable pace, is role specific, and performed throughout the job cycle (Ask “who needs to know what by when?”).

There are multiple TIC trainers in Oregon.

Element #4: Policy, Procedure, and Practice Review

Policies and procedures offer a mechanism to sustain TIC, allowing helpful practices to flourish and evolving over time in response to feedback and growing knowledge about the field. Policies and procedures are reviewed through a TI lens with a process that defines how misalignment with TI values is handled. The process will continuously examine “who is at the table” and whose voice and experience is centered. Changes are made in areas within an organization’s locus of control. The limitation of regulatory bodies is recognized and system change is sought.

Element #5: Feedback and Quality Assurance

Feedback and quality assurance techniques are used to impact practice. Trauma-informed organizations demonstrate inclusive and effective feedback practices that solicit how staff and service recipients feel and experience the organization. The feedback process is routine, multimodal, and centers those most impacted by the work. The feedback received and plans for practice change are shared. These processes demonstrate knowledge about the impacts of trauma in the organization’s methods, language, how the feedback that is sought, and how the information is used.