Agency policies
As commitment to trauma informed care (TIC) continues to grow, provider organizations and agencies across multiple systems are beginning to create or adopt policies to shape practice. Clackamas Behavioral Health Care Trauma-Informed Services Policy is a good example of one such policy.
Decision-making roles for individuals with lived experience
Many of us have “lived experience” of adversity or trauma. What is meant here, however, is that provider systems are beginning to invite and include trauma survivors in leadership roles in their organizations who have sought or received services from the organization or system (e.g., mental health or addictions). It is the “lived experience” in the service system that can bring a new and important perspective to assessment, planning and accountability.
Feedback and suggestions from employees and service recipients
Many organizations already have client or staff satisfaction surveys in place. These surveys can be modified to include questions directly related to trauma informed care.
The Clackamas County Behavioral Health Clinics Adult Consumer Services Survey is an example of a feedback survey that includes trauma informed care questions. Keep in mind that it is critical, however, to provide information back to clients or staff about the results and what the organization is doing to address key concerns that emerge.
Workforce Wellness
Agencies attend to workforce wellness in a variety of ways, from creating a culture where appreciation is a regular part of staff or team meetings, to offering flexible scheduling for employees or the opportunity to work from home, to requiring employees to take earned vacation time, to including self-care plans as a regular part of supervision, to providing on-site wellness opportunities or discounted memberships for health and wellness programs in the community.
Find more resources in the Workforce Wellness category. TIO’s TIP Sheet, A Trauma Informed Workforce: An Introduction to Workforce Wellness, is a good place to start.
Physical environment review
Many aspects of the physical environment can affect staff as well as individuals seeking or using services if they have histories of trauma or adversity. Some aspects of the setting may make it difficult or impossible for individuals to enter, engage or focus their attention.
It’s often not possible to know exactly what might have a negative effect on an individual without paying attention, noticing discomfort and asking about it. However, sample scans for potential environmental triggers (or ways to make the environment more welcoming) are included in agency assessment tools found in the Scanning the Physical Environment category in the TIO Resources Library.
Physical environment review
Many aspects of the physical environment can affect staff as well as individuals seeking or using services if they have histories of trauma or adversity. Some aspects of the setting may make it difficult or impossible for individuals to enter, engage or focus their attention.
It’s often not possible to know exactly what might have a negative effect on an individual without paying attention, noticing discomfort and asking about it. However, sample scans for potential environmental triggers (or ways to make the environment more welcoming) are included in agency assessment tools found in the Scanning the Physical Environment category in the TIO Resources Library.
Safe space
When an individual experiences an acute stressor, whether it is personal or the result of a circumstance or an encounter at work, it can be helpful to have a quiet place to go – either to regroup alone, to debrief with a colleague or supervisor or to release stress hormones through physical activity.
Organizations may or may not have the resources to set aside a permanent “safe space” (a breakroom is not private enough) but it may be possible to designate an office that can be made available for this purpose when needed. This requires commitment and creativity on the part of staff – and dissemination of information about what is available and under what circumstances.
Physical safety and crisis protocols
It is important when developing crisis protocols or incident response plans that organizations identify not only what to do within the first hours of an incident but what needs to be done days and months later. Plans are more effective if they are developed by staff with different roles in the organization. Plans need to be part of orientation but also practiced and updated regularly.
Some considerations for creating a crisis protocol can be found on the TIO TIP Sheet Considerations for Responding to Crisis.
Organizational training capacity
Organizations and systems that are committed to trauma informed care will want to think about how to sustain momentum over time – not only to meet the needs of new staff that are coming on board but also to deepen understanding and expertise among the champions.
We strongly encourage adapting training materials from TIO or from other sources and creating ongoing training programs that are not dependent on outside resources.
Hiring and onboarding practices
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category on the Additional Resources for the Standards of Practice page.
Hiring and onboarding practices
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Supervision and support
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Supervision and support
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Supervision and support
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Supervision and support
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Supervision and support
One of the key areas where organizations can begin to shift the culture to be more responsive to the impact of trauma is through human resources policies and procedures, starting with hiring and onboarding.
Specific suggestions and considerations can be found on the TIO TIP Sheet Human Resources Practices to Support TIC. Additional resources can be found in the Human Resources Practices category of the TIO Resource Library.
Staff skill in talking about trauma
It can be helpful to acknowledge out loud that individuals seeking or entering services at your agency are likely to have had trauma or adversity in their lives. This can help make a person feel safer in your office and more likely to engage.
It is important for all staff to be able to talk about trauma in a way that feels comfortable for them and for the person they are talking with. It is also important that staff help each other reframe challenging behaviors through a trauma lens. Sample trauma education statements can be found in the TIO Trauma Lens Exercise resource.
Intake forms
It’s often the case that agency intake forms or documentation requirements were written in the distant past and have never been reviewed or updated. Some questions may be unnecessary and could be triggering for individuals with a trauma history. Often they can be eliminated. In other cases, the wording or timing of questions can be changed to be less intrusive or more respectful. When difficult questions are necessary, staff can sometimes make it easier by providing context or preparing the individual for what is coming.
Trauma specific services
Trauma Specific Services (TSS) are programs, interventions, and therapeutic services specifically aimed at treating the symptoms or conditions resulting from a traumatizing event(s). See the tip sheet Trauma Specific Services: A Resource for Implementation and Use for guidance on how to select appropriate trauma specific services.
Agency self-assessment
Agency self-assessment can help identify specific areas to focus on. This can occur in a number of different ways. Existing protocols can be helpful in organizing the process and some examples can be found in the Assessment & Strategic Planning category on the TIO Resources page. Some are extremely detailed; others, like the Standards of Practice, provide an overview of areas of strength and challenge. Self-assessment can also be organized around the principles of trauma informed care or based on specific issues identified by staff or clients.
Agency policy review
Organizations that are implementing TIC will need to review existing policies to determine if they are compatible with TIC principles. Organizations may need to modify existing policies or adopt new policies to support a culture that promotes empowerment, safety, transparency and self-worth.
Sample questions to use in the review of existing or new policies can be found in the TIO Guide to Existing Policies resource.
Communication and dissemination
Implementing trauma informed care requires sustained momentum across the entire organization. One way to work on this is by keeping the entire community (staff, leadership, service recipients when possible) informed about and able to give input on priorities and plans. Dissemination of TIC efforts can also be enhanced by ongoing education and concrete ideas about how to apply the principles of TIC.
Some organizations have created monthly or quarterly emailed newsletters to sustain interest and momentum. Examples can be found on the TIO Newsletters Sign Up page.
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Foundational Trauma Informed Care Trainings and Courses