Standards of Practice for Trauma Informed Care – FAQs

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In large complex organizations, it may not be feasible to apply all the Standards across the entire agency. Certain sections of the tool (Agency Commitment, for example) could be used for the whole system, but others may work better if individual programs or departments within the agency use the Standards independently, at least to start with.

Absolutely not. Traumatic experiences and re-traumatization happen at the personal level; that’s where much of the energy for trauma informed care rests. It is essential to listen to those experiences and begin to address the conditions that make individuals feel unsafe, powerless, or not valued in large and small ways. The Standards can help create management-level supports to improve the personal experience, but it’s important to work on both levels simultaneously. Otherwise, some staff or clients may feel unheard and buy-in can be lost. Mapping the immediate concerns onto the Standards (there is usually strong overlap) can be a useful way to integrate the approaches.

It is intended to be a group process that includes discussion of each item and a consensus rating. A relatively small group can do the initial work, ideally representing different roles in the agency (or program). It works well for this to be a sub-committee of a larger Trauma Informed Care Workgroup with volunteers who are interested in addressing trauma informed care at the organizational level as well as at the individual and interpersonal level.
Based on experiences to date, the Standards seem to work well as a framework for planning—a way to identify strengths and weaknesses and to prioritize areas to work on. For some of the Standards, an in-depth assessment (for example, of the physical environment, of policies or an intake procedure, etc.) will be needed to identify specific changes to make. The benefit of the Standards is that they provide a common set of benchmarks across agencies and a way to track progress.
Typically we recommend taking one section of the Standards at a time and setting a schedule of four-six meetings to cover the entire set. Most organizations start with Agency Commitment or Workforce Development, but it doesn’t really matter. However, we highly recommend that everyone in the group reads the entire Standards document (including the Guidelines) from beginning to end before starting in on the discussion. Knowing what’s coming later will help keep group members on topic. Someone will need to facilitate the discussion, keep an eye on the time, keep everyone on topic, and document what is said.
The Standards of Practice were developed as a discussion tool and not designed to be used as a survey. Some organizations have used this approach, however, and there may be value in a quick set of ratings on the items to get a sense of the level of agreement/disagreement among staff and—where there’s agreement—to identify accomplishments or areas to prioritize. However, the questions may need to be modified to work as a survey and ideally would ask what has been done to address each of the Standards rather than simply whether something has been done. Numerical ratings alone are not a good substitute for in-depth discussion and are unlikely to help much with planning.
Great question. See the answer to the question “Once we’ve completed the Standards, what then?” below. 
Here’s a suggested workflow for the process:
  • Small-group review of Standards; written documentation of areas of strength and areas of opportunity; preliminary ratings on each Standard; agreement on initial priorities (not too many) to recommend for action.
  • Results presented to larger Trauma Informed Care workgroup for discussion and input; consensus on priorities (be prepared to modify preliminary document with additional detail, differences of opinion, etc.).
  • Presentation to leadership team or senior management for input and feedback, agreement on priorities; presentation to advisory group/board.
  • Summary of process, outputs, and the recommended priority areas to all staff via newsletter or email (or at all-staff meeting) with opportunity for feedback or input. It may be too much to present every Standard to the whole staff, but everyone who wants it should have access to the entire document.
  • Trauma Informed Care workgroup creates work plan to address priorities areas and begins to develop action steps, implementation plans, follow up, etc.

The initial Standards document can be updated annually or more often to reflect progress in the various domains.

Yes. In collaboration with partners in primary healthcare, we now have available a version of the Standards that has been modified to more closely meet the clinic setting. Access the Healthcare Standards of Practice here.

We have modified the Standards to create the Education Standards of Practice for Trauma Informed Care. This tool is more specific to the education settings and is integrated with other educational metrics. However, these Standards are still in draft form until the vetting process is complete. Trauma Informed Oregon does not specialize in education and there may be other tools available or in development that could be equally or more useful.