December 13, 2018

From Mandy Davis, LCSW, PhD, Director, Trauma Informed Oregon

What is the relationship between working toward equitable and inclusive services and trauma informed care (TIC)? Is restorative justice trauma informed? Is person centered practice trauma informed? As we continue to evolve the trauma informed work it is important to make the connections between approaches, how they are complementary or contradictory, so that we understand the value each of these approaches provides our work and it is not considered “another thing to do.”

Trauma Informed Oregon (TIO) is prioritizing the question about how trauma informed care efforts relate to equity work. I started asking this question about three years ago in hopes of making a helpful illustration of how these two lenses were interconnected. There is not an illustration to share (yet) but I do want to share what I am discovering and exploring.

TIC means using our understanding of the impact of trauma, (defining trauma to include harm caused by our systems—historical trauma, collective trauma, macroaggression, and microaggression) to change how our systems function so we provide more engaging and effective services. For me, equity work is focused on developing systems where your identity does not define your outcomes and inclusion is not just providing access to a service but having that service provided in a way that the recipient feels valued, heard, and cared for.

How do These Approaches Intersect?

Here is where I am today and I welcome you to share your experiences and thoughts with us.

  • Is equity work trauma informed? I think if you are doing effective equity work it is trauma informed. Trauma can be the part of your identity that is impacting your outcomes (e.g., you do not go to the hospital because the last time you were there something traumatic happened) and/or trauma can be caused because you are denied access to culturally relevant and linguistically appropriate services.  Because of the core values and principles that equity work is built upon, trauma informed practices are often happening but not called trauma informed. I also recognize that equity work may not always reflect the principles of TIC because it is not funded, does not include representative voices, is not given adequate time, does not acknowledge responsibility of the systems causing harm, or equates the work to hiring a person of color to do all the work.
  • Does TIC address equity? I think if you are doing effective TIC work it will address equity BUT this has to be made an explicit part of your trauma informed work because of the risk of it being neglected. For example, not acknowledging that although trauma can happen to anyone it happens differently in populations for whom entire generations have been harmed by our policies and laws. In addition to that, services necessary for healing have been denied, or trauma has been addressed as a one-size-fits-all experience.

This work, equity and TIC, is about transforming organizations, policies, and procedures that perpetuate inequity and cause harm to those that promote inclusion and wellness. I am noticing that it can be tempting to jump from the equity train to the trauma informed care train because topics such as racism can be challenging to talk about. And then from the trauma informed care train to the resilience train because resilience feels more positive. I believe that we need all three lenses and experiences to repair and reinvent our structures to promote wellness for all.

How to Center Equity and Inclusion in the TIC Movement

A specific area we are focused on here at TIO is how to center equity and inclusion in the TIC movement (de-center colonization). We recognize that much of the work has been grounded in white dominant culture ideas of trauma and healing and therefore do not represent the experiences of many. One way we are doing this work is hosting listening sessions with community members where we are asking, How is the trauma informed movement helping or hurting your work to promote wellness in your community? We are beginning to ask about ways in which people do not feel represented in the trauma informed work. A few examples we have heard include:

  • Failing to listen to, learn from, and acknowledge the extensive work that has been done to address disparity and promote equity.
  • Defining trauma as a discrete incident versus the often daily experiences of a person of color, or
  • Defining behavior as someone who is “activated” versus a person’s discomfort with a truthful conversation about race or bias, or
  • Using trauma informed to justify treating an individual’s behavior without holding systems accountable, or
  • Not valuing/reimbursing traditional health workers for healing services.

I believe the practice of Equity and TIC has to be done simultaneously for change to happen. I advocate for this by recommending contracts, polices, or mission statements not separate this work. Or by recommending that trauma informed related work be part of an equity initiative. I find myself saying that trauma informed is not a noun but instead an adjective—it is how we do the work. People need housing, food, healthcare, and education, but they need these services to be provided through a lens of equity, inclusion, resilience, and trauma informed.

TIO is committed to embedding equity and inclusion in how we do our work. I want to hold our project accountable and will provide updates of how we are putting this commitment into practice. Here are some examples of our work thus far and I look forward to more as we continue our learning and you share your ideas and critiques with us.

My original goal in exploring this question was to develop an infographic to easily share the necessary relationship between equity, inclusion, and TIC. Instead I got distracted reading, listening, and thinking that this relationship, like most, is complex, emotional, healing, and painful at times. What focuses me in this work is when I listen to the experiences of others. Knowing the experiences of a person, a people, a building, or region helps connect me to the hurt that has happened and to the amazing healing that connection brings. Please read these blogs from those who are sharing their experiences and wonder what needs to transform, who was impacted, and how and what can I take away and practice in my daily activities.

Helpful Blog Posts

Why I Rock – Read about this year’s amazing Why I Rock Conference that gathered young, black/African American girls to celebrate women of color leaders, both historical and current, from Portland. You will also read about Sherrelle Jackson who founded this event and is an amazing leader and inspiration for me. You will see why she received The Northwest Public Employees 2018 Robert Phillips Regional Diversity Award.

I Never Thought Choosing My Name Would Bring Me Trauma – Elliott Orrin Hinkle shares how being able to pick your name is both beautiful and traumatic. Included is a resource for being an effective Trans Ally.

Validation of Our Voice – Carmen Flores helps us remember that our words and interactions with students make lasting impressions and the importance of all voices being heard.

Culturally Specific Apps – Charlie McNeely, from TIO, provides some Smart Apps that highlight contributions as well as provide tools for Black, Indigenous, and people of color for the digital world.

Translation vs. Culturally Informed Foundations of TIC: Challenges and Learnings – Learn from two amazing people and trainers about the experience of providing a bi-cultural and bi-lingual TIC foundations training.

Introducing the TIC Screening Tool: Adding Detail to Implementation – The organizational screening tool is here! Stephanie Sundborg and Camilla Pettle, here at TIO, have been busy getting this resource ready to make available and interactive on the TIO website—check it out and let us know what you think.

What’s Going on at TIO

SAVE the DATE: October 16–18, 2019, there will be a conference focused on Trauma Informed Care in Oregon. October 2019 will be Trauma Informed Oregon’s 5th anniversary and we look forward to showcasing the amazing work and learning that is happening throughout Oregon.We need your help and advice. If you are willing to serve on the planning committee as an adviser, or as a reviewer, please fill  out this quick survey.

In November, we were able to present our Foundations of TIC training to participants from Developing Equity Leadership through Training and Action (DELTA) program and community members. We asked for a critique about the delivery method and content through a lens of equity and inclusion. We are excited to have begun this conversation and partnerships.

TIO staff participated in our second in-house retreat in November. Time is set aside with no meetings and pausing email so staff feel supported to explore, complete, or delve deeper into a project or area of interest. Staff worked on equity integration, a learning curriculum, measures, and tip sheets.

In October, we graduated another cohort of Train the Trainer! We compiled results from two surveys with graduates. From these surveys, we found that nearly half of the Train the Trainer graduates had provided a Foundations Training and that overall, 2,602 people across Oregon were trained in Foundations of Trauma Informed Care.

Where We’ve Been:

In the past few months TIO staff have worked in Lane County, Corvallis, Salem, Portland, St. Helens, and North Clackamas. We’ve also crossed state lines to work in San Francisco, CA, and King County and Kitsap County, WA.

We participated in the Shoulder to Shoulder Conference, the International Trauma Summit of the World Federation for Mental Health Conference, and the Action to Access, 2018 ACEs Conference in California (it was great to see Oregon well represented). We also stayed informed at the 2018 Oregon State of Reform Health Policy Conference.

To Do List:

SAVE the DATE: Trauma Informed Care Conference Oct 16–18, 2019. If you are willing to serve on the planning committee as an adviser, or as a reviewer, complete this quick survey.

Tell Oregon which of the 14 health related issues are most important to you! Please take and share this survey (we need youth voice!). Please consider ways to share this survey with clients, consumers, patients, service recipients, or other people with lived experience.

Some helpful videos and resources related to equity:

 Resources for coping through the holidays: