September 26, 2019

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

You get the green light and you want (or need) to train up your organization or system to be able to implement Trauma Informed Care (TIC). Where do you start? Who needs to know what by when? Who should deliver the information? How often? How much will it cost? You do a quick internet search for trauma informed training and you get 63,400,000 responses (gulp). You narrow this down to trauma informed training in Oregon and that gets you 2,630,000 responses. You ask around and poke around some more and you find yourself overwhelmed with different options to buy training or use free resources—maybe nothing seems complete or relevant to your work or is out of your budget.

These are the conversations we are having with many of you and we wanted to use the newsletter to share and connect on these questions. There is little research out there to guide us in how best to deliver information to result in change. The field is developing rapidly and I expect we will have more informed answers soon. For now, this newsletter is full of information about the how, what, who, and measurement of training.

Here are a few of my thoughts . . .

TIC is about changing our culture, our ways of thinking and doing. Most of us know culture change takes more than a training—that learning and skills happen incrementally (read this about the Kernels of Learning) and require multiple modalities and repetition. Whether it is “Learn, Do, Teach,” “Practice Makes Perfect,” or “Learn through Failure” we need opportunities to practice.

Barriers to these best practices often include funding, turnover, lack of expertise, urgency, and access to up-to-date information. Considering the need and barriers my most confident response to the question of how to train is to make a plan. A plan that spans over time, includes multiple modalities (technology and in-person), and addresses different needs across the agency (what does the administrator need that’s different from the front office staff). The best strategy is to have the time and resources up front to embed the learning in current structures (onboarding, case consults, existing staff meetings, video modules, etc.) that can withstand turnover, administrative changes, and funding shifts.

This plan you will advocate for will not only address how you approach delivering information but also what information and skills are provided. This question needs thought because not everyone needs the same depth of knowledge or skill. Not attending to these differences, risks wasting resources (staff buy-in as well as financial). See Stephanie’s blog about “the gist” because I think belief in this work is critical to move it forward—think about how to “teach” belief. We find that when folks are stuck in this work they have forgotten why they are doing the work (this video illustrates the concept well). They are focused on how to do it but can’t articulate why. Now some people just want to know how and that is fine (I had a person once say to me, Mandy just tell me what you want me to say. I did, and they did, and it worked). However, there has to be enough people that know the why because this allows you to use knowledge to develop new or modify existing skills to best serve your community.

Recently, in a training we tried out a simplified approach to TIC and it went something like this: First, understanding and accepting alternative explanations for behaviors (through a trauma lens); then, developing skills for when the “lid is flipped” (regulation focused); and developing skills for when the “lid is not flipped” (prevention focused). This lead us to thinking that, maybe, what folks need to know about is Awareness, Regulation, and Reflection. What if these were your training goals and competencies?  As we strive for a just and resilient community I want to encourage you to extend information sharing to families, friends, and neighbors of all ages.

The following blog posts are examples of the how, what, who, and measurement of training.

Helpful Blog Posts

What’s Going on at TIO

  • Upcoming Conference
    • I am so excited to hear from so many great projects and people who will be at the conference. We have over 350 registered!
    • We had to close registration. Please put your name on the wait list and regardless we’ll be sure to take notes and pictures to share with all.
    • Thanks to all of you who made TIC selfie videos. Even Finn made one!
  • Improving Supervisor’s Training for TIC implementation.
  • Working on Trauma Policy at the organizational and system level.
  • Celebrating our fabulous leadership team this month. This group has been with TIO since the beginning and some will carry on. We are expanding our options to be more inclusive of voices and experiences to guide our work. Webinars, Feedback technology, affinity group meetings, and an application to serve on the steering committee for TIO will be out in November!

Where We’ve Been

  • TIO staff have been to Eugene, Mt. Hood, Hillsboro, Portland, and Yamhill talking with higher education, healthcare, education, and the HIV Continuum of Care Conference about training, implementation, and policy.

To Do List: