Become a Trauma-Informed Community

Return to Opioid Top-Level Strategy Map or the Zoom Map (Minimize Desire to Misuse Opioids) or ZOOM MAP - Become a Trauma-Informed Community  

Become a Trauma-Informed Community

= To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.” == Root Causes of Trauma == Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA. For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.” Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services. Some communities have developed expanded versions of the ACES survey to address issues specific to their issues. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care. == What Is a Trauma Informed Community? == The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.” If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.  

== Trauma-Informed Systems == The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective:  *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness. === Child Welfare === Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family.  === School Systems === For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."   === Healthcare === Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help. === Justice === In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence. === Ensuring Diversity in Trauma Informed Settings === ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community. == Successful City Initiatives == === Tarpon City, Florida: Peace4Tarpon === Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority. === Washington State: Compassionate Schools === This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.  

= Tools & Resources = ACEs Connection: Main information exchange and resources for local, state, and and national ACEs initiatives.https://www.acesconnection.com/ Adverse Community Experiences and Resilince: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) -https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing Compassionate Schools,Washington State Office of Superintendent of Public Instruction (OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf National Child Traumatic Stress Network Learning Center: Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  http://learn.nctsn.org/ National Institutes of Health: Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: https://www.ncbi.nlm.nih.gov/books/NBK207201/ Trauma Informed Schools Resource Guide, Wilson Foundation  http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf  

=   =