Trauma is a widespread, harmful and costly public health problem. Trauma can be caused by a single event such as a natural disaster or abuse. An individual’s thoughts, feelings, and behaviors are filtered through their experience and perspective. Trauma has no boundaries with regard to age, ethnicity, geography, or sexual orientation. The need to address trauma is increasingly viewed as an essential component of effective service delivery in social and human services. In addition, the service system can retraumatize individuals if staff are not educated about the population and individuals your organization is serving. Being intentional on how services are delivered to protect clients is imperative because re-traumatization can negatively affect a client’s willingness to participate and engage in treatment and support services.

There is yet to be a common definition of trauma-informed care within the industry. Trauma-informed care (TIC) is an approach based on knowledge of the impact of trauma, aimed at ensuring environments and services are safe, welcoming, and engaging for service recipients and staff. There is growing consensus in the field that suggests trauma-informed care is a strengths-based framework, one of which is grounded in an understanding of and responsiveness to the impact of trauma.  TIC emphasizes safety for both providers and survivors and creates opportunities for survivors to rebuild a sense of control and empowerment.

The benefits of having an organizational culture rooted in TIC has a multitude of positive effects including improved client engagement, better health outcomes, increased provider and staff wellness, and treatment adherence.  A TIC approach is considered a path to create safety for clients, an environment that cares for and supports staff and creates opportunities for choice, power, and control for clients that help build therapeutic interactions and reduces the possibility of re-traumatization. It allows the organization to increase the quality of services while reducing unnecessary interventions and costs. It also assists in minimizing negative encounters and events. Overall, research has shown an increase in client and family satisfaction as well as job satisfaction among staff when trauma-informed care is used to guide practice.

Implementing a system-wide approach to addressing trauma requires a commitment to changing the practices, policies, and culture of an entire organization. According to SAMHSA’s concept of a trauma-informed approach there are four assumptions to focus on:

  1. The realization of the widespread impact of trauma and understanding of potential paths for recovery.
  2. The recognition of the signs and symptoms of trauma in clients, families, staff, and others involved with the system.
  3. The response to fully integrate knowledge about trauma into policies, procedures, and practices.
  4. The practice to actively resist re-traumatization.

Keep in mind each organization may be in a different step in the process of culture change, however the first action an agency should consider is completing an organization-wide assessment, such as the Trauma-Informed Organizational Assessment (TIOA) created by National Center for Child Traumatic Stress (NCCTS), to assess current practices. The results of the assessment may guide your organization to determine what step you should start at when considering focusing on a trauma-informed care approach. More information can be found here: https://www.nctsn.org/trauma-informed-care/nctsn-trauma-informed-organizational-assessment. To be able to conduct a full culture change there should be governance and leadership appointed to the process.

In summary, changing an organization’s framework, lens, or approach is intense work requiring diligence and focus and may take longer than expected. As discussed throughout this blog post, the benefits are abundant. An organization with a framework of trauma-informed care will see success in its clients, staff, and longevity of the agency. Contact a Marsh McLennan Agency (MMA) advisor to learn about this or other risk service approaches for your non-profit or human services organization.

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