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Trauma-Informed Systems of Care

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Three Aspects of Trauma-Informed Systems of Care

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A Culture Shift: The Core Values of Trauma-Informed Care

• Safety• Trustworthiness and Transparency• Peer Support• Collaboration and Mutuality• Empowerment, Voice, and Choice• Cultural, Historical and Gender Issues

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Trauma-Informed Systems of Care Align…

Culture

PoliciesPractices

Values

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Trauma-Informed Systems

• Trauma-informed systems can:

– Increase the effectiveness of treatment and engagement with clients who have experienced trauma

– Decrease the likelihood that clients are re-traumatized

– Decrease the secondary trauma and compassion fatigue experienced by helpers

– Help a traumatized organization become a recovery-focused organization

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The Triune Brain

Prefrontal Cortex

Limbic System

Brainstem

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Transition Between Stimulus and Response

Cortex

Hippocampus

Sensory Thalamus

Very Fast

StimulusTraumaticReminder

Slower

Amygdala

ResponseTraumatic

State

(LeDoux, 1996)

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Trauma’s Developmental Impact (www.ACEstudy.org)

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What Does This Mean for Us?

Paradigm Shift from the Question:

“What is wrong with you?” to

“What happened to you?” 

 Keep asking — Is what I am doing respectful and trauma-informed? Is it how I would like to be treated?

Avoid re-traumatizing those we serve.

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Effects of Trauma: Emotions

• Survivors of trauma can take longer to return to baseline after sympathetic activation

• Trauma can lock emotions in the body, therefore somatic expression becomes important

• Trauma can significantly impact an individual’s interpersonal and emotional relationships

• Difficulty regulating emotional experiences

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Effects of Trauma: Behavior

• What helps someone survive their trauma is what can harm someone when they aren’t in their trauma

• Maladaptive behaviors can also be self-protective

• An immunity to change can develop which makes it difficult to let go of maladaptive behaviors

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Effects of Trauma: Cognition

• Hyper-vigilance and hypo-vigilance effects how people cognitively process information

• Survivors often have distorted beliefs about their experiences and level of control over the situation or their response

• Beliefs about oneself, others, and the world are often rooted in survival and self protection

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Relationships and TIC

Relationships are imperative to a sense of safety, recovery and healing.

• Trauma-informed providers

– understand how trauma can effect how survivors relate to others, resulting in healthier and more productive relationships

– understand that relationship dynamics that might look like pathology are often more linked to trauma

– Understand that the only way to heal is in relationship—being mindful of the competing value of survival vs thriving

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Manifestation of Trauma in Systems

• Survival mentality (short-term thinking and planning)• High self-protection• Ruptures in relationships (high level of mistrust)• Triangulation • Blame and punishment• Poor or limited communication• Misuse of power and control• Strong focus on victimization• High reactivity and emotional contagiousness• Low morale and staff satisfaction

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Resources

• http://www.thenationalcouncil.org/

• http://homeless.samhsa.gov

• http://www.kansascac.org

• http://www.mentalhealth.samhsa.gov/nctic

• http://www.nasmhpd.org/NCTIC.cfm

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Thank You!

Joyce McEwen Crane, PhD, LCP – joyce.mcewencrane@wichita.edu

Teresa Strausz, LMSW, MSOD – teresa.strausz@wichita.edu