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Domain of Program Quality: Trauma-Informed Approach

Research across the fields of behavioral health, medicine, education, child welfare, and social services   demonstrates that past traumatic experiences can impact the ways in which individuals receive and respond to services and that trauma-informed approaches show better outcomes for service recipients.

Trauma, broadly defined, describes “an event, series of events, or set of circumstances that is experienced by an individual as physi­cally or emotionally harmful or threatening and that has lasting adverse effects on the in­dividual’s functioning and physical, social, emotional, or spiritual well-being.” Examples of experiences that can lead to trauma include exposure to violence, severe illness, natural disasters, and chronic poverty.

Adverse childhood experiences (ACES) are a subset of adversarial experiences which, when experienced in childhood, increase the likelihood of negative physical and mental health outcomes later in life. Prolonged or severe exposure to traumatic life events can lead to toxic stress, which can be particularly damaging for young children who are in the peak years of brain development.

Trauma-informed practices, therefore, ensure that service providers are educated about trauma and understand how it can impact service recipients’ present-day behavior, needs, and service participation.

Best Practices for Trauma-Informed Approach

Secure Strong Organizational Commitment

Active organizational leadership and commitment to trauma-informed care enables successful and sustainable implementation of this approach. It requires an identified point of responsibility within the organization to lead the charge in becoming trauma-informed, as well as leadership and staff commitment to applying the principles of a trauma-informed approach to all areas of functioning, including staff hiring, training, and support.

Build Trauma Awareness

When staff at all levels of the organization have a basic understanding of the ways trauma can affect individual, family, and community well-being, they are better able to avoid behaviors or practices that may retraumatize clients and can instead create a safe, trauma-informed service environment. Ensuring trauma awareness requires comprehensive trauma training for all staff who may come in contact with clients directly or indirectly and also includes supportive practices for staff who have experienced trauma and/or who experience secondary traumatic stress as a result of their work.

Conduct Trauma Screenings

Trauma screening and assessment are essential to identifying individuals with histories of trauma and ensuring that they receive appropriate, trauma-informed services and referrals. Trauma screening enables practitioners to understand the individual and family’s needs and context and build effective service plans that account for trauma and adversities.

Ensure Physical & Psychological Safety

A successful trauma-informed approach includes attention to physical and emotional safety within the treatment setting as well as an environment that promotes trust and respect between clients and staff. Practitioners can make environmental conditions trauma-informed by attending to factors that include facilities design (such as well-lit spaces) and administrative processes (like emphasizing patience and flexibility).

Monitor Quality

Ongoing tracking, monitoring, and assessment of trauma-informed principles help ensure effective use of evidence-based trauma screening and treatment. Organizations can assess their trauma-informed practices and identify improvements by implementing data collection practices which allow them to identify where implementation has been successful and where changes can be made to enhance quality.

Read more about a Trauma-Informed Approach.

Trauma-Informed Approach Case Studies

Bringing Out The Best

NC Infant Toddler Program

Visit our Continuous Quality Improvement Resource Library to learn more about CQI for social service providers.

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