Applying Trauma-Informed Principles to a Social Work Practice

Applying Trauma-Informed Principles to a Social Work Practice

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Introduction

Trauma is a common, risky, and costly health problem. It can be caused by loss, abuse, violence, or neglect among other emotionally hurtful experiences. Trauma can affect anyone regardless of gender, race, age, status, or ethnicity. This is why it has become important to effectively address the problem through a trauma-informed approach. Failure to effectively address trauma increases the risk of substance use and mental disorders as well as chronic physical illnesses. It is thus important that organizations provide proper support and intervention, specifically trauma-informed care, to help clients overcome traumatic experiences. This paper evaluates the implementation of domains and principles of trauma-informed care at Chadwick Center for Children and Families, provides ideas to the proper implementation of the principles, and addresses the barriers to creating trauma-informed care in the organization.

Chadwick Center for Children and Families

Chadwick Center for Children and Families is a private non-profit agency that focuses on child advocacy. Its purpose is to create a coordinated and better community response to neglect and abuse of children. Its vision is to create a world that is safe for children and families. A world that is free from neglect and abuse. The organization seeks to promote the wellbeing and health of children who are abused and traumatised. By focusing on family violence and child maltreatment, the organization seeks to protect every child and strengthen each family through a family-centred approach.

Implementation Domains

10  DomainsImplementation at Chadwick Center for Children and Families
Governance and LeadershipLeadership and governance should be in a position to support the implementation of trauma-informed care (SAMHSA, 2014). At the organization, the governance and leadership support the implementation of a trauma counselling program. However, it is not specifically established for supporting and implementing a trauma-informed approach.
PolicyIf an organization supports a trauma-informed approach then it has written protocols and policies that establish the approach as a crucial part in its mission. The organization has written policies that support the importance of trauma counselling. The organization works in collaboration with other agencies, though not many, a reflection of trauma-informed principles.
Physical EnvironmentThe physical environment that supports a trauma-informed approach is safe, and inviting to staff and people seeking services (SAMHSA, 2014). At the organization, the physical environment promotes a sense of collaboration and a sense of safety. Employees and customers usually have a feeling of being physically and psychologically safe.
Engagement and InvolvementPeople in recovery, those receiving services, survivors, and family members are to some level engaged and involved in various areas of the organizational functioning. The engagement and involvement are not at expected levels especially in program design, workforce development, and access to peer support.
Cross Sector CollaborationThe principles of a trauma-informed approach require collaboration across sectors (SAMHSA, 2014). The organization collaborates with few organizations in helping people with traumatic experiences due to lack of enough resources.
Screening, Assessment, Treatment ServicesLicensed family and marriage therapists, and Licensed clinical social workers use evidence-based practices such as cognitive processing therapy, a reflection of a trauma-informed method (SAMHSA, 2014). Some of the interventions are however sometimes unavailable due to limited resources.
Training and Workforce DevelopmentAn organization that supports and sustains trauma-informed approach invest in continuing training and peer-support. The HR department uses trauma-informed principles in employment, and employee evaluation (SAMHSA, 2014). At the organization, all the staffs in the organization specialize in abuse, trauma, and in working with families and children. They participate in regular training on helping people who undergo through abuse and traumatic experiences.
Progress Monitoring and Quality AssuranceThe organization assesses, tracks, and monitors effective use of evidence based practices in screening, assessing, and treating trauma.
FinancingAlthough there are financing structures for supporting trauma-informed care, limited finances prevent effective implementation of the approach.
EvaluationThe measures adopted to evaluate program implementation reflect the trauma-informed approach (SAMHSA, 2014). The organization uses evaluation designs in evaluating the implementation of the trauma counselling program.

Key principles central to a trauma-informed care

Key PrinciplesImplementation at Chadwick Center for Children and Families
SafetyThe physical setting of the organization is safe for staff and for people seeking their services (SAMHSA, 2014). The interpersonal interactions also promote a sense of safety, physically and psychologically.
Trustworthiness and TransparencyMost decisions and operations in the organization are done with transparency (Chadwick Center, 2018). However, those that are not done in transparency jeopardize the goal of building trust with staff and clients.
Peer SupportSometimes trauma survivors are used in giving hope and a sense of safety for those seeking help from traumatic experiences
Collaboration and MutualityMost of the organizational staff work in partnership with clients in providing trauma care (Elliot et al., 2005). Involving everyone is however important for effective healing.
Empowerment, Voice and ChoiceStaffs are empowered to effectively provide support to the clients. More support is however needed to make them feel safe. Clients are also given an opportunity to take part in their treatment. When the client is a child, their care givers take part in decision-making. However, more engagement and involvement of clients is required for effective trauma-informed care (SAMHSA, 2014). 
Cultural, Historical, and Gender IssuesThe organization incorporates policies and processes that are responsive to cultural issues. In most cases, the history of trauma is also addressed.

Ideas for improving the principles that are not well implemented

To improve the principle of transparency and trustworthiness, the organization should ensure that whenever a major decision is being made, all relevant people including staff, clients, and their families are involved (Elliot et al., 2005). This will increase transparency essential for building and maintaining trust.

The principle of peer support is not well implemented at the Chadwick Center for Children and Families. Support from trauma survivors is essential for building trust, establishing hope, and promoting healing and recovery (Biggs et al., 2010). It is thus important that the principle is well-implemented. The organization should introduce in their trauma counselling program, a section that will regularly see trauma survivors sharing stories and their lived trauma experiences with people seeking help with trauma or with their families (Elliot et al., 2005). The organization should ensure that all people seeking help with trauma attend these sessions. This will be a key drive towards recovery.

The principle of collaboration and mutuality is not well-implemented in the organization. The organization should make administration changes by promoting power sharing. Everyone should be given a role to play towards the healing process (Covington, 2008). Every person in the organization including clerks, housekeepers, professional staffs, and administrators should be empowered to take part in making decisions.

To improve the principle of empowerment, voice, and choice, the organization should make changes in the trauma counselling program. A section that focuses on identifying the strengths and experiences of a traumatic patient should be introduced. These will then be built upon in promoting trauma recovery (Webb, 2011). Additionally, a program should be introduced that focuses on giving clients an opportunity and power to set goals that will determine the kind of action that staff should take towards recovery (Elliot et al., 2005). The program will prevent the clients from being recipients of coercive treatment with against trauma-informed approach.

Barriers to creating trauma-informed services

Limited time

There are many clients seeking services at Chadwick Center for Children and Families. Apart from offering help to clients with trauma, the organization has several other programs. The available time is shared among all these programs. This is one reason why clients, staff, and other members of the organization are not engaged and involved in all operations and decisions, a key value to trauma-informed care. This also makes it hard to collaborate and partner with ever organizational staff and clients, a fundamental principle for trauma-informed care (Chadwick Center, 2018). If the organization is primarily focusing on healing people from traumatic experiences, then it would have more time dedicated to trauma interventions associated with trauma-informed care.

Limited financial resources

Chadwick Center for Children and Families is stated is a private non-profit organization. It relies on donations in offering its services. This means that the funds can never be enough to provide trauma-informed care. This is why the organization fails in the implementation of financing domain. There are limited resources to successful train staff on trauma, to establish peer-support, and limited resources for developing cross-agency collaborations that are trauma-informed (Covington, 2008). Sometimes the resources are too limited to provide evidence-based practices in treating trauma. This barrier also limits the workforce. With a shortage in the workforce, the organization cannot be able to offer trauma-informed care.

Lack of clear guidelines and policies

The organization has policies that support trauma-informed care. However, the policies and guidelines are not clear enough to promote trauma-informed care. For instance, there lacks a clear definition of a trauma-informed approach (SAMHSA, 2014). Guidelines on how to translate principles into practice are also limited.

Cultural barriers

Clients from various cultural backgrounds seek help from the organization. Generalizing interventions for all clients makes it hard to implement trauma-informed care. Instead, interventions that are culturally-specific are required for a trauma-informed approach. Due to cultural differences, care providers or clients may lack the confidence to inquire or share trauma associated with sexual abuse (Covington, 2008). This limits the ability to implement trauma-informed care.

Poor management for trauma-informed care

Although the leadership and governance of the organization support trauma-informed care, limited investment is directed in the implementation and sustenance of the approach. There is no identified leadership for specifically leading and overseeing implementation of trauma-informed care (SAMHSA, 2014). Attention is given on the trauma counselling program in general.  

Conclusion

Clearly, trauma is a major problem that can easily be addressed through trauma-informed care. Chadwick Center for Children and Families has made good attempts towards addressing trauma through the trauma counselling program. However, the organization needs to effectively implement the domains and principles of trauma-informed service to effectively address traumatic experiences. Some of the barriers to creating trauma-informed services include limited resources, poor management, cultural barriers, and lack of proper guidelines and policies. The organization should make some organizational, programmatic, and administrative changes to effectively implement the six principles of trauma-informed care.

References

Biggs, M., Simpson, C. & Gaus, M. (2010). Using a Team Approach to Address Bullying of    Students with Asperger’s Syndrome in Activity-based Settings. National Association of Social Workers, 135- 142.

Chadwick Center (2018). About Us. Available at https://www.chadwickcenter.com/trauma-    counseling-services/

Covington, S. (2008). Women and Addiction: A Trauma-Informed Approach. Journal of Psychoactive Drugs, SARC Supplement 5, November 2008, 377-385.

Elliot, D., Bjelajac, P., Fallot, R., Markoff, L., and Reed, B. (2005). Trauma-informed or   trauma-denied: Principles and implementation of trauma-informed services for women. Journal of Community Psychology, 33(4), 461-477.

Substance Abuse and Mental Health Services Administration (SAMHSA) (2014).    SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach.           HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Webb, N. B. (2011). Social work practice with children (3rd ed.). New York, NY: The            Guilford Press. Chapter 15, “The Interpersonal Violence of Bullying: Impact on        Victims, Perpetrators, and Bystanders/Witnesses”