Implementing Trauma-Informed Care Is Continuous Process, and Other Lessons Learned from Johnson County Task Force

Childhood trauma is directly tied to increased risk for poor health and health-related outcomes in adulthood. Trauma-informed care reflects the knowledge of this relationship so staff can better partner with clients in their recovery. Valorie Carson joins us once again to share some of the experiences of the Task Force in its effort to move to trauma-informed care.

By Valorie Carson, Community Planning Director for United Community Services of Johnson County

Across the country and here in the Kansas City metropolitan area, organizations are considering adopting trauma-informed practices and policies in order to improve outcomes for those they serve, and improve outcomes for their staff. One example of such an effort is the Johnson County Trauma Informed Care Task Force, located in Johnson County, Kan.

The Task Force was created in response to training from the Substance Abuse and Mental Health Services Administration’s National Center for Trauma-Informed Care (NCTIC) in October 2011.

In the spring of 2012, the Task Force was formally assembled with representatives from law enforcement and corrections, mental and behavioral health, domestic violence, child abuse and neglect, substance abuse treatment, early childhood learning and development — 11 separate member organizations that wanted to better understand trauma informed care, assess current knowledge and practices among their staff, and discern how best to implement trauma-informed practices and policies.

One thing was immediately self-evident: no organization or agency would ever be “done” implementing trauma-informed care. It is not a four-week program that can be put in place and walked away from. Once begun, it would be a continuous process requiring ongoing reflection on practices and policies, training for new staff and boosters for long-time staff, and an attentive eye on the organization’s culture in order to prevent returning to prior practices.

Additionally, organizations found that:

  • Flexibility around an organization’s scope of implementation is important — implementation isn’t all or nothing as different organizations have different capacities and factors influencing their decisions.
  • Assembling a group of organizations that are at different stages of the implementation process provides an opportunity for mentoring and shared learning across systems, while also building a knowledge base for future members.
  • Establishing a deep understanding of the core components of trauma-informed care and being capable of applying the principles in multiple systems is more important than picking the “right program.”
  • Staff, time and resources must be dedicated for the planning and implementation process in order for the effort to move forward in a timely way. Staff cannot be expected to do this “on the side” or in addition to their current work and with no resources.
  • Both prevention and effective intervention are necessary to reduce the impact of childhood trauma. Unless the community — within which multiple systems of care are implementing trauma-informed practices and policies — is also intentionally building and strengthening resilience among its children and youth, the “pipeline” of future clients for mental health centers, substance abuse treatment centers, juvenile and adult corrections, and child protective services will never diminish.

The majority of people are touched by at least one form of childhood trauma – if not personally, then through their interactions with their loved ones, colleagues and strangers. Multiple studies, most recently in Minnesota, have found that 55–63 percent of adults report at least one adverse childhood event (ACE). Two of five adults report two or more.

Once as a community we recognize that those we work with or serve could be experiencing health problems or engaging in negative health behaviors because of past trauma, we can more effectively intervene and support their recovery — and that of ourselves. Any organization that has human beings as staff can benefit from a trauma-informed perspective — but especially those that work with populations who are at increased risk.

Valorie’s third installment about trauma-informed care will examine more closely her third bullet point: how to build resilience — that ability to bounce back from adversity — among children and youth.

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