- SAMHSA identified trauma as resulting from an event, a series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.
- Trauma-informed just means that your organization has a framework to understand that the people you serve may or may not be victims of some sort of trauma in the past.
- With a trauma-informed approach and using asset-based development principles, we can give clients skills to become self-sufficient and empower them to live a more positive and resilient life.
- Everybody can learn from trauma-informed care principles because we all have to start thinking about how we interpret behaviors and ask different questions to better our communities.
- American Institutes for Research (AIR)
- Building a Trauma-Informed Organizations and Systems
- 130 – Dr. Becca Johnson – Trauma Sensitivity
- 169 – Dr. Jodi Quas: Communicating with Child Victims
- 200 – Trauma Healing Institute
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Dave [00:00:00] You’re listening to the Ending Human Trafficking podcast, this is episode number 204, Is Your Organization Trauma-Informed and Why Should It Be?
Production Credits [00:00:10] Produced by Innovate Learning, maximizing human potential.
Dave [00:00:31] Welcome to the Ending Human Trafficking podcast. My name is Dave Stachowiak.
Sandie [00:00:37] And my name is Sandie Morgan.
Dave [00:00:39] And this is the show where we empower you to study the issues, be a voice, and make a difference in human trafficking. Sandie, we’ve certainly mentioned the word trauma on the show before. Today we’re going to dive in a lot more on what it means to be trauma-informed and why organizations should care about that. This is something that you’ve done a lot of thinking on yourself and then also with the partners, we’ve worked with, right?
Sandie [00:01:03] Yes. And over the last well since the semester ended, I’ve been to New York City, to the U.K. – five cities there, Washington D.C., and then took a team to Obera, Argentina. I had so many conversations with leaders, with organization leaders, government folks, and just sitting on the airplane talking to people, or in the airport waiting for your delayed flight to re-board. And over and over again trauma came up. It’s a word that people are talking about. We’ve talked in the past about adverse childhood experiences, which are part of the trauma that informs how a child develops. So, I thought let’s talk about it from more of a systems level. What about organizations and how they address preparing their staff to deal with people who have a past of trauma.
Dave [00:02:07] And I’m really curious of the folks you mentioned, where you’ve had those conversations on travel and with other partners and organizational leaders. What context is the word trauma coming up for them? What are you hearing?
Sandie [00:02:22] Well, a lot of frustration was what I was hearing. We rescue people and you know from previous podcasts I really try not to use the word rescue because you can recover someone and then it’s a long healing process. And so many of my conversations were around “we rescued them and now you know they’re not making the progress we thought”. Or and I know that this probably doesn’t sound very nice but sometimes people in the service industry and in the nonprofit world they get tired, they become disillusioned and they begin to question well if they don’t want to change, I guess I can’t do anything about that. So, they take a rather fatalistic approach, they may even begin to blame the victim. By that I mean, “well if they’re not going to do what we told them to do, then we can’t help it if we’re not getting the results.” And so, they want to know what we should do because we’re not making the progress that we wanted to make.
Dave [00:03:37] You mentioned the distinction between the word rescue and recovery, and we’ve talked about this on the podcast before that the language we use is really important as far as our mindset. When you think about language and just what we mean by trauma, there are things that come up for me when I think of the word trauma but I’m guessing that’s limited in comparison to the things that we really should be thinking about with trauma.
Sandie [00:04:05] Well and I want to distinguish between PTSD and just generalized trauma. And PTSD, we’ve talked about in the previous podcast that can be part of the trauma response that we may have. But I just want to focus on basic general trauma and how to be trauma-informed. And so in this definition, which is from the SAMHSA website, which is our Substance Abuse Mental Health Services Administration, and they have great resources I’ll put some links in the show notes, but they identify trauma as resulting from an event, a series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being. So, we’re not talking just about physical abuse or just about psychological abuse, it could be anything, but if it causes a lasting effect on that person’s sense of well-being then it’s defined as trauma. And we have a significant ability to remember the feelings that we had and not necessarily remember the circumstances.
Dave [00:05:40] When trauma shows up, what does it look like?
Sandie [00:05:43] Well, and this is what becomes very frustrating for people who are working in difficult circumstances as a service provider, a law enforcement officer, a teacher, even a university teacher. It looks like difficulty following through on commitments, or avoiding meetings and other isolating behaviors, and engaging in a lot of interpersonal conflict, being really easily agitated and becoming aggressive, and often demonstrating the lack of trust and even kind of a conspiracy thing everybody’s against me- they’ve all targeted me. And then it just doesn’t make sense, but they end up in those same kinds of abusive relationships and often to completely escape that, they start using substances.
Dave [00:06:45] I’ve heard the term on our show before and we mentioned this in the title tot, the term “trauma-informed”. What is trauma-informed?
Sandie [00:06:53] Trauma-informed just means that your organization has a framework to understand that the people you serve may or may not be victims of some sort of trauma in the past. And so, they would have a grounding and an understanding of the impact of trauma. And they would see those seven identifiers that I just listed and not immediately say, “I’m going to dock you 10 points because you didn’t show up and you didn’t follow through on your commitment.” You’re going to respond differently. You’re going to ask another question, you’re going to ask, “why?” A lot of people have been quoting Brene Brown in recent days and the whole idea that we have to be curious and ask another question instead of just responding.
Dave [00:07:58] Indeed.
Sandie [00:07:58] And then another quality of trauma-informed, because trauma-informed doesn’t mean we just excuse that behavior, but it does mean that we’re going to use a strengths-based service delivery approach. And that is something we talk a lot about on this we call it building on resiliency, asset development. You can go back through some of our podcasts and see what strength-based service is really all about. In research, they’ve emphasized that responding to trauma that creates emotional safety for both the provider and the survivor creates opportunities for survivors to rebuild a sense of control and empowerment. So, control and empowerment. So, if you just tell someone you can’t do that, does that fix the problem? And your behavior is not acceptable, does that fix the problem? So, for instance, someone shows up at your small group at your clinic and they’re combative they’ve gone off to the side and they don’t want to engage with other people. So, do you respond with, “well now you can’t come anymore.” That would be one way to deal with it whereas in a trauma-informed environment you’re going to look for a way to give that person a sense of control and empowerment. And so, you might be able to say I understand you don’t want to join the group right now, would you like to sit over here on the side. So, you give them the ability to make a choice.
Dave [00:09:57] And you’re giving some agency.
Sandie [00:10:00] Some agency, exactly.
Dave [00:10:02] And you use the word curiosity a bit ago in reference to Brene Brown and there is a sense I have of this of when I see these things as a provider or an organization, or working with the public not that we may not go down the routes you articulated, but that maybe the first thought would be, “Oh interesting, I’m getting this response, why?” Like you know and not necessarily asking the question why but being a little curious of like what could I do that might try to put myself in the shoes of this other person a little bit before I go further on what I decide to do next.
Sandie [00:10:42] Well and we recently interviewed someone from the Trauma Healing Institute. And their recommendation was don’t ask them, “why did you do that?” Ask them “what happened?” So, you get more information that is more concrete and gives them an opportunity to express themselves. And sometimes asking for them to explain things actually makes them more stressful. So, giving them the opportunity to either do this or that creates that sense of making a choice and that opportunity is an opportunity for empowerment.
Dave [00:11:22] Yeah, I like that distinction because the why, I was thinking a few minutes ago and I said why that may not be the word you use because it puts people on the defensive. So, you’ve got to explain why did you do that. But even just changing that one word of what, what caused this to happen. Just then you’re having a conversation with more agency.
Sandie [00:11:38] Well and the idea that we need to have trauma-informed approaches in our organizations. SAMHSA has four Rs, and I just love it when I’ve got a pneumonic to help me remember things. So, if you’re a director then these four Rs are for you. A program or a system that’s trauma-informed: number one realizes the widespread impact of trauma and the potential paths for recovery. It recognizes the symptoms of trauma in clients in families. So, maybe the person who brings them to your clinic and in staff and others. So, you may think you’re just looking at this victim but the person the staff member there may also be experiencing trauma, so trauma-informed is also for staff. So, number one realizes, number two recognizes, number three responds by fully integrating knowledge about trauma into policies and procedures and practices and actively resist. The fourth is re-traumatization. And that’s our goal, we don’t want to traumatize people any further.
Dave [00:12:55] How does this show up as a public health issue?
Sandie [00:12:58] That is why I love SAMHSA and I love using our American Research Institute as well. Public health, we’ve talked about public health here and how we predict what a problem might be and then we come up with a plan to overcome it. So, in our public health issue, we’ve identified the prevalence of trauma. And you’ve already heard on past podcasts. The Adverse Childhood Experiences quiz and how we’re using that in working with children. Well, and according to these statistics 98 percent of female offenders in our social service system had an experience with trauma. And most often interpersonal and domestic violence. Ninety-six percent of adolescent psychiatric inpatients have histories of exposure to trauma. And 93 percent of homeless mothers have a lifetime history of interpersonal trauma. And in our juvenile justice simple youth 90 percent had multiple traumas from an early age. And 75 percent of adults with substance abuse disorder had histories of trauma.
Dave [00:14:28] The numbers are pretty staggering, aren’t they?
Sandie [00:14:31] So, in a trauma-informed system we have to recognize that and promote resilience and healing. And so, we talk about that. And I started asking organizations, “do you have a trauma-informed training program? Do you have a trauma-informed policy? What are the guidelines for your organization?” And this is what I discovered from my informal survey. A handful of people had been to a trauma-informed training, the rest of the organization hadn’t. Only the people who had been able to actually attend that and what I thought was generalized across the service industry is not as generalized as I expected. I thought every organization would have a trauma-informed approach to how they worked with their clients, with their students, and with the people that they serve in their community. I know non-profits that do outreach in the community and I was in another country on an outreach and coming back a couple of people volunteers need to be trauma-informed because they were disappointed the response had not been what they were expecting. And so, their summation was these people were not grateful. Well was that if you look at the signs of trauma and how people respond, and you go back to that list of people who are not following through on their commitments and practicing isolating behaviors and being aggressive. Those are all signs that we should be thinking about this from trauma not about how they responded to us. It’s not about us, right? So, what do we do if we realize our organization does not have any kind of guidance on trauma?
Dave [00:16:43] And I’m curious of that question you just posed? There are two lenses. One is the organization that has sent someone, or a couple of people have gone through some of the training that you mentioned in cases. Where that has been the case, what’s a good next step? The people who have some knowledge that is within the organization but maybe the organization as a whole is not integrated that knowledge. Where can they start?
Sandie [00:17:09] I think that they can start with doing an assessment agency-wide and finding out what has already been done. Who does have the training and what the next steps are going to be? And one of the organizations that I really like has produced a building a trauma-informed organization system, sort of a tool kit. And their tool kit starts with Phase 1. And this is what we need to do whenever we’re implementing a new agenda. We want to start with exploration we want to assess the group. AIR’s trauma-informed organizational capacity scale measures the current level of organizational trauma-informed care. Because what I begin to think about is if I go to somebody and say we need to do this, this, or this my higher-ups may say well that’s not in the budget maybe we’ll do it next year. But if I do an assessment first and bring the scale in that shows exactly where we are and I’m able to demonstrate why this is a risk factor for our organization. That is what will actually help catalyze change. And there are five steps in that assessment. The first one is just finding out where our knowledge base is and beginning to evaluate relationships with service users. And they also measure respect and how your organization is actually fostering trauma-informed service and then how do you continue to promote it. Because what happens in the long haul is people get started on something, but we don’t have a way to go back and make sure it’s maintained next year and the year after. And that assessment tool is available online, we’ll put a link to that.
Dave [00:19:17] And the second part of the question then for the organizations that have not really thought much about this or gone through any kind of training, is it a similar starting point or is there a different starting point?
Sandie [00:19:29] Well, I think first of all it is learning more about what trauma-informed means. And so that means that you actually have to bring in or send your people out to get that kind of training and bring it back to your organization. The needs of your organization are part of that assessment. And sometimes there may be a sense that we don’t really need to do this because our level of client doesn’t have as much trauma. And I would question that because we are beginning to understand that people, especially in the service industry or providing social services, people are showing up. And from that list of statistics that we just gave from public health, people are showing up and they come from some sort of interpersonal trauma situation, family violence situation, they may have been homeless which in and of itself is traumatic. They may be coming, when we start working with refugee populations, literally from an area of war and conflict. So, how do we begin to integrate trauma-informed services in how we respond? It isn’t enough to line people up and hand out bags of groceries. We have to take a more longitudinal approach to how this person is going to not just be fed physically but also become more healthy- emotionally, mentally.
Dave [00:21:17] When you see examples of organizations that have done that well, that have gone beyond just the physical needs and it really looked at something from a more longitudinal approach. What’s an example of something that you’ve really seen that you really like and that it really fits in with it?
Sandie [00:21:33] I love working with folks from DEA, our Drug Enforcement Agency. We’ve had representatives at the last few Ensure Justice conferences and I never sense this judgemental attitude towards the clients they serve. They always tell me you know I know so-and-so is really struggling with this substance abuse disorder, but if you knew their story, if you knew what happened when this young man was a child, this would give you more grace and more compassion. And I learn a lot from watching them. Which is why I eventually going to the SAMHSA Website, where there are so many amazing resources because we have learned by, I would almost say, reverse engineering. This person got here not because just making bad choices or poor choices, but because they didn’t know how to deal with something, they didn’t have the skills. And we can help give them those skills and use asset base development principles to bring them to a place where they become self-sufficient and they are empowered for a more positive and resilient life. And I think that it has been a little bit slow going, but this matters to you because you are part of a system, I’m part of a system, and there are systems that teach our children. Teachers need to be trauma-informed. A child may show up late and the child gets in trouble. But you have to ask what’s going on with Mom, what’s going on with Dad. What’s happening? You’re in security at a mall, do you need to be trauma-informed? Well if someone loses it at the mall, you need to know what are some things you can do to help them feel empowered, and calm down, and avert maybe a tragedy. Health care professionals, of course, and emergency medical service personnel. They go in and they’re ready to start an I.V. and do all these things. But if someone is approached that’s in a high state of reactivity because of trauma that person needs to know how to help them center and become grounded so that they actually can help them. So, you might be jogging through the park and you avoid something because it feels uncomfortable. But if you’re trauma-informed instead of making a judgment you might make a phone call that will get help for someone. And I think from a community-based perspective, that’s important. The resources are there to get started. You can go to SAMHSA, you can go to the AIR Website, the staff development resources developing how to sustain your knowledge to assess your progress and review your goals and evaluate your impact. These are all important pieces of that agenda that will help produce more empowerment for the clients and the people that you serve. And really, we’ll put the links to the trauma-informed scale and to a couple of other resources. You can go back to the Ending Human Trafficking podcast 130, 169, and 200. But I really think that we have to start thinking about how we interpret behaviors and ask different questions instead of how I stop that, how do I avoid that. Ask what might have happened to lead to that behavior. And my personal experience in this area really began as a child and my dad was my model. I still remember he was a church usher. And there was a lady that came to church that was really difficult and loud, and it was a little scary I was like 12 years old. And my dad met her with kindness and gentleness. He didn’t tell her you to have to quiet down. He didn’t make any kind of challenging remarks to her. He spoke to her gently, he asked her some questions, “what’s going on? How can I help you?” And then he made sure she was in a place where she felt comfortable and by comfortable, I mean she felt safe. And week after week, she came back, and she always made sure that when she walked in the church she went straight to my dad and he made sure she went to the place where she felt safe. And on the way home that first day I remember my dad asking me how I was doing because I had watched something that was a little traumatic. And I told him it was a little scary, she was really loud. And my dad said she has had some experiences that weren’t happy. And so, we just want to make sure that she feels safe, that’s all. And I learned from my dad how important it is not to judge first but to ask another question and create as much safety as you can for another person. And that’s not even in an agency, it’s not in a big organization, it’s walking through the doors of a church. Everybody can learn from trauma-informed care principles.
Dave [00:27:49] Sandie, you also are just a great example of doing this and creating a safe space for so many different kinds of people and organizations that partner with the Global Center for Women and Justice. So, thank you for also integrating this into our work, to our Center, and to our board. It’s really just fantastic to see you walk the talk on this. And as Sandie mentioned, there’s a number of links here to resources that will be helpful to you if you are in one of those organizations that maybe have had a little thinking on this but haven’t taken the next step to really integrated into the strategy and the operations. Or maybe you haven’t yet taken that first step and this framework will be a place to begin on that. And we’re inviting you to take the first step as well on your learning and your growth. Maybe this is the first time you’re listening to the show, or maybe it’s the second or third time, but if trauma-informed isn’t the place to start for you right now- I’d encourage you to hop online and begin at the very beginning is to download a copy of Sandie’s book, The Five Things You Must Know, a quick start guide to ending human trafficking. You can find that at endinghumantrafficking.org. It will teach you the five critical things that Sandie’s identified that you should know before joining the fight against human trafficking. Again, that’s at endinghumantrafficking.org, that’s also the place that all of our episode notes, documents, all the links we mentioned today will be. And of course, you can always reach out to us directly as well with questions, our email address is email@example.com. And don’t forget the next Ensure Justice conference, the annual conference that the Global Center for Women and Justice hosts each year in Southern California, is coming up next March 6th and 7th 2020. EnsureJustice.com is where to go. Sandie, I’ll see you back in two weeks.
Sandie [00:29:45] Thanks, Dave.
Dave [00:29:46] Thanks, everybody.