Trauma researchers, practitioners, and survivors have recognized that the understanding of trauma and trauma-specific interventions is not sufficient to optimize outcomes for trauma survivors nor to influence how service systems conduct their business. The contexts in which trauma is addressed or treatments deployed contributes to the outcomes for the trauma survivors, the people receiving services, and the individuals staffing the systems. Referred to as trauma-informed care, this framework is essential to the context of care. SAMSHA’s concept of a trauma-informed approach is grounded in a set of four assumptions and six key principles.
Assumptions – The Four R’s
A trauma-informed organization:
- Realizes that trauma can affect families, groups, organizations, and communities as well as individuals
- Recognizes the signs of trauma and understands that these signs may be gender-, age-, or setting-specific and may be expressed by people seeking service as well as those providing services;
- Responds by infusing principles of a trauma-informed approach into every aspect of the organization and service provision; and
- Resists re-traumatization of clients as well as staff.
Six Key Principles of Trauma-Informed Approach
- Trustworthiness and Transparency
- Peer Support
- Collaboration and Mutuality
- Empowerment, Voice, and Choice
- Cultural, Historical, and Gender Issues
How We Support
Trauma-Informed Care Learning Collaborative
In collaboration with the Texas Children Recovering from Trauma initiative, Texas System of Care supported a statewide learning collaborative focused on trauma-informed approaches to care. Behavioral health providers participated in a year-long learning collaborative facilitated by the National Council for Behavioral Health. Sixteen organizations identified implementation teams, including parents, youth, and adults with lived experience and participated in three face-to-face training and networking events over the course of the year. They also participated in monthly learning collaborative calls with National Council coaches and had access to webinars and other resources on trauma-informed care.
Texas System of Care collaborated in the development of the Texas Child and Adolescent Needs and Strengths (CANS 2.0), which incorporated a trauma screening tool. The CANS 2.0 has been adopted by the Department of Family and Protective Services and is being piloted in East Texas and Collin County Systems of Care.
Training and Technical Assistance
Texas System of Care staff provide training and technical assistance to support organizations in incorporating trauma-informed approaches to care. In addition to individualized training on elements of trauma-informed approaches, staff are trained in:
- National Child Traumatic Stress Network’s Core Competencies in Childhood Trauma
- National Center on Safe and Supportive Learning Environment’s Trauma Sensitive Schools
- National Child Traumatic Stress Network
- Trauma Informed Care Implementation Resource Center
- SAMHSA’s Concept of Trauma and Guidance for a Trauma Informed Approach
- DFPS Trauma Informed Care Training
- Trauma-Focused CBT Online Training
Substance Abuse and Mental Health Services Administration. 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, 2014.