Trauma-informed care (TIC) refers to the ways in which organizations and providers respond to the needs of trauma survivors and create environments that foster their recovery. As organizations working with clients who have experienced many adverse life events including significant trauma, it is our job to integrate our knowledge and understanding of extreme stress and trauma into everyday practices and across organizational policies. Integrating TIC into an organization is a critical strategy for helping families and their children.
Trauma-informed organizations operate from a set of core principles that include (Guarino et al., 2007):
- Understanding trauma and its impact: Trauma is a common experience across all populations in our society. Those who experience poverty and homelessness are likely to accumulate multiple traumatic events across their lifetime, often leading to health and mental health conditions. Traumatic events have the capacity to overwhelm a person’s coping strategies and functioning capacity often leading to physical and emotional pain, chronic distress, behavioral changes, and health problems. For an organization to move towards TIC, staff at all levels must have a foundational understanding of trauma and how it impacts people’s behavior and health.
- Promoting physical safety: The experience of homelessness can be stressful and disorienting. Organizations must work to create space that is secure and welcoming, allowing families to feel comfortable and in control of their lives. If possible, organizations should create opportunities for privacy, and provide multiple quiet areas, and spaces with comfortable furniture and soft colors, and opportunities for children to play indoors and outside. Furthermore, rules should be flexible and tailored to the needs of each family, as it is important for caregivers’ autonomy and for children’s sense of routine and normalcy. Mandatory meal times and bedtimes in addition to other rules may interfere with this objective. To read more, visit: designresourcesforhomelessness.org.
- Promoting emotional safety, and building supportive, trusting relationships: Emotional safety refers to the degree to which people can be open and vulnerable without fear of retaliation. It is important that case managers and all staff make space for clients to share their concerns and frustrations about programs and policies, and that staff have the capacity to respond to trauma-related behaviors and emotional distress. Environments that require strict behavior and discourage authenticity can exacerbate stress, anxiety, and trauma responses.
- Sharing power and governance:With input, feedback, and involvement from service users, policies can be adapted to become more trauma-informed. Organizations can foster empowerment by giving service users a voice in designing and implementing services. Their involvement affirms that they have a unique and valuable perspective, and are experts in their own care. Whether they are leaders, on staff, share their stories, or conduct support groups, the presence of former service users sends a message that their opinions matter and that people do recover—a stance that promotes hope and resilience among survivors.
- Ensuring equity and practicing cultural humility: Trauma is also linked to experiences of marginalization. Not feeling comfortable or validated as you navigate unfamiliar places can exacerbate traumatic stress. To effectively respond to the unique needs of each individual, it is critical for shelter staff to receive training on social and racial equity and to have familiarity with the unique experiences of diverse populations.
- Integrating care:Like most people, families experiencing homelessness need more than housing and employment support to live healthy, meaningful lives. People of all ages living with trauma histories also need access to health care and mental health services. A multitude of services can be integrated into shelter-based programming. Finding opportunities to bring community partners and health care professionals into the shelter is the best way to reduce barriers to services. However, providing transportation and other supports can also help link families to the care that they need.
- Promoting recovery, and supporting service user choice, control, and autonomy:Recovery-oriented programs differ from traditional top-down approaches to service-provision by ensuring that people receiving services provide input into the nature of service delivery, lead the process of goal-development and are encouraged to envision their lives after exiting the program. Case managers should see clients as collaborators by building on their strengths and supporting their hopes and priorities.
Guarino, K., Soares, P., Konnath, K., Clervil, R., and Bassuk, E. (2009). Trauma-informed organizational toolkit: Section I- trauma-informed organizational self-assessment. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, and the Daniels Fund, the National Child Traumatic Stress Network, and the W.K. Kellogg Foundation.