Trauma.

It’s currently a famous buzzword in the mental health field. And for good reason! Nearly 90% of the U.S. population has experienced a traumatic event and almost 10% meet criteria for Post Traumatic Stress Disorder (Kilpatrick, Resnick, Milanak, Miller, Keyes, & Friedman, 2013). In addition to it being quite common, it can also be dangerous. Experiencing traumatic events has been linked to horrible long-term effects on people, including, substance use, chronic health conditions, and risky and dangerous behaviors (SAMHSA, 2017). This is not even hitting the most obvious effect that trauma has on individuals: distressing mental health conditions, such as anxiety, depression, and PTSD. But as the need has grown for trauma treatment, mental health professionals have started to realize that many of their practices are not reflecting the same kind of values in being sensitive to those who have experienced trauma.

It’s a shift from asking, “What is wrong with you?” to “What happened to you?”

As a result, many organizations and individual practitioners started to subscribe to what is now referred to as “trauma informed care”. Essentially, trauma informed care is an approach to treatment that recognizes the reality that many of the clients that we serve have experienced trauma. It is a bit of a more mindful approach to how we engage our clients in all aspects. From the moment that they first call our offices to schedule an intake, to their very last discharge session, staff at every level are mindful of the potential trauma that clients have experienced and thus, allowing this awareness to influence how we engage with them.

In 2016, the organization I worked for was chosen to participate in the Trauma Informed Care Learning Community through the National Council for Behavioral Health. This was an excellent opportunity as my team spent a full year dissecting our behavioral health program and figuring out how we could make our program better, safer, and more trauma informed. We added language around “trauma informed care” to our job descriptions, we added another trauma symptom checklist during intakes, and we put up banners in the front lobby that said “We are a Trauma Informed Organization”. In the end…nothing really changed.

Why? Because trauma informed care is not just a “good idea”. It isn’t something that you put on a bumper sticker and stick to the wall and then suddenly you are “trauma informed”. Instead, trauma informed care is a mindset. It is a practice. And it all starts with your clients. THEY will tell you what it means to be trauma informed.

As I closed out the year with our Learning Community, I had to do a presentation on what big accomplishments our organization was able to make over the course of the year. All of the other organizations presented on how they had transformed their programs in a million different ways. My presentation was the last one. I didn’t have a PowerPoint and I didn’t really even have much of a presentation. I got up in front of the group and talked about all of the changes that we made and how in the end, it really didn’t make a difference. Now, there were definitely things that we learned about trauma informed care principles but the main takeaway from us was that we had come to the conclusion that until we involve our clients more in gathering feedback, we would not see the changes that we had hoped to see in our care.

After the presentation I spoke with one of the faculty members for the program and he was impressed with my honesty (I think this might have been code speak for “you really blew this presentation”). But he said to me something that I will never forget. He said, “Jacey…I think you are overthinking this. Next time you think of trauma informed care, just think of excellent customer service. In many ways, it’s the same thing.”

For me and my organization, this was transformative information. The parallels between trauma informed care and excellent customer service really are similar and once we started to engage clients in a new way of allowing them to tell us how to treat them, everything changed for us. And we truly became a trauma informed organization.

Understanding Client Needs

The focus of this course is to provide you with tools that will allow you to meet your clients’ needs and provide them with a better experience from a trauma-focused approach. There are a lot of ways that we could talk about trauma and experience management because these are very big and important topics. But one of the foundations to providing a trauma informed and positive experience for all clients is understanding what your clients need and want in the first place.

It’s important to note that those of us in the behavioral health refer to those who access our services somewhat differently – some people call these individuals “clients”, some call them “patients”, and others ditch both of these terms and opt for a less clinical term like “families” or the person’s name. For simplicity’s sake, we will use the term “clients” in this course. But just know that when I refer to “clients”, this would be all-encompassing to also account for families, parents, caregivers, and anyone else who is an important part of the person’s experience journey.

I know that we have a wide variety of professionals who will take this course. You will all vary greatly in terms of your roles and your backgrounds in the field of mental health. Some of you may have worked on trauma-informed care initiatives before, and for others this may be entirely new. This approach is in no way an exhaustive approach to providing this type of care. Instead, this is simply one way to practice trauma-informed care through taking the first (and necessary) step to gaining understanding of your clients’ experience with your services and making important changes that can have a major impact in how they form a positive encounter with you and/or your agency.

Although we will highlight some very important aspects of trauma and the client experience correlation within this course, the video below provides an excellent overview of why Trauma-Informed Care is so important to the clients that we serve.

Why Trauma Informed Care? https://www.youtube.com/watch?v=4THxcEwNweo&t=895s

So we are going to start off with a quick overview of trauma and experience management, including why it is important and how it is unique in behavioral health. Then we will move into the tools to understand client needs, and finally how to use the information that you learn to make an impact in your work with clients.