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County of Delaware Trauma Informed Care Plan



Definition of Trauma-Informed Care (TIC)

Trauma-Informed Care involves recognition of the pervasiveness and significance of individually-based trauma, and a commitment to relationships, programs, and interventions that seek to mitigate the effects of past trauma and prevent re-traumatization. (Hodas, 2014)


Why does Trauma-Informed Care Matter for Child-Serving Systems?

Numerous studies shown that the children and families served through the child-serving systems have experienced violence, abuse, and neglect from childhood onward, and that most of these children and adults have been exposed to multiple experiences of trauma. (Mueser et al, 1998) The Adverse Childhood Experience Study (ACES) (1990-1994) shows a strong correlation between adverse childhood experience and long term mental and physical health outcomes.

For more information on the Adverse Childhood Experiences Study, please view the follow video from Dr. Nadine Burke-Harris:


Through the development of trauma-informed organizations and staff, we are able to practice "universal precautions" that recognize the pervasiveness of trauma, that reduce the potential for re-traumatizing children and families, and that help to make the service experience less overwhelming and more effective (Maine THRIVE, 2008). By changing our orientation from "what's wrong with this child and family" to "what has happened to this child and family" and by applying trauma-informed principles: safety, trustworthiness, choice, empowerment, collaboration, and cultural and gender responsiveness (Fallot, 2008) across our agencies we increase engagement, motivation, and participation (Hodas, 2014). Providing trauma-informed care can "alter an individual's self-perception, world-view, residual symptoms, and even brain functioning" (Hodas, 2014).

Through starting the journey to become trauma-informed child-serving systems, our agencies and staff will benefit also from learning about how trauma affects staff, how to reduce burnout, and how to support staff to address secondary trauma. By using trauma-informed care to guide our relationships and support within our agencies, we can increase employee well-being, morale, retention, productivity, and recruitment. (Maine THRIVE, 2011).


How Do Agencies Become Trauma-Informed?

Becoming a Trauma Informed Organization means making a commitment to enhancing the practices, policies, and culture of an organization. This type of enhancement requires that staff at all levels and in all roles, modify what they do based on an understanding of the impact of trauma and the specific needs of trauma survivors. This type of change also requires that staff, supervisors, and administrators change the way they treat one another and provide more supports and supervision for self-care and the secondary trauma experienced by staff. This process takes time and requires that an organization understand stages of change and how to identify the organization's own strengths and weaknesses. The process varies from organization to organization and is a journey, not a destination. (Maine THRIVE, 2011)


Current Trauma Informed Care Initiatives

  • County of Delaware's Trauma Informed Care Plan

  • Delaware County System of Care Children's Cabinet and Coalition support Trauma and Self-Care trainings

National, State, and Regional Movements to become more Trauma-Informed

  • Child Welfare

  • Juvenile Court and Probation

  • Mental Health

  • Drug and Alcohol

  • Homeless Services

United Way of Greater Philadelphia and Southern New Jersey Trauma-Informed Communities Collective Impact Work

The United Way has been convening stakeholders and providing trainings on trauma-informed care and evidenced-based trauma specific services in communities in SE PA and Southern NJ. The United Way has launched a trauma-informed community initiative in Delaware County in April, 2015.


2015 Approved Plan for Delaware Human Services Administration (HSA), Juvenile Court and Probation and Juvenile Detention Center

  • All agencies identified a Trauma-Informed Care leader who is in a position of authority to make agency-wide enhancements. The Leaders convened a Trauma-Informed Change Team that includes representatives from every level of their agency including Administrators, Supervisors, Caseworkers, CQI staff, and Receptionist/support staff. The Trauma-Informed Care Change Team typically does not have more than 8 members.

  • A half-day Trauma-Informed Care 101 training for all Trauma-Informed Change Team members occurred in September 2015 from all involved agencies. The goal was to make sure all Trauma Change team members share the same basic understanding and language. Dr. Gordon Hodas, M.D. the System of Care consultant on Trauma-Informed Care, gave the sessions.

    • In 2017, the Department of Human Services contracted with Institute for Family Professionals to provide 8 Trauma 101: Overview of Trauma Informed Care trainings as well as the DCIU to provide 7 Caring for the Caregiver trainings, a skill based training that focuses on the importance of self-care.

    • In 2017, The County's Department of Emergency Services and Domestic Relations joined the Trauma Informed Care Initiative.

    • The United Way continues to partner with The Institute for Family Professionals, now Lakeside Global as part of their collective impact in providing free of cost Enhancing Trauma Awareness courses that can lead to a Trauma Informed Care Competence Certificate.

The TIC Change Teams are the champions for trauma-informed care within each agency.


Annual DelCo TIC Organizational Self-Assessment:

  1. A Trauma-Informed Organizational Self-Assessment is a tool that organizations can use to examine their current practices and take specific steps to become trauma-informed.

  2. Assessment can be completed in 10 minutes or less, and the questions are clear. The Organizational Assessment is now available on Survey Monkey and/or hard copies for those employees without an email account.

  3. It is recommended that staff at all levels of each agency take the TIC Organizational Self-Assessment annually.

  4. A 2- 3-week window is offered for each department/agency to complete the assessment/survey monkey.

  5. The TIC Change Teams in each department receive the results. The data is utilized to develop a strategic plan to become a trauma-informed department. Becoming a trauma-informed organization is a long-term journey. It is recommended that each department chose achievable short term and long terms goals and a commitment to working on those goals for the year. Typically, 1-2 strategic goals are set annually.

  6. Tools developed by Maine THRIVE are available to assist each department in determining priorities and practice and policy changes.

  7. The first TIC Organizational Assessment completed in 2016 created the baseline and is administered each year to measure progress on goals and to set the strategic plan for the following year.

The Trauma Informed Change Team leaders meet periodically and/or communicate via email to discuss progress, strengths and needs as well as develop a strategic plan.


Trauma Informed Care Resources

Sample County Organizational Assessment

An Introduction to Trauma Informed Care PowerPoint

Dr. Hodas Trauma Informed Checklist

Dr. Hodas 25 Reasons why TIC works- insert PDF here


Self Care Resources

Relaxed Breathing

How Breathing affects Thinking- insert PDF here

Mindfulness Exercises

Progressive Muscle Relaxation

Grounding

Relaxation Techniques

Self Care Plan