Sunday, February 23, 2014

A New Venture

I am about to start an exciting new venture- plunging into social media. I am taking a couple of courses to help me develop an on-line branch of my consulting business. I envision creating more on-line learning and consulting options. My particular passion is the day-to-day operations in our treatment programs. How can we assure that every moment is as healing as possible? How can we maximize the ability of every treater, whatever their job role, to create a new relationship template in the brains of our trauma survivors? I have experienced how hard our work is and how we constantly operate at the edge of disaster. We don't have enough resources and we manage severe and scary behaviors. We have regulations, scrutiny and extensive reporting requirements. And, we have wonderful, caring skillful staff and a deep commitment to our important mission. The clients we serve have been hurt, not through their own fault. Given these realities, how can we make sure that we deliver effective, powerful treatment? And how can we improve the experiences of our employees so they stay energized and hopeful in the work?

I have been devoted to these goals through my training, teaching, presenting, consulting, this blog and my book. Now I would like to extend my reach through cyberspace. Would you like to be part of this? I would love to develop an advisory group to help me figure out I can be of most use. If you are interested let me know by clicking "comment" below.

Meanwhile, wish me well and you will be hearing more in the future.

Sunday, February 16, 2014

Signs that Trauma Informed Care is Eroding- and What to Do about It

This post is part of my new focus on how to sustain trauma informed care. It describes indicators that a trauma informed approach to treatment may be eroding in a team, factors that may be contributing to that erosion, and actions to take to restore compassionate and effective treatment.

Signs that trauma informed care is eroding:
·         Grounding are more frequent and longer
·         Restorative tasks begin to look like punishments
·         People start talking about clients “getting away with” things
·         Behaviors are described as deliberate and attempts to get at staff
·         Team members are not trying to understand behavior or figure out how it is adaptive for the client. Instead they focus on how to change it. 
·         Divisions start between team members, there is more blaming of each other
·         Team members start asking for more rules to govern their interactions
·         Staff stay in offices and interact less with clients
·         The words “consistency” and “structure” are used more than usual
·         Activities begin to have to be earned, and clients are not allowed to attend fun events or arts or recreation activities due to recent problem behaviors
·         Clients are described in pejorative terms such as “manipulative” and “borderline
·         People say things like "she wants to be that way"
·         People make hopeless and cynical statements
·         Less laughter and fun
·         People are talking about returning to points and levels or adding more severe consequences

What to look for as contributing factors:
·       Client turnover
·         Staff vacancies and over work of remaining staff
·         A new, more severe type of client
·         Administration being less available
·         Any particular staff having severe problems
·         Personal issues and losses
·         New reporting or oversight demands
·         Difficult incidents and/or bad discharges

What to do:
·         Talk about it
·         Acknowledge changes and stressors
·         Make a plan to solve particular issues ( I.e. Hiring) with deadlines and responsible people and stick to it
·         Discuss vicarious traumatization (VT), do VT exercises, acknowledge difficulty of work
·         Provide opportunities to reflect on successes
·         Arrange team building retreats and fun events
·         Increase staff recognition
·         Emphasize the mission and the importance of the work
·         Increase administrative presence
·         Remember past successful clients, and how they started
·         Do not get sucked into making more rules for clients or staff- look beneath to the meaning     

 Let me know your thoughts- have you had any experiences with observing the erosion of trauma-informed thinking in your teams? What has been helpful?