Sunday, July 13, 2014

What Does a Trauma-Informed Culture Look Like?

We just finished a Joint Commission survey. We did very well. One of my best moments was when the surveyor remarked that this was a special agency. A staff member asked him what he saw that made it special. He replied, "many agencies teach their staff about trauma-informed care. In this agency, that approach is deep in the culture."

So I have been thinking: what did the surveyor observe that enabled him to know that?

He experienced:

The outpatient therapist talking about how the mother of her client had suffered early trauma, and how this was complicating her response to her daughter.

An in depth discussion of a diabetic girls' eating a large muffin snack at school, that included systems issues, peer issues, biological factors, her loneliness and hopelessness, and the pediatrician's personal experience with diabetes and eating muffins.

A group home therapist who was worried that a client who was " doing everything right" still wasn't letting any one get close to her.

Leadership response to discovered problems that focused on systems issues rather than scapegoating.

A discussion of whether a girl with a self- harm history should be allowed to work with knives in the kitchen that reject the simplistic solution of trying to keep her away from any sharp objects.

Group home staff sharing the pain of watching a girl make plans to live with her father and being afraid he will disappoint her.

An in home service discussing their struggles to implement an evidence based practice while maintaining the provision of concrete help they know makes such a difference to families- even when getting new beds is nowhere in the formula.

The longevity of staff at the agency.

The willingness of a program to take a kid back after a lengthy hospitalization despite their doubts to save her from placement in a shelter.

Foster parents who readily related the behavior of their foster son to his past experiences of being hurt.

The warmth and connection between staff, and staff with clients.

And there are probably many more things. I felt proud observing all this. It was one of those times when I could appreciate all that we have accomplished.