1 Trauma-Informed Systems of Care

2 Three Aspects of Trauma-Informed Systems of Care Trauma Informed Systems Trauma Informed Care Trauma Treatment Trauma Informed Leadership

3 A Culture Shift: The Core Values of Trauma-Informed Care Safety Trustworthiness and Transparency Peer Support Collaboration and Mutuality Empowerment, Voice, and Choice Cultural, Historical and Gender Issues

4 Trauma-Informed Systems of Care Align… Culture PoliciesPractices Values

5 Trauma-Informed Systems Trauma-informed systems can: – Increase the effectiveness of treatment and engagement with clients who have experienced trauma – Decrease the likelihood that clients are re-traumatized – Decrease the secondary trauma and compassion fatigue experienced by helpers – Help a traumatized organization become a recovery-focused organization

6 The Triune Brain Prefrontal Cortex Limbic System Brainstem

7 Transition Between Stimulus and Response Cortex Hippoca mpus Sensory Thalamus Very Fast Stimulus Traumatic Reminder Slower Amygdala Response Traumatic State (LeDoux, 1996)

8 Trauma’s Developmental Impact (

9 What Does This Mean for Us? Paradigm Shift from the Question: “What is wrong with you?” to “What happened to you?” Keep asking — Is what I am doing respectful and trauma- informed? Is it how I would like to be treated? Avoid re-traumatizing those we serve.

10 Effects of Trauma: Emotions Survivors of trauma can take longer to return to baseline after sympathetic activation Trauma can lock emotions in the body, therefore somatic expression becomes important Trauma can significantly impact an individual’s interpersonal and emotional relationships Difficulty regulating emotional experiences

11 Effects of Trauma: Behavior What helps someone survive their trauma is what can harm someone when they aren’t in their trauma Maladaptive behaviors can also be self-protective An immunity to change can develop which makes it difficult to let go of maladaptive behaviors

12 Effects of Trauma: Cognition Hyper-vigilance and hypo-vigilance effects how people cognitively process information Survivors often have distorted beliefs about their experiences and level of control over the situation or their response Beliefs about oneself, others, and the world are often rooted in survival and self protection

13 Relationships and TIC Relationships are imperative to a sense of safety, recovery and healing. Trauma-informed providers – understand how trauma can effect how survivors relate to others, resulting in healthier and more productive relationships – understand that relationship dynamics that might look like pathology are often more linked to trauma – Understand that the only way to heal is in relationship—being mindful of the competing value of survival vs thriving

14 Manifestation of Trauma in Systems Survival mentality (short-term thinking and planning) High self-protection Ruptures in relationships (high level of mistrust) Triangulation Blame and punishment Poor or limited communication Misuse of power and control Strong focus on victimization High reactivity and emotional contagiousness Low morale and staff satisfaction

15 Resources

16 Thank You! Joyce McEwen Crane, PhD, LCP – Teresa Strausz, LMSW, MSOD –