1. Trauma-Informed Care: Strategies for implementing a trauma-informed, integrated health setting Micki Lamb, LPCC-S Erin Lucas, LISW-S Micki Lamb, LPCC-S Erin Lucas, LISW-S Early Childhood Programs Presents

2. Trauma-Informed Care: Strategies for implementing a trauma-informed, integrated health setting  Micki Lamb, LPCC-S Trauma-Informed Care Coordinator Hopewell Health Centers, Inc. 90 Hospital Drive, Athens, OH 45701  Erin Lucas, LISW-S Early Childhood Programs Director Hopewell Health Centers, Inc. 90 Hospital Drive, Athens, OH 45701 Trauma-Informed Care

3. Restroom location Cell phone reminder Feel free to pass notes  Refrain from side bar conversations Respect each other  Opinions  Feedback on videos  During activities Housekeeping: Setting the stage for success Trauma-Informed Care

4. Agenda: Setting Expectations for the day Objectives Understand and identify processes used to assess and plan for implementing Trauma Informed Care practices within a community mental health setting. Describe the role of Compassion Satisfaction group supervision to promote staff self-care in the Trauma Informed Care process. Identify specific action steps to take in order to begin implementing trauma-informed care principles at their job sites. Activity  Fold a piece of paper into thirds 1.What do I know? 2.What do I want to know? 3.What did I learn?

5.  Gather Champions  Assessment of agency needs  Develop priorities  Subcommittees  Implement strategies Trauma-Informed Care Trauma-Informed Care: Process

6.  Educate and motivate upper administration  Invite Core Team members that are already champions of trauma-informed care, whether or not they identify as such  Select potential team members from several disciplines or strata within the agency  Start small and branch outward Trauma-Informed Care Trauma-Informed Care: Gather Champions

7. Survey agency strengths and needs  Select a model that identifies domains  Assess strengths and needs in each domain  Example:  National Council TIC Learning Community, or the Trauma-Informed Organizational Self-Assessment on your thumb drive. Trauma-Informed Care Trauma-Informed Care: Assessment of agency needs

8. National Council domains  Early screening and comprehensive assessment of trauma  Consumer driven care and services  Trauma-informed, educated and responsive workforce  Provision of trauma-informed, evidence-based and emerging best practices  Create safe and secure environments  Engage in community outreach and partnership building  Ongoing performance improvement and evaluation OMHAS key principles  Safety  Trustworthiness and transparency  Peer support  Collaboration and mutuality  Empowerment, voice, and choice  Cultural, historical, and gender issues Trauma-Informed Care Trauma-Informed Care: Domains

9.  Core Team  identifies where to start based on ease or urgency of need and develops a behavioral plan for change that identifies who, what, when, how  Evaluation  Identify a way that the team or subcommittee can chart progress  completing objectives  improvements on surveys  Meetings  Suggest Core Team meetings at least every other week. Subcommittees will meet as needed. Trauma-Informed Care Trauma-Informed Care: Develop priorities

10. Trauma-Informed Care Trauma-Informed Care: Core team and Subcommittees  Core Team  identifies where to start based on ease or urgency of need and develops a behavioral plan for change that identifies who, what, when, how  Develops subcommittees  Reports to agency administration  Meets at least every other week  Subcommittees  Meets as needed to implement strategies  Reports back to core team at regular meetings  Chart progress  completing objectives  improvements on surveys  Other evaluation tool

11.  Subcommittees implement strategies  Examples  Newsletter  Lobby updates  Trainings  Compassion Satisfaction Group Supervision Trauma-Informed Care Trauma-Informed Care: Implement strategies

14.  Lobby Updates Trauma-Informed Care: Implementation Trauma-Informed Care

15.  Consumer and partner surveys and staff observations  Lobby looks like a bus station  Nowhere I can sit safely with my back to the wall  Not sure where to check in  Children’s area meant adults abandoned kids to the toys  People staring at me as I enter  No green living things in lobby  I can’t get out of these couches without help  No literal “welcome” to agency  Furniture 20 years old, not easily cleaned and de-stained, dull Trauma-Informed Care: Implementation Trauma-Informed Care

16.  Trainings  Stress management in the workplace  Supervision to promote Trauma-Informed Care  Maintaining Compassion Satisfaction Trauma-Informed Care: Implementation Trauma-Informed Care

17.  Compassion Satisfaction Group Supervision  Assessment  Identify needs  Develop plan  Implement strategies  Ongoing evaluation Trauma-Informed Care: Implementation Trauma-Informed Care

18.  Assessment  Use of ProQOL  Proqol.org  Strengths survey  http://freestrengthstest.workuno.co m/free-strengths-test.html  Reflection  How are you doing?  What have you done to take care of yourself?  What have you done to encourage someone else?  What has someone else done to encourage you? Trauma-Informed Care: Compassion Satisfaction Group Supervision Trauma-Informed Care

22.  Identify needs  Group feedback  Information from ProQOL, survey  Use answers to weekly questions to gather needs Trauma-Informed Care: Compassion Satisfaction Group Supervision Trauma-Informed Care

23.  Develop plan  Reflection  Identification of strengths  Hope-less vs. Hope-full  Personal “tank”  Pessimism vs. Optimism  Personal goals  Defining success Trauma-Informed Care: Compassion Satisfaction Group Supervision Trauma-Informed Care

24.  Implement strategies  Group discussion  Accountability partners  Activities  Journals & decorating  Playing cards  Team flags  Joy jug  Mirrors Trauma-Informed Care: Compassion Satisfaction Group Supervision Trauma-Informed Care

25.  Ongoing evaluation  Weekly self assessment  Annual ProQOL  Review of goals Trauma-Informed Care: Compassion Satisfaction Group Supervision Trauma-Informed Care

26.  Use various methods to keep direct service staff current, trauma-informed, and using models to fidelity.  TTCBC may be hosted regionally for various similar agencies to engage in non-identified case consultation, and for education or review of various trauma treatment issues/models. Potential participants are given a written resource to read prior to the meeting. In a live and/or teleconferenced format, one member briefly introduces the topic and help moderate discussion. Then cases can be examined through that lens. Trauma-Informed Care: Book Club Trauma-Informed Care

28.  Concerns?  Questions? Trauma-Informed Care: Implementation Trauma-Informed Care

29. Reflection: Taking key points home with me!  What did I learn today?  What can I do tomorrow?  What can I add next week?  What do I need?  What can I add next month?  What do I need? Trauma-Informed Care

30. Closing: Thank you for your time and attention! Evaluation Contact Information: Micki Lamb mlamb@hopewellhealth.org Erin Lucas elucas@hopewellhealth.org Trauma-Informed Care

31. Resources: http://mha.ohio.gov OHMHAS provides assessment/screening instruments, environmental TI assessment, information about specific populations, trainings/events, TIC Regional Collaboratives, TtT trauma trainers by region. http://mha.ohio.gov www/compassionfatigue.org Self-tests, suggested readings including “Top 12 Self-Care Tips for Helpers”. http://wims.mentalhealthfirstaid.org Search for regional trainings for support staff on mental health/trauma with specific populations. http://wims.mentalhealthfirstaid.org Trauma-Informed Care

32. Resources: www.samhsa.gov Order or download Trauma-Informed Care in Behavioral Health Services (TIP 57) for trauma and resiliency screening/assessment, creating a TIC organization, building trauma-informed workforce, TIC supervision, secondary traumatization, many resources. www.samhsa.gov OMHAS TIC TtT packets and slides http://www.thenationalcouncil.org Information about TIC and how to access the TIC learning community. http://www.thenationalcouncil.org Muskie.usm.maine.edu/helpkids/SupervisionProject/INSupervi sor Use of supportive supervision to affect compassion satisfaction; use of humor; self-assessment of compassion fatigue. Trauma-Informed Care