Organizational Self Assessment

Trauma informed organizations need leadership that:shutterstock_127393877

  • Initiates and/or promotes organizational change consistent with Trauma informed practices
  • Develops a strategy for strengthening trauma informed practices over time
  • Considers resources, organizational capacity and pressures in developing trauma information practices
  • Recognizes all staff contribute to trauma informed practices at the organizational level

The organizational checklist outlined here is based on a checklist developed by Dr. Nancy Poole and colleagues at the British Columbia Centre of Excellence for Women’s Health. The checklist included here has been modified and added to for general purposes of this Trauma Tool Kit. (To view the original and complete Organizational Checklist developed by Dr. Poole visit www.bccewh.bc.ca .) The organizational checklist is a tool that can be utilized by organizations as a guideline for the implementation of trauma informed practice. The checklist has been developed to be used as a starting point for an ongoing process of becoming a trauma-informed organization or system.

Overall Policy and Program Mandate

Criteria

Clearly written policy statement

  • Your organization has a policy or position statement that includes a commitment to trauma-informed principles and practices
  • The policy/position statement identifies the relationship between trauma and programming, and the implications for service access and design
  • The policy/position statement is endorsed by leadership

Evidence informed practises

  • Services are base on an optimistic, strength-based and evidence-informed, trauma-informed model

Overall leadership style

  • Program directors and clinical supervisors understand the work of direct care staff as it relates to the provision of services to people who have experienced trauma.
  • Leadership allows staff time and other resources (e.g. space, money) to focus on implementing trauma-informed services.
  • Leadership is aware of the impact that trauma has on its workforce and that many of its employees have been effected by traumatic events in their lives.
  • Leadership promotes democratic principles

Collaboration

  • Collaboration and shared decision making is a key part of leadership style. Collaboration is inclusive of consumers in the development of trauma informed approaches.
  • Clients/patients/residents (C/P/R) and staff are encouraged to provide suggestions, feedback and ideas, and there is a structured and transparent process for this.

Point of Responsibility

  • There is a clearly defined point of responsibility for implementing trauma-informed services. This may involve a trauma “initiative”, committee or working group” that is fully supported and endorsed by administration and includes consumers.

Hiring Practices

Criteria

Trauma in job description/interview

  • Job description includes knowledge, skills and abilities to work with people affected by trauma
  • Job interviews include trauma content, including questions about knowledge and skills related to trauma-informed practise.

Training to promote general awareness

  • All staff, at all levels receive basic foundational training and continued training (as appropriate) that furthers their understanding of trauma including a basic understanding of the; psychological, neurological, biological, relational and spiritual impact that trauma has on people.
  • Staff members are released from their usual duties so that they may attend training

Staff receives training on the following topics:

  • The links between mental health, substance use and trauma (and co-occurring disorders)
  • Cultural competency (including different cultural practices, beliefs, rituals, different cultural responses to trauma and the importance of linking cultural safety and trauma informed practise)
  • How gender influences the types of trauma experienced, an individual and systemic responses to trauma
  • Communication and relationship skills (including non-confrontational limit setting, “people first” language (e.g. people who are experiencing homelessness, reflective listening, skills, etc.)
  • Minimizing re-traumatisation (including psycho educational framing, coping mechanisms, a cultural safety lens, de-escalation strategies, grounding and emotional modulation techniques)
  • Vicarious trauma, how it manifests and ways of minimizing its effects (including self-care, resiliency and personal/professional boundaries)
  • Understanding and being able to recognize fight, flight freeze responses
  • Mindfulness and developing their capacity to be self soothing and self compassionate
  • Understanding and appreciating the mind/body/spirit connection
  • Suicide prevention and gatekeeper training

Staff receives training that promotes awareness of services

  • Awareness of trauma-specific services in the mental health system
  • Awareness of the range of specialized service outside of mental health and substance use system to support people with trauma, such as anti-violence services, services for refugees & victims of torture, veterans’ services LGBTTQI * services, Aboriginal healing services, gender specific support groups

Regular Supervision

  • All staff that work with trauma survivors have structured, strength-based supervision from someone who is trained in understanding trauma

Staff Meetings

  • There are regular staff meetings that include opportunities for knowledge exchange on working with trauma
  • Staff is encouraged to discuss ethical issues associated with defining personal and professional boundaries

Peer Support

  • Opportunities for peer support and consultation are regularly offered

Support for all safety

  • Part of regular supervision is used to help staff understand their own stress reactions
  • Self-care is encouraged among staff and issues related to safety/self-care addressed at staff meetings
  • The organization regularly seeks input from staff about their safety, and / or assesses staff safety through other mechanisms, and makes improvement wherever possible
  • The organization provides appropriate supports to staff that have experienced vicarious trauma
  • The organization promotes a psychologically safe work environment for staff and volunteers:  A psychologically healthy and safe workplace has been defined as, “a workplace that promotes workers’ psychological well-being and actively works to prevent harm to worker psychological health including in negligent, reckless or intentional ways.” (www.workplacestrategiesformentalhealth.com)

Universal Screening

  • There is an intake policy that clearly states the purpose of screening for history of trauma and how it will be used to inform service planning g, that apply to all consumers, regardless of how they enter the system ( “which door”)
  • The screening and assessment process is fully discussed with C/P/R and C/P/R choice and control of what will be disclosed is emphasized throughout
  • The potential for re-traumatization during screening and assessment is formally acknowledged by the organization, and policies are in place to minimize the potential for re-traumatization
  • The screening and assessment protocol is informed by currently available academic and practice evidence about being trauma-informed

Location for intake assessment

  • Intake conducted in a private, confidential space
  • Appropriate interpreters are provided, as needed (e.g. not family member or an interpreter untrained in trauma)

Follow-up

  • Screening is followed up (as appropriate )with opportunity for consumers to become aware of how trauma is connected to mental health and substance use concerns, to learn coping skills, to disclose history of trauma at their pace
  • Supports are in place for consumers after assessment if trauma history is discussed

Policies and Procedures

Criteria

Overall

Your organization ensures that all current policies and protocols are not hurtful or harmful to trauma survivor, are respectful and promote safety, trust and flexibility

Consumer Choice

  • C/P/R ‘s are given full choices in what services they receives, and is allowed to make decisions about their level of participation and the pacing of these services
  • C/P/R’s are encouraged to make informed choices by providing educational and discussion of potential services available to them, and the benefits, limitations and objectives of each

Survivor Involvement

  • People who have been affected by trauma are involved in the creation and evaluation of policies and protocols
  • C/P/R are able to make suggestions for improvement in ways that are confidential and anonymous and/or public and recognized

Cultural Competency

  • All policies respect culture, gender, race, ethnicity, sexual orientation and physical ability

Privacy and Confidentiality

  • All staff and consumers are aware of what is involved in the informed consent process (including the extent and limits of confidentiality, what is kept in records, where the records are kept)
  • There are established processes that support consumer awareness and understanding of informed consent

Safety and Crisis Planning

  • All C/P/R’s have individualized safety plans that are fully integrated into the programs’ activities (include a list of stressors, specific helpful strategies, specific non-helpful strategies, a strategy for coping with suicidal thoughts and a list of persons that they feel safe around)
  • There is service policy that informs how individual safety plans are used in a crisis and reviewed when necessary

Avoiding Re-Traumatization

  • There are policies or procedures in place to minimize the possibility of retraumatization

Supportive/Emotionally Safe Program

  • C/P/R rights are posted in visible places
  • The program avoids involuntary or potentially coercive aspects of treatment (e.g. involuntary medication, seclusion, restraints)

Physical Environment

  • The space around the program building is safe (e.g. parking lot and sidewalks well lit, directions to the program are clear)
  • The physical environment is attuned to safety (e.g. calming and comfortable)

Referrals

  • Based on intake assessments, C/P/R’s are referred to accessible, affordable trauma-specific services as necessary
  • C/P/R’s are engaged in the decision about referral to external programs, if any, and are informed about what to expect of the referral agency
  • C/P/R’s are supported through the transition to external services

Monitoring and Evaluation

Criteria

Monitoring

  • Information on C/P/R experiences of trauma is gathered and used to inform service planning

Evaluation

  • The evaluation of trauma-informed policies and practices are conducted as part of the regular review and planning process, and this information is used to inform and adjust practice.
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