While many care providers are talking about being trauma-informed, fewer actually know what that means. The Teaching-Family Association would like to be out in front of our members’ needs by defining and modelling what it means to be trauma-informed, and providing resources regarding trauma-informed care and focused, trauma-informed practices.
We’ve asked our members for trauma screening tools, training modules, trauma-specific policies, treatment plans, and evaluation feedback, and we’ve compiled these resources here.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers an excellent and extremely comprehensive treatment improvement protocol for offering trauma-informed care in behavioral health services. The document is quite long, however, so it may not be the best resource for introducing others to the idea of trauma-informed care, or you may not want to wade through it to find what you are looking to find.
It does, however, go into detail on all key areas of trauma-informed care and its implementation. For your convenience, we split the document into its chapters and loosely organized the modules of our collected resources according to its organization. The SAMHSA document is often a good starting point for any of the below topics, but other resources may be more valuable to the task at hand.
The collected resources also contain examples of how our members are implementing trauma-informed care, training modules regarding trauma, bite-sized advice and trauma-informed strategies, forms and tools for screening and assessment of both clients and one’s organization, and media materials to facilitate discussion about trauma.
Overview of Resources
What is Trauma, and what does it mean to be Trauma-Informed? (Introductions & the Basics)
Awareness of Trauma
Impact of Trauma
Examples from TFA Members
Member Training Presentations
1. What is Trauma, and What Does it Mean to be Trauma-Informed?
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach: provides an excellent introductory overview of trauma and trauma-informed care including six key principles of trauma-informed care and ten domains for inquiry into developing a trauma-informed approach.
NCTSN Definition of Trauma-Informed Care: lists seven elements of service delivery that the National Child Traumatic Stress Network defines as Trauma-Informed Care.
Adverse Childhood Experiences Study: an overview of the seminal study that introduced an empirical understanding of Trauma and its impact in societal and health contexts. Includes a questionnaire to determine individual ACE score.
ACEStudy.org: in the download section of the website, you can access the original ACE study and other publications regarding its findings and implications.
Social Work Podcast: An Overview of Trauma-Informed Care: Interview with Nancy J. Smyth, Ph.D.: includes a striking personal example of the prevalence and significance of re-traumatization in social services and an excellent discussion about trauma-informed care in general.
Trauma Informed Care: A Socio-Cultural Perspective (SAMHSA Chapter 1): an excellent overview of Trauma-Informed Care, its goals, and how it fits into the context of service delivery.
Common vs. TIC views for In-Service Training: Frames, practically, what it means to be Trauma-Informed in service delivery.
Trauma Awareness (SAMHSA Chapter 2): examines characteristics and types of trauma and offers valuable advice to counselors on addressing trauma in service delivery.
Summary of Georgetown National TA Center webinar entitled “Healing from Trauma: Young Adult and Family Perspectives and Recommendations”: includes basic outline of five stages of trauma from a youth and family perspective with recommendations of what could help with each stage.
Understanding the Impact of Trauma (SAMHSA Chapter 3): discusses reactions to trauma which is applicable in understanding the impact of trauma as well as being more aware of behaviors that may result from trauma. Includes a detailed chart of Immediate and Delayed Reactions to Trauma, advice to counselors on such topics as working with clients who are self-injurious, and DSM-5 diagnostic criteria for ASD and PTSD.
TED Talk: How Childhood Trauma Affects Health Across a Lifetime: Includes a detailed overview of the Adverse Childhood Experiences study. Reinforces the importance of trauma screening and the idea that trauma may have health implications in terms of both mental AND physical health.
Childhood Trauma Leads to Brains Wired for Fear: Interview with Dr. Bessel van der Kolk: Dr. Bessel van der Kolk studies how the structure of the brain is changed after trauma. This 10 minute interview discusses trauma and how it affects the developing brain, specifically. Van der Kolk also mentions a study they did that found yoga to be an effective treatment for PTSD.
2. How the Teaching-Family Model is Already Trauma-Informed
SAMHSA Guiding Principles for Trauma-Informed Care aligned with Teaching-Family Elements: this one-page resource is an excellent starting point to understand and share with others how the Teaching-Family Model has always delivered trauma-informed care, well before the impact of trauma was empirically understood. The overlap between SAMHSA’s guiding principles and the Teaching-Family elements are striking and speak for themselves.
TFA Trauma-Informed Care Standard: original announcement of the adoption of a TFA standard for Trauma-Informed Care.
Examples from our Members Implementing Trauma-Informed Care
Trauma Informed Care Transition Analysis (Children’s Home of Cincinnati)
7 Essential Ingredients for Implementation of Trauma-Informed Care (Methodist Family Health)
Adjustments to Improve TIC: one agency’s Model-compatible adjustments to heighten focus on delivering trauma-informed care.
Trauma Informed Care Feedback Example: an example of Teaching-Family Model consultation feedback regarding an agency’s implementation of Trauma-Informed care.
Trauma Informed Care Presentation to Board: a presentation outline to a board of directors regarding changes focused on delivering trauma-informed care.
See also: Recovery Plan with Instructions and Sample (Catholic Charities Hawaii) in section #5.
See also: excerpt from VHBG Training Manual – Trauma-Informed Care (Virginia Home for Boys & Girls) in section #3, as well as VHBG’s Self-Care Plan in section #7.
See also:: several training presentations from our members in section #3.
3. Trauma Training Modules
Child Welfare Trauma Training Toolkit Trainer’s Guide: a comprehensive training guide developed by the National Child Traumatic Stress Network (NCTSN) with detailed lesson plans.
VHBG Training Manual – Trauma-Informed Care: easy to follow diagrams including a workflow of how VHBG provides trauma-informed care.
Trauma-Informed Care Training Presentations from our Members
Trauma Informed Care 2015 (Tenessee Family Solutions)
An Introduction to Trauma Informed Care (Methodist Home for Children)
Trauma-Informed Approaches (Hope Center for Children)
2015 Caregiver Presentation (Amy Davis, Teaching Family Model Development Manager)
Trauma Informed Care (Jessica Gregory, MSW – Virginia Home for Boys & Girls)
4. Client Screening and Assessment Tools
Screening and Assessment (SAMHSA Chapter 4): discusses proper time and setting for trauma screening and assessment, barriers and challenges to screening, choosing instruments, and cross-cultural contexts. Includes SLE Screening tool and PTSD checklist, as well as various valuable advice to counselors.
See also: SAMHSA Chapter 3 (in section #1).
UCLA PTSD Reaction Index: several of our members reported that they use this reaction index published by the National Child Traumatic Stress Network as a screening tool for trauma. This is packaged as a presentation but includes necessary forms and instructions for using them.
CANS-MH Form and Manual: other members reported they used the Child and Adolescent Needs and Strengths (CANS) Mental Health screening tool, a multi-purpose interviewing tool that addresses many facets of mental health including trauma.
Screening and Assessment Tools (SAMHSA): this appendix of the SAMHSA document offers a listing of other potential screening tools for trauma.
Peabody Treatment Progress Battery Youth Hope Assessment: four question measurement of resiliency.
CRAFFT Screening Questionnaire: an assessment questionnaire related specifically to drug and/or alcohol abuse.
Protective Factors Survey: a lengthier assessment for parents of children indicating potential traumas and safety environment.
5. Trauma-Specific Treatments and Planning
Clinical Issues Across Services (SAMHSA Chapter 5): discusses and describes specific services to provide (i.e. peer support and psycho-education), and strategies to create a trauma-informed environment including but not limited to identifying and managing triggers, building resilience, and establishing appropriate pacing and timing.
Trauma-Specific Services (SAMHSA Chapter 6): discusses delivery of services such as immediate interventions, CBT treatments for PTSD and trauma, as well as a mindfulness application to build resilience or mitigate reactions.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Implementation Manual: a comprehensive manual developed by NCTSN for the implementation, delivery, and maintenance of TF-CBT practices, a short-term treatment approach that can achieve results in as few as 12 sessions. Appendices include UCLA screening tools (PTSD Indexes, DSM-4) with scoring information, and an organizational readiness assessment tool.
Recovery Plan with Instructions and Sample (Catholic Charities Hawaii): a recovery planning form used after a “sentinel event” similar to the incident debrief guide below that outlines what happened, how the youth will react in the future, how the youth will make amends for what happened and what privileges the youth will have while adhering to the plan.
Self Care and Safety Plan: a form for organizing a self-care plan for counselors and a “safety” plan for youth experiencing behavioral issues due to traumatic triggers.
Incident Debrief Guide: a form and step-by-step workflow for dealing with behavioral crises potentially arising from trauma. Useful in identifying triggers.
SOAR Planning: a strengths-based treatment planning worksheet developed by NCTSN.
Coping Skills Plan: similar worksheet as the above safety plan; identifies triggers and individualizes response based as an agreement between youth and practitioner.
6. Organizational Implementation and Assessment
Trauma-Informed Organizations (SAMHSA Part 2, Chapter 1): describes a step-by-step strategy to implement trauma-informed care in an organization.
Trauma-Informed Organizational Toolkit for Homeless Services: a comprehensive resource for organizational self assessment of trauma informed care. The included guide recommends that all staff within an organization should complete the assessment, as it creates an understanding of what it means to be trauma-informed and why it is important. It also results in a more accurate, aggregate self-assessment. The included guide explains each criteria in detail for reference. A third section offers advice on creating organizational change.
USF Organizational Self Assessment: an organizational self-assessment regarding planning stages of implementation.
7. Personnel Issues – Recruitment, Retention, and Assessment
Building a Trauma-Informed Workforce (SAMHSA Part 2, Chapter 2): Discusses systems for hiring and training trauma-informed individuals. Includes a competency checklist, strategies to prevent secondary traumatization, and a compassion satisfaction scale (PRoQOL) which assesses on work-satisfaction, burnout, and secondary traumatic stress scales. Includes take-away advice on related subjects.
VHBG Training Manual – Self-Care Plan: a self-care plan outline for counselors relevant to avoiding secondary traumatization.
See also: Self Care and Safety Plan in section #5: an organizational form for self-care as a counselor attached to a similar form for youths in care.
The Role of Self-Care on Compassion Satisfaction, Burnout and Secondary Trauma Among Child Welfare Workers: discusses and outlines Trauma-Informed self-care and its effect on PROQoL factors.
8. Media to Facilitate Discussion
ReMoved Short Film: a dramatic short film depicting a traumatized girl going through the foster care system. Several members noted that they used this film to initiate discussion of trauma.
See also: TED Talk: How Childhood Trauma Affects Health Across a Lifetime in section #1: features an excellent discussion of the Adverse Childhood Experiences study.
See also: Social Work Podcast: An Overview of Trauma-Informed Care: Interview with Nancy J. Smyth, Ph.D. in section #1: begins with a striking personal example of the prevalence and significance of re-traumatization in social services. Could supply a jumping-off point for discussion without having to listen to the entire interview.
See also: Childhood Trauma Leads to Brains Wired for Fear: Interview with Dr. Bessel van der Kolk in section #1: a shorter (10 minute) audio segment that discusses how the developing brain is shaped by trauma.