How to Create Trauma-informed Systems of Care within Organizations

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By Seanna Crosbie, LCSW

Important to Know:

Organizations should…

  • Adopt universal trauma screening for clients.
  • Advocate for “no seclusion/ no restraint” policies
  • Use trauma-informed indicators that include safety, collaboration, cultural inclusivity, empowerment, and choice.

What is meant by “trauma-informed”?  The term is often misunderstood, even within the clinical world.  Some social workers believe that using evidence-based treatments with trauma survivors meets the criteria for being trauma-informed.  However, if a social worker is employed within an organization, the provision of evidenced-based treatments is only one small aspect of being truly trauma-informed.

Consider this: we have systems that were created to help children and adults at some of the most vulnerable times in their lives.  But, some of these systems have policies and procedures that can cause harm in our efforts to help children and adults.  In fact, some of these systems and organizations revictimize clients, often unintentionally, as well as increase the risk of secondary trauma in social workers.  So, what does it mean, on an organizational level, to be trauma-informed?  I encourage social workers to consider the definition provided by Substance Abuse and Mental Health Services Administration:

“…Every part of its organization, management, and service delivery system is assessed and potentially modified to include a basic understanding of how trauma affects the life of an individual seeking services. Trauma-informed organizations…are based on an understanding of the vulnerabilities or triggers of trauma survivors …so that these services and programs can be more supportive and avoid re-traumatization. “

Trauma-informed organizations utilize trauma screening for clients, ideally universal, to determine who may need trauma intervention.  This means that organizations who are not focused on serving victims still need to ask about trauma and recognize the role trauma may have in driving thoughts and behaviors.  For example, home visitors, doctors, and teachers are not providing services specifically related to trauma, but they need to ensure that they recognize when a trauma survivor may need intervention.

Trauma-informed organizations adopt “no seclusion/no restraint” policies since physical restraints can be triggering and/or cause revictimization.  Additionally, organizations evaluate clients and staff on trauma-informed indicators including safety, collaboration, cultural inclusivity, empowerment, and choice.

Everyone within the organization is trained on trauma, including clinical and administrative staff, volunteers and board members. In a trauma-informed organization, clients are greeted by staff who are knowledgeable about trauma and honor a survivor’s need for safety and trust when reaching out for services. Additionally, trauma-informed organizations are mindful of the impact of trauma work on staff and implement strategies to reduce the risk of secondary trauma.

When we, as social workers, think of trauma-informed care, it is important for us to include the system-level change within organizations.  After all, social workers are trained not only to make micro-level interventions such as therapy but to also address systems in which we serve our clients.  The ultimate goal is for our clients can heal from trauma in a compassionate system, and social workers are employed in organizations that intentionally support their work and wellbeing too.

Return to Clinician’s Corner

More Articles in This Issue:

Adverse Childhood Experiences (ACE) Study: The evidence behind what we know

 Social Workers Can Collaborate with Physicians to Create Aces-informed Healthcare

How to Administer a Trauma Screening Using the ACEs Questionnaire

ACE’s In Foster Care: Rethinking trauma-informed care

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