Sad businesswomanThis post is part of this month’s focus on how to sustain trauma informed care. It describes indicators that a trauma informed approach to treatment may be eroding in a team, factors that may be contributing to that erosion, and actions to take to restore compassionate and effective treatment.

Signs that trauma informed care is eroding:

  1. Grounding are more frequent and longer
  2. Restorative tasks begin to look like punishments
  3. People start talking about clients “getting away with” things
  4. Behaviors are described as deliberate and attempts to get at staff
  5. Team members are not trying to understand behavior or figure out how it is adaptive for the client. Instead they focus on how to change it.
  6. Divisions start between team members, there is more blaming of each other
  7. Team members start asking for more rules to govern their interactions
  8. Staff stay in offices and interact less with clients
  9. The words “consistency” and “structure” are used more than usual
  10. Activities begin to have to be earned, and clients are not allowed to attend fun events or arts or recreation activities due to recent problem behaviors
  11. Clients are described in pejorative terms such as “manipulative” and “borderline”
  12. People say things like “she wants to be that way”
  13. People make hopeless and cynical statements
  14. Less laughter and fun
  15. People are talking about returning to points and levels or adding more severe consequences

What to look for as contributing factors:

  1. Client turnover
  2. Staff vacancies and over work of remaining staff
  3. A new, more severe type of client
  4. Administration being less available
  5. Any particular staff having severe problems
  6. Personal issues and losses
  7. New reporting or oversight demands
  8. Difficult incidents and/or bad discharges

What to do:

  1. Talk about it
  2. Acknowledge changes and stressors
  3. Make a plan to solve particular issues ( I.e. Hiring) with deadlines and responsible people and stick to it
  4. Discuss vicarious traumatization (VT), do VT exercises, acknowledge difficulty of work
  5. Provide opportunities to reflect on successes
  6. Arrange team building retreats and fun events
  7. Increase staff recognition
  8. Emphasize the mission and the importance of the work
  9. Increase administrative presence
  10. Remember past successful clients, and how they started
  11. Do not get sucked into making more rules for clients or staff- look beneath to the meaning

Let me know your thoughts- have you had any experiences with observing the erosion of trauma-informed thinking in your teams? What has been helpful?

 

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