Creating TraumaInformed Systems to Systems Initiatives for Women, Children and Families

1
Creating Trauma-Informed Systems to Systems
Initiatives for Women, Children and Families
2008 Early Childhood Comprehensive Systems
Partners MeetingMarch 14, 2008

• Kath Schilling M.Ed., CAS, LADC I
• Trauma Integration Specialist
• Director Project WAVE
• Institute for Health and Recovery
• www.healthrecovery.org

2
Mission Statement

• The Institute for Health and Recovery is a
  statewide service, research, policy and program
  development agency. IHRs mission is to develop
  a comprehensive continuum of care for
  individuals, youth and families affected by
  alcohol, tobacco, other drug use, mental health
  problems violence/trauma.

• Our work is based on principles of
• Establishing collaborative models of service
  delivery
• Integrating gender-specific, trauma-informed and
  relational/cultural models of prevention,
  intervention and treatment
• Fostering family-centered, strengths-based
  approaches
• Advancing multicultural competency with the
  service delivery system

3

• We provide
• Capacity building with existing agencies and
  systems on numerous issues
• Direct care client services grounded in Evidence
  Based Practices
• On-site Group interventions facilitated in a
  train-the-trainer model
• Staff training and technical assistance

4
IHR Services/Programs

• Systems Change
• HIV Prevention/Education
• Homelessness
• Central Access to Residential Treatment Housing
• Trauma
• Tobacco Education Treatment
• Youth

National and Statewide Systems Program
Development Women RISE (Risk Identification,
Strategies Empowerment) Project RISE (Recovery
through Information, Support Engagement) FLT
Project (Families Living Together) Family
Residential Treatment Programs Sober Living
Programs Community Housing Programs Trauma
Integration Services Project WAVE (Women
Achieving Vital Empowerment) Shattuck/ hopeFound
Project Genesis Department of
Corrections Department of Mental Health TAPE
Project (Tobacco, Addictions, Policy
Education) MTCP Smoke-Free Families
Initiative Youth Central Intake Care
Coordination SCAP (Suffolk County Adolescent
Project) RAYS (Regional Access to Youth
Services) SAFE (Strengthening Adolescents
Family Empowerment) Parenting Child
Development Nurturing Program Curriculum
Development Distribution Child Welfare
Engagement Project Family Recovery Project SBIRT
Community Health Centers CAPTA Project FASD
Projects
5

• IHR works across state systems in Massachusetts
  to integrate trauma-informed and trauma specific
  practices
• The 3 main systems IHR currently works with are
• Department of Public Health (DPH) /
• Bureau of Substance Abuse Services (BSAS)
• Department of Mental Health (DMH)
• Department of Corrections (DOC)

6

• IHR currently participates in several state-wide
  trauma-related commissions and policy committees
• Governors Commission on Correction Reform
• Governors Commission on Sexual and Domestic
  Violence
• DPH/DMH Emergency Room Access for People with
  Behavior Health Needs Work Group
• DMH Restraint and Seclusion Advisory Committee

7
Trauma Creating a Paradigm Shift

• Shift Towards trauma-informed, trauma-specific
  family treatment which includes resilience and
  strengths based prevention and treatment services
  for children
• Incorporating Services for Children Into
  Substance Abuse Treatment Paradigm Shifts and
  Lessons Learned
• Beth Reed, Norma Finkelstein, Lisa Russell,
  Vivian Brown, Nancy Van de Mark

8
System Change Strategies

• Build connections at multiple levels with
  information flowing between them
• Bring together diverse constituencies affected by
  proposed changes
• Openly and respectfully discuss differences
• Use relational skills to create collaborative and
  mutually empowering environment in which all
  members have impact on groups decisions

9
Department of Public Health / Bureau of
Substance Abuse Services (DPH/BSAS)

• Goal All substance abuse treatment programs in
  MA will provide trauma-informed care
• 2002 Provision of trauma-informed care included
  in terms and conditions of all contracts
• 2003 Presented results of WCDVS across state
• 2004-2006
• Conducted regional SA/DV summit meetings
• Provided trainings on trauma-informed care twice
  a year opened to state-wide audiences
• NE Regional Conference on Integrating SA, DV, and
  MH (SAMHSA)
• Trauma needs assessment with sample of SUD
  programs
• Offered training on trauma-informed care and
  trauma-specific interventions to SUD programs
  upon request

10
DPH/BSAS Trauma Integration Revised Change Plan

• Prioritized women, and women and childrens
  residential treatment programs throughout MA
• Held initial state-wide meetings to familiarize
  SUD programs with family centered trauma
  initiative
• Applied change strategies learned from previous
  projects including
• Identifying champion for change
• Forming change team
• Team identifies targets for change
• Gathering data before and after change is
  implemented

11

• Implementation of Revised Strategy
• Agency submits letter indicating interest
• Completes Trauma-Integration self-assessment
• Chooses champion individual at supervisory
  level responsible for implementing change
• Staff, including supervisors, attend four hours
  of trauma training on site
• Champion meets with staff (team) to begin
  trauma-informed planning
• Consultation provided for plan development as
  necessary
• After plan, may request additional training
  and/or TA
• Support provided for plan implementation over
  following six months, including training in
  trauma specific groups
• Program repeats assessment at end of consultation
  period.

12
Women, Co-Occurring Disorders and Violence Study
(WCDVS)

• Three grants in Massachusetts (WELL Project)
• IHR put considerable focus on state-level systems
  change
• State Leadership Council
• Local Leadership Councils
• Organizational Assessment Trauma Tool-Kit
• Included WELL Child Childrens sub-study

13
Project WAVE

• SAMHSA/CSAT Targeted Capacity Expansion grant
• Targeted women and their children affected by
  SUDs seeking services for, or fleeing from,
  interpersonal violence
• Worked in partnership with the primary SUD agency
  on Cape Cod, two domestic violence agencies and
  Barnstable County
• Services delivered at two domestic violence
  agencies
• - SUD/Co-occurring disorder screening,
  outreach, engagement, intervention
  and care coordination
• - Seeking Safety, Nurturing Program, WELL Child
• groups co-facilitated with SUD/DV staff in
  train-the- trainer model