Excerpt

Many individuals experience trauma during their lifetimes. Although many people exposed to trauma demonstrate few or no lingering symptoms, those individuals who have experienced repeated, chronic, or multiple traumas are more likely to exhibit pronounced symptoms and consequences, including substance abuse, mental illness, and health problems. Subsequently, trauma can significantly affect how an individual engages in major life areas as well as treatment.

This TIP provides evidence-based and best practice information for behavioral health service providers and administrators who want to work more effectively with people who have been exposed to acute and chronic traumas and/or are at risk of developing traumatic stress reactions. Using key trauma-informed principles, this TIP addresses trauma-related prevention, intervention, and treatment issues and strategies in behavioral health services. The content is adaptable across behavioral health settings that service individuals, families, and communities—placing emphasis on the importance of coordinating as well as integrating services.

Contents

• Consensus Panel
• KAP Expert Panel and Federal Government Participants
• What Is a TIP?
• Foreword
• How This TIP Is Organized
• Part 1. A Practical Guide for the Provision of Behavioral Health Services
  • Chapter 1. Trauma-Informed Care: A Sociocultural Perspective
    • Scope of the TIP
    • Intended Audience
    • Before You Begin
    • Structure of the TIP
    • What Is Trauma?
    • Trauma Matters in Behavioral Health Services
    • Trauma-Informed Intervention and Treatment Principles
    • As You Proceed
  • Chapter 2. Trauma Awareness
    • Types of Trauma
    • Characteristics of Trauma
    • Individual and Sociocultural Features
  • Chapter 3. Understanding the Impact of Trauma
    • Sequence of Trauma Reactions
    • Common Experiences and Responses to Trauma
    • Subthreshold Trauma-Related Symptoms
    • Specific Trauma-Related Psychological Disorders
    • Other Trauma-Related and Co-Occurring Disorders
  • Chapter 4. Screening and Assessment
    • Screening and Assessment
    • Barriers and Challenges to Trauma-Informed Screening and Assessment
    • Cross-Cultural Screening and Assessment
    • Choosing Instruments
    • Trauma-Informed Screening and Assessment
    • Concluding Note
  • Chapter 5. Clinical Issues Across Services
    • Trauma-Informed Prevention and Treatment Objectives
    • Treatment Issues
    • Making Referrals to Trauma-Specific Services
  • Chapter 6. Trauma-Specific Services
    • Introduction
    • Trauma-Specific Treatment Models
    • Integrated Models for Trauma
    • Emerging Interventions
    • Concluding Note
• Part 2. An Implementation Guide for Behavioral Health Program Administrators
  • Chapter 1. Trauma-Informed Organizations
    • Strategy #1: Show Organizational and Administrative Commitment to TIC
    • Strategy #2: Use Trauma-Informed Principles in Strategic Planning
    • Strategy #3: Review and Update Vision, Mission, and Value Statements
    • Strategy #4: Assign a Key Staff Member To Facilitate Change
    • Strategy #5: Create a Trauma-Informed Oversight Committee
    • Strategy #6: Conduct an Organizational Self-Assessment of Trauma-Informed Services
    • Strategy #7: Develop an Implementation Plan
    • Strategy #8: Develop Policies and Procedures To Ensure Trauma-Informed Practices and To Prevent Retraumatization
    • Strategy #9: Develop a Disaster Plan
    • Strategy #10: Incorporate Universal Routine Screenings
    • Strategy #11: Apply Culturally Responsive Principles
    • Strategy #12: Use Science-Based Knowledge
    • Strategy #13: Create a Peer-Support Environment
    • Strategy #14: Obtain Ongoing Feedback and Evaluations
    • Strategy #15: Change the Environment To Increase Safety
    • Strategy #16: Develop Trauma-Informed Collaborations
  • Chapter 2. Building a Trauma-Informed Workforce
    • Introduction
    • Workforce Recruitment, Hiring, and Retention
    • Training in TIC
    • Trauma-Informed Counselor Competencies
    • Counselor Responsibilities and Ethics
    • Clinical Supervision and Consultation
    • Secondary Traumatization
    • Counselor Self-Care
• Appendix A Bibliography
• Appendix B Trauma Resource List
• Appendix C Historical Account of Trauma
• Appendix D Screening and Assessment Instruments
• Appendix E Consumer Materials
• Appendix F Organizational Assessment for Trauma-Informed Care
• Appendix G SAMHSA Resource Panel
• Appendix H Field Reviewers
• Appendix I Cultural Competency and Diversity Network Participants
• Appendix J Acknowledgments
• Part 3
  • Section 1 A Review of the Literature
  • Section 2 Links to Select Abstracts
  • Section 3 General Bibliography

This publication was produced under contract numbers 270-99-7072, 270-04-7049, and 270-09-0307 by the Knowledge Application Program (KAP), a Joint Venture of The CDM Group, Inc., and JBS International, Inc., for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). Andrea Kopstein, Ph.D., M.P.H., Karl D. White, Ed.D., and Christina Currier served as the Contracting Officer’s Representatives.

Suggested citation:

Substance Abuse and Mental Health Services Administration. Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

The views, opinions, and content expressed herein are the views of the consensus panel members and do not necessarily reflect the official position of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for the instruments or resources described are intended or should be inferred. The guidelines presented should not be considered substitutes for individualized client care and treatment decisions.