Transforming Your Organization With a Trauma-Informed Approach

Even when organizations don’t directly engage with trauma, they are touched by it. The effects of trauma are present when employees call in sick. They are present when tensions build between staff and clients. And they are present when high turnover occurs and stretches budgets.

Trauma-informed organizations change these painful patterns by acknowledging both the far-reaching effects of trauma and the many paths to heal it, becoming more effective in the process.

Why become a trauma-informed organization?

Trauma is embedded in human services organizations because it is extremely common. Almost 70% of adults in the U.S. have experienced some kind of traumatic event in their lifetime.

Further, many of the immediate struggles that lead clients to work with your agency may also be rooted in trauma. Research shows that, compared with those without trauma, people with one adverse childhood experience are almost twice as likely to attempt suicide, use an illicit drug, or report COPD. The chances of these negative outcomes — and many others — rise with each additional adverse childhood experience.

Rates of trauma are even higher among those working in the human services field than in the general population. Further, about half of mental health professionals report moderate to high burnout or exhaustion from work-related stress. Burnout among human services staff has been linked to outcomes that harm not only employees, but the organization as a whole. For example:

• Burned out staff can develop negative feelings toward the population being served. These feelings impact client experiences, client outcomes, and organizational effectiveness.
• Burnout leads to frequent sick leave and absences, disrupting services and productivity.
• High rates of turnover within the field are also linked to burnout. Turnover translates to additional costs for recruiting, hiring, and training new employees, and it severs client-provider relationships.

High turnover is particularly hard on clients because a strong therapeutic alliance with a counselor or other clinician is one of the best predictors of an individual’s ability to recover from trauma. Turnover among staff not only creates disruptions for persons served, affecting their feelings of safety and trust, it is costly for the organization as a whole. Estimates of the cost of replacing employees range from 50% to 200% of their annual salary.

With support, you can meet the challenges of trauma and burnout with systemic change that reduces costs and improves client outcomes. In other words, building a trauma-informed organization is worth it.

Foundations of healing organizations

Because trauma affects the organization as a whole, not just the individuals within it, an effective response to trauma takes place at the organizational level.

Trauma-informed care is rooted in six principles. These principles, which providers may be familiar with applying with the individuals they serve, can also be implemented by leaders on an organizational scale. Here’s how the six principles of trauma-informed care apply to systemwide change.

Safety

• Ensure the physical and emotional work environment feels safe by implementing policies and procedures to proactively prevent stalking, harassment, and violence.
• As part of the onboarding process, train staff on how the therapeutic relationship can trigger clients and mimic the dynamics of abuse, and how to avoid this through healthy boundaries. Training topics can include the basics of trauma-informed care, crisis prevention and intervention, and abuse and exploitation prevention.

Trustworthiness and transparency

• Build supervisory relationships based on trust by training supervisors on trauma-informed supervision.
• Improve retention to develop strong relationships between the organization and staff as well as between staff and clients. Retention comes from offering tangible support like competitive wages and benefits, manageable caseloads, and ongoing professional development. Implementing these changes may mean making other structural changes like reevaluating funding through a trauma-informed lens.

Peer support

• Consider hiring peer professionals to leverage the power of connection in the process of healing from trauma.
• Create safe, nonjudgmental spaces such as case conferences for staff to exchange feedback and emotional support.

Collaboration and mutuality

• Engage all stakeholders, including clients and all staff, in the process of implementing trauma-informed care. Seek their input at every step of the process.
• Train staff to promote collaboration at every level of the organization — between managers and supervisees, between therapists and clients, and between the organization and external stakeholders.

Empowerment, voice, and choice

• Recruit people with trauma-informed perspectives by reaching out to organizations of trauma survivors. Reaching out to survivors also helps to break down the false binary of traumatized clients vs. expert clinicians, and it builds a culture that normalizes coping with trauma.
• Empower staff members to set goals for their own professional development, and provide support to help them meet those goals.

Cultural, historical, and gender issues

• As part of ongoing program evaluation, survey the demographics of the clients you serve, and seek to hire those with the same demographics.
• Develop a client or community oversight board that ensures your organization meets the needs of those you serve.

How to implement trauma-informed system change

Trauma-informed change within an organization must be guided by its leaders. According to the Substance Abuse and Mental Health Services Administration, “desirable organizational change doesn’t occur by accident. It comes from steadfast leadership, a convincing message that change is necessary and beneficial for staff and consumers, and resources that support change.”

The first concrete step to becoming trauma-informed is a full organizational assessment. Trauma-informed organizational assessment tools can help you determine where the organization falls short of trauma-informed principles and integrate these principles into strategic planning, visioning, and evaluation.

Evaluating the implementation of trauma-informed values is an iterative process with no end point. Throughout it, organizational leaders need to act as safeguards, honoring the well-being of their team in the face of demanding work and often an environment of scarcity.

This means holding boundaries. It may mean seeing fewer clients or closing the office altogether for a day of strategic planning that everyone can be involved in. In short, it means changing our understanding of the work at hand from meeting clients’ immediate needs to creating transformative cultures of care.