Imagine sitting in a parking lot, drumming up all your courage just to walk into a behavioral health center. You have never seen a counselor before, and you are very nervous. You haven’t had a good night’s sleep for weeks. You have nightmares, seem to always be ‘on edge’ and anger easily. You wonder if the people inside are nice and if the social worker will be helpful.
After what seems like an eternity, you walk through the front door. You enter a large, mostly empty and gloomy waiting room. The front desk is surrounded by walls with a sliding plexiglass window separating the receptionist from the waiting room. The receptionist greets you with a curt hello. They do not look away from the computer, but give you an instruction to place your name on the sign-in sheet and take a seat. You hear someone loudly complaining about their busy schedule and hoping that at least one client does not show up so they can get some paperwork finished. You wonder if that is the person you will be seeing. Your palms are clammy, and your heart is racing. You decide to skip the appointment and leave.
Now think about your organization. How do clients experience your waiting room, reception area, staff interactions? Why is this experience important to consider?
The cultural shift
Anyone can experience trauma. According to the Adverse Childhood Experiences Study by Vincent Felitti, M.D., and Robert Anda, M.D., approximately 75% of the population has experienced at least one traumatic event in their lives.
Service organizations have the potential to retraumatize individuals, and being trauma-informed does not mean just displaying competence in treating the symptoms of trauma. Trauma-informed care is about an organizational commitment to provide services that are welcoming, compassionate and genuine. It is about ‘walking’ in the shoes of an individual seeking services to begin to understand how they may experience your organization. It is about the environmental elements of the building, waiting rooms and offices – are the rooms painted with warm colors? Are there inspiring messages/décor around?
Using a trauma-informed lens means shifting your focus from viewing trauma as an injury (i.e., “what is wrong with you?”) to empathizing with the the traumatic experience and its effects on persons served (i.e., “what has happened to you?” “What have you experienced?”). For many organizations, this can represent a shift in culture and values. It can also represent a challenge for the leaders within the organization.
Some concrete first steps your organization can take to be more trauma-informed are:
- Ensuring that ALL staff understand trauma and its impact on individuals and communities. This can be achieved through trainings, supervision and staff meetings.
- A commitment to open communication and the use of a strengths-based perspective.
- Recognizing the signs and symptoms of trauma in all individuals, e.g., clients and staff.
- Integrating all the knowledge gained into policies, procedures, practices and interactions. This can include changes such as universal screening for history of trauma and a review of all organizational practices to ensure that they are respectful, safe and flexible.
Little things make a big impact
Now imagine walking through a front door. You enter a small waiting room painted in a bright color. There are positive affirmations hung on the walls. As you walk up to the front desk, you are greeted with a warm hello as the receptionist takes the time to stand up and speak to you and to explain the sign-in process and the next steps. You overhear a conversation between two coworkers as they make changes to an overbooked schedule.
You sign in and take a seat. You are still nervous but also feel that you have come to the right place. The people seem nice and professional and there is a calmness that is difficult to describe. You feel more hopeful than you have felt in weeks.
The second scenario is one that all organizations aspire to; it will engage clients, have a positive impact on clinical outcomes and improve the wellness of your organization.