Transcript Document 7148039

Creating Trauma-Informed
Systems to Systems Initiatives for
Women, Children and Families
2008 Early Childhood Comprehensive
Systems Partners Meeting
March 14, 2008
Kath Schilling M.Ed., CAS, LADC I
Trauma Integration Specialist
Director – Project WAVE
Institute for Health and Recovery
http://www.healthrecovery.org
Institute for Health and Recovery
Mission Statement
The Institute for Health and Recovery is a statewide service,
research, policy and program development agency. IHR’s
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
Institute for Health and Recovery
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
Institute for Health and Recovery
IHR Services/Programs
Systems Change
National and Statewide Systems & Program Development
HIV Prevention/Education
Women RISE (Risk Identification, Strategies & Empowerment)
Homelessness
Project RISE (Recovery through Information, Support & Engagement)
FLT Project (Families Living Together)
Central Access to Residential
Treatment & Housing
Family Residential Treatment Programs
Sober Living Programs
Community Housing Programs
Trauma
Trauma Integration Services
Project WAVE (Women Achieving Vital Empowerment)
Shattuck/ hopeFound – Project Genesis
Department of Corrections
Department of Mental Health
Tobacco Education &
Treatment
TAPE Project (Tobacco, Addictions, Policy & Education)
MTCP Smoke-Free Families Initiative
Youth
Youth Central Intake & Care Coordination
SCAP (Suffolk County Adolescent Project)
RAYS (Regional Access to Youth Services)
SAFE (Strengthening Adolescents ~ Family Empowerment)
Family & Children
Parenting & Child Development
Nurturing Program – Curriculum Development & Distribution
Child Welfare Engagement Project
Family Recovery Project
Screening & Early
Identification
SBIRT – Community Health Centers
CAPTA Project
FASD Projects
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• 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)
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• IHR currently participates in several state-wide
trauma-related commissions and policy
committees
– Governor’s Commission on Correction Reform
– Governor’s 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
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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
Institute for Health and Recovery
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 group’s decisions
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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
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DPH/BSAS Trauma Integration
Revised Change Plan
• Prioritized women, and women and children’s
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
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• 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.
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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 Children’s sub-study
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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-thetrainer model
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