Corinne Henderson is a psychotherapist and a Senior Policy Advisor at MHCC. She spoke to us about ‘Your trauma, my trauma’: creating trauma-informed working environments'. MHCC and ASCA have worked together since 2010 to advocate for a Policy Framework that involves change at every level of an organisation’s culture to embed trauma informed care and practice (TICP), including: Governance, management and leadership; policies and structures; consumer and carer/family participation; direct service delivery and programs; information and education; outcomes and evaluation and a healthy and effective workforce. It was highlighted that a cultural shift is also necessary across all service systems including mental health and human services because mental health is ‘everybody’s business’. This is particularly important in the current dynamic environment such as changes in funding, the NDIS, Partners in Recovery and other innovative initiatives.
Corinne argued that TICP needs to be integrated and embedded within the recovery approach. As we work to minimise barriers to recovery, we also need to reduce the possibility of re-traumatisation. Vicarious trauma, resulting from empathic engagement with trauma survivors and their trauma material, combined with a commitment or responsibility to help them, must also be acknowledged. There is a real chance for traumatisation and re-traumatisation for both consumers and staff who may be triggered by ongoing exposure. Engaging with consumers with lived experience of trauma is likely to create stressors that deeply affect administrators, practitioners and support staff.
MHCC has been working on a Trauma Informed Care and Practice Organisational Tool (TICPOT) which is one element of a broader national strategic direction. TICPOT is targeted at CMOs across Mental Health and Human services and includes a how to guide to: assess current processes and practices, develop an organisational change strategy, embed TICP principles into every aspect of an organisation, and build and sustain quality improvement. It will include guidelines, an audit tool, assessment tools, templates, checklists and information to assist organisations to build trauma informed policies and practices, and embed a sustainable trauma informed culture.
Corinne explained that all organisations must review their organisational structures and staff support structures including recruitment and retention, workforce development and training and supervision. Administrative policy must involve: knowledge and understanding of trauma; responding appropriately to trauma and the effect of trauma; workforce education and training; collaboration with consumers, carers, policy makers, managers and frontline staff. Organisations must foster healthy and effective workforces and provide education and training particularly in: assessment and screening; understanding unusual or difficult behaviors and adaptation arising from trauma; boundaries and trauma dynamics; establishing safety; avoidance of re-traumatisation; and the relationship between trauma and vicarious trauma. The importance of cultural competency was also highlighted, as was the importance of supervision to support, develop and sustain practice. Wherever possible training and programs should be multi service and multidisciplinary, and include consumers and carers as trainers to ensure that learning is grounded in lived experience.
Training in the TICPOT is due to roll out from April 2014, and MHCC will also provide a consultancy service to work with an organisation over a period of time to assist them to become trauma informed. TICP training is available through the MHCC registered training organisation.
MCHH Guidelines on Trauma Informed Care and Practice