Trauma Informed Supervision

FACIL ITATED BY

MARY WOOD S , BC - RN, LCS , LAD C, MS H S

S ENIOR CONS ULTANT

C4 CONS ULTING

J ONATH AN P. D E CARLO, CAC I I I

CEO, C4 CONS ULTING

ASAM Disclosure of Relevant Financial Relationships

Date of Activity: August 12th, 2020

Name Commercial

Interests

Relevant

Financial

Relationships:

What Was

Received

Relevant

Financial

Relationships:

For What Role

No Relevant

Financial

Relationships

with Any

Commercial

Interests

Mary Woods N/A N/A N/A None

Jonathan De Carlo N/A N/A N/A None

BreatheWE INVITE YOU TO JOIN US

IN A GROUNDING EXERCISE…

3

Agenda

• Discuss the role of supervision in producing a Trauma Informed environment

• Identify three ways an organization can create a Trauma Informed Supervision practice.

• Examine best practices & solution to create a sustainable Trauma Informed workplace.

• Interactive Discussion – submit your considerations in the Q&A

Staf

f

Trauma

The Road paved with good intentions

Challenges & Opportunities

§ Organizational Need Awareness

§ Staff Need Awareness

§ Client Need Awareness

Trauma Informed Care

Safety - Ensuring physical & emotional safety for theOrganization, Staffs, Participants, & Families.

Trustworthiness & Transparency - Transparency to build trust inrelationships; Making tasks clear & Maintaining appropriateboundaries.

Peer Support - Key to start building trust, establishing safety, &empowerment through peer to peer engagement.

Collaboration - Maximizing collaboration & sharing of powerwith participants.

7

Trauma Informed Care

Empowerment, Voice, & Choice - Prioritizing participantsempowerment & skill–building, as well as prioritizing participantchoice & control.

Cultural Humility - care that differs from cultural competence, bycentering on an individual's cultural experience as the reference,honoring & attending to the individual's cultural context &influences in their care.

Mutual Responsibility - Each person is responsible for their part inthe relationship & for their own behavior.

Compassion - Looking at the entirety of the person including theirexperiences and environments rather than being judgmental &dismissive.

8

Core Principle Applications For Staff Support:

Safety – Critical Incident Debriefing & Other Protocols

Trustworthiness & Transparency – Ongoing communication & clear practices

Choice – staff are involved in decision making

Collaboration – staff participate in identifying challenges & engaging solutions

Empowerment – staff are encouraged to grow & provide feedback

Cultural Humility – remaining teachable & maintaining conscious context

Mutual Responsibility – “when wrong promptly admit it”

Compassion – seeking to understand rather than assume or judge

Trauma Impacts & Self Care

Self Care Opportunities:

Assessment

▪ Work/life balance & resource utilization

Self Care Planning▪ Comprehensive Self-Care Plan

Integrated Supervision

▪ Administrative & Clinical

Primary Trauma

Secondary Trauma/Vicarious Trauma

Compassion & Empathy Fatigue

▪ Emotional Exhaustion

▪ Compassion Satisfaction

Vicarious Trauma• Vicarious trauma (VT), the exposure to the trauma experiences of others, is an

occupational challenge for the fields of victim services, emergency medicalservices, fire services, law enforcement, and others

• Working with victims of violence and trauma changes the worldview ofresponders and puts individuals and organizations at risk for a range ofnegative consequences

• A vicarious trauma-informed organization recognizes these challenges andproactively addresses the impact of vicarious trauma through policies,procedures, practices, and programs

For more information on Vicarious Trauma and its impacts: Vicarious Trauma Toolkit https://vtt.ovc.ojp.gov/about-the-toolkit.

NAADAC Ethical Principles

PRINCIPLE III: PROFESSIONAL RESPONSIBILITIES & WORKPLACE STANDARDSIntegrity:

Addiction Professionals shall conduct themselves with integrity. Providers aspire to maintain integrity in

their professional & personal relationships & activities. Regardless of medium, Providers shall

communicate to clients, peers, and the public honestly, accurately, & appropriately.

PRINCIPLE VII: SUPERVISION AND CONSULTATIONImpairment:

Supervisees, including interns and students, shall monitor themselves for signs physical, psychological,

&/or emotional impairment. Supervisees, including interns and students, shall seek supervision &

refrain from providing professional services while impaired. Supervisees, interns & students shall notify

their institutional program of the impairment & shall seek appropriate guidance & assistance.

NAADAC Code of Ethics: www.naadac.org.

NAADAC Ethical Considerations

White WL. 1993.

Loyalty:

The responsibility to not abandon those with whom you work

Diligence:

To work hard in the chosen profession, to be mindful, careful & thorough in the services delivered

Non-malfeasance:

Do no harm to the interests of the client

Supervision

NAADAC Code of Ethics. www.naadac.org .

Addiction Professionals, acting in the role of Supervisor or Consultant, shall take reasonable steps to ensure that they have appropriate resources and competencies

when providing supervisory or consultation services. Supervisors or consultants shall provide appropriate referrals to resources when requested or needed.

Addiction Professionals offering supervisory or consultation services shall have an obligation to review with the consultee/supervisee, in writing and verbally, the rights

and responsibilities of both the Supervisory/Consultant and supervisee/consultee. Providers shall inform all parties involved about the purpose of the services to be

provided, costs, risks and benefits, and the limits of confidentiality.

Trauma Informed Supervision Tools

15

Professional Quality Of Life Scale (ProQOL 5)▪ Self Assessment with a Likert Scale

▪ Compassion & Empathy Fatigue

▪ Compassion Satisfaction

Reflective Supervision ▪ Relationally driven

▪ Developmentally appropriate

▪ Culturally responsive

▪ Mitigates vicarious trauma & decreases staff turnover

Integrate TIC Principles into existing supervision practices

PROQOL MEASURE; HELLER SS, GILKERSON L. 2009.

Integrating Trauma Informed Supervision

Acknowledges➢ the prevalence of trauma

Understands➢ how it affects all individuals

involved with the organization

Resists➢ re-traumatization

Acts➢ by putting Trauma Informed

Care knowledge into practice

16

✓ Interview assess for trauma informedknowledge & skill

✓ Sharing job updated description

✓ There are opportunities for applicants toaddress emotional & physical safetyconcerns regarding the job & theenvironment

✓ Prolonged orientation (investment in staff)

✓ Orientation schedule that gets done

✓ Initial expectations are clearlycommunicated between employee &supervisor

✓ The onboarding process includes personal& agency-wide safety measures &procedures

✓ Employee transitions clearly & consistentlycommunicated in the entire organization ina timely manner with dignity, respect, &safety

Trauma Informed HR

17

Trauma Informed Organizational ToolsTrauma-Informed Organizational Capacity Scale (TIC

Scale)

Includes (35) items across (5) domains:

▪ Build trauma-Informed knowledge & skills

▪ Establish trusting relationships

▪ Respect service users

▪ Foster trauma-informed service delivery

▪ Promote trauma-informed procedures & policies

Attitudes Related to Trauma-Informed Care

(ARTIC) Scale

▪ The first psychometrically valid measure of TIC published in the peer reviewed literature.

▪ The ARTIC measures the favorable or unfavorable attitudes of service providers toward TIC.

▪ Offers (3) different depths based on organization need (45, 35,10)

▪ Helps understand current attitudes & Opportunities for change & growth

18

TIC Integration

Organizational Strategies for Attunement

Leadership & Mission

Management & Supervision

Employee Empowerment & Work Environment

Training & Professional Development

Staff Health & Wellness

19

Planning TIC Supervision

20

Baseline Organizational Health

▪ Assessing current supervision systems

▪ Identify - Discuss- Solve

▪ Integrating Opportunities

Developing an Organizational Health Plan

▪ What works best for your organization?

▪ Integrative Approach

▪ Prevention & Maintenance

▪ Realistic & Achievable

Trauma Informed Care

21

Considerations &

Discussion

References & Additional Resources. ARTIC Scale. (n.d.). Retrieved March 16, 2020, from https://traumaticstressinstitute.org/the-artic-scale/

Dilley, S. (n.d.). Supporting the supporter: vicarious trauma and support needs webinar report. Retrieved May 12, 2020, from http://www.suddendeath.org/uncategorised/222-supporting-the-supporter-vicarious-trauma-and-support-needs-webinar-report

Heller, S. S., & Gilkerson, L. (2009). A practical guide to reflective supervision. Washington, D.C.: Zero to Three.

ProQOL Measure. (n.d.). Retrieved March 3, 2020, from https://www.proqol.org/ProQol_Test.html

Trauma-Informed Organizational Capacity Scale (TIC Scale). (n.d.). Retrieved March 15, 2020, from https://www.air.org/sites/default/files/trauma-informed-organizational-capacity-scale.pdf

NAADAC Code of Ethics - NAADAC: The Association for Addiction Professionals NCC AP ... (n.d.). Retrieved May 14, 2020, from https://www.naadac.org/assets/2416/naadac-code-of-ethics-033117.pdf

NCBH (2019) CHECKLIST FOR TRAUMA-INFORMED HUMAN RESOURCES PRACTICES. (n.d.). Retrieved May 16, 2020, from https://www.thenationalcouncil.org/wp-content/uploads/2019/11/Checklist-for-Trauma-Informed-Human-Resources-Practices.pdf

Trauma-Informed Organizational Capacity Scale (TIC Scale). (n.d.). Retrieved March 15, 2020, from https://www.air.org/sites/default/files/trauma-informed-organizational-capacity-scale.pdf

Vicarious Trauma Toolkit: About the Toolkit. (n.d.). Retrieved May 13, 2020, from https://vtt.ovc.ojp.gov/about-the-toolkit

White, W. L. (1993). Critical incidents: ethical issues in substance abuse prevention and treatment. Bloomington, IL: Lighthouse Training Institute.

TIP 57: Trauma-Informed Care in Behavioral Health Services. https://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816

24