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…
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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.
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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.
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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
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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
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✓ 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
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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
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TIC Integration
Organizational Strategies for Attunement
Leadership & Mission
Management & Supervision
Employee Empowerment & Work Environment
Training & Professional Development
Staff Health & Wellness
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Planning TIC Supervision
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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
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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
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