Examples of Trauma-Informed Practice in Canada

Example 1 - Transforming Services

The work of the Jean Tweed Centre, Toronto, ON

The Jean Tweed Centre in Toronto first opened in 1983 as a treatment program specifically for women with substance use concerns. Since then their programs have evolved to include both residential and day programming including programs for women and their children. Early on, as part of their woman-specific focus they recognized the trauma experiences of the women they were supporting and began providing trauma-informed and trauma-specific services. They transformed their services in a four-stage process.

Step 1 – Identifying the issue
Through tracking, they noticed that over 80% of their clients had a trauma-related experience. With this information, and influenced by the work of Judith Herman, program leaders began to research the topic and address the issue through:

  • Education – they provided education for their staff and invited the Ministry of Health funders to be part of the learning;
  • Proposal development – they received funding for a clinical supervisor and trauma counsellor; and,
  • Program evaluation – they learned that the approaches used to raise the issue of trauma were, in some cases, contributing to instability and retraumatization .

Step 2 – Shift to trauma-informed
Services shifted from standardized screening and discussion of trauma to a more “trauma-informed” approach. Service providers became much more knowledgeable about the issues, and focused on creating a safe environment where trauma was acknowledged and the impact understood.

Step 3 – Depth and capacity
Looking to deepen their capacity to support women who experience trauma, staff were offered more in-depth training in the practice of mindfulness and in the Seeking Safety model, which combines first-stage trauma treatment and relapse prevention. Now: 1) all programs at the Centre are trauma-informed; 2) Seeking Safety groups are offered to all women; and, 3) a dedicated trauma counsellor provides individual counselling for women and consultation/education with staff.

Step 4 – Continuing braided support
Emphasis is placed on integrating and braiding trauma and substance use services as new programs are developed. For example, in their more recently developed outreach services for pregnant and parenting women, they may see the impact of trauma in apprehension, birth, parenting, etc. With a trauma-informed approach, staff are able to address both aspects of healing concurrently.

Overall, the key aspects of the braided approach include:

  • Ongoing staff education – maintaining a foundation of knowledge and training for all staff;
  • Support for a concurrent and staged approach that combines trauma-informed with trauma-specific services;
  • Clinical and peer supervision that builds reflexive practice for all staff; and,
  • Evaluation – continuing to listen to the experiences of women as they move through their journey, building on clinical wisdom and incorporating evidence-informed practice.

Example 2 – Development of Trauma-Informed Practice and Support Training (TIPS)

By the  Victoria Sexual Assault Centre, Victoria, BC 

Since 1982, the Victoria Sexual Assault Centre (VSAC) has focused on healing and prevention and education about sexualized violence. In order to deliver a range of prevention initiatives, they partner with a number of community services. Over time, the agency found that requests for information and support from community providers working with trauma survivors were increasing. VSAC found that previous models for support and information to community agencies were no longer sufficient to meet the needs of community providers as they attempted to address the urgent and complex needs of clients. VWSAC educators realized that they needed to increase community capacity to respond to trauma/violence survivors.

The TIPS Curriculum
In 2008, VSAC formed an advisory committee to develop a curriculum for training youth support workers to provide trauma-informed care in a multitude of settings. The curriculum was modified for other agencies serving marginalized women. Building on the skills that community support workers already have, the curriculum focuses on providing first-stage skills and knowledge on the interconnections of trauma, mental health and substance use. After every training, the advisory committee modified the curriculum based on evaluations. From this they have created a flexible, modular curriculum that can assist a variety of community organizations in becoming trauma-informed.

The TIPS training emphasizes being trauma-informed and referring to trauma-specific services. The curriculum incorporates trauma-related effects, information, and skills as they relate to the survivor, the service provider, and the survivor/provider relationship. These three areas are included into the following components:

  • Trauma competence – Understanding what trauma is, its prevalence and its effects on the survivor. Trauma is broadly defined and includes: colonial trauma, intergenerational trauma and developmental trauma;
  • Understanding the client/survivor – Response to trauma from the survivor, from the family and the response to the survivor from others in society. A view of trauma within the larger context of living is explored, not focusing only on the individual;
  • Client empowerment – Client choice within the context of safety can present challenges for service providers and the curriculum explores these issues;
  • How working with survivors of trauma may affect supporters; and,
  • Safety – providing both internal and external safety to a wide range of clients. Physical safety is often paramount to service providers, but providing emotional containment for survivors requires a different set of skills.

Currently most of the TIPS trainings have been for direct service workers. Nonetheless, the training encourages that a trauma lens be applied to all levels of an organization. Future plans for the curriculum are to extend the training to management and administration with the aim of influencing trauma-informed practices more broadly.

 

 
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