Change Never Felt So Right

CHRIS Kids, a non-profit organization located in Atlanta, GA, is laser focused on improving our community by providing children, adults and families with high-quality, trauma-informed behavioral health services and support systems. Since 1981, the organization has transformed more than 30,000 lives through a myriad of community based and housing services aimed at giving youth and adults a “hand up” and not just a hand out.

The scope of services changed quite dramatically in 2013 as the organization universally embraced trauma informed practice.

We have always worked to provide “trauma informed” assistance and services. However not until we uncovered the ACE study and dissected the study’s findings, did the light bulb truly come on. The ACE Study brought awareness, cohesive thinking, and a sense of urgency that ignited the organization’s desire to change…and to do so immediately.

Before even embarking on the journey of change, we wanted to determine an organizational ACE baseline and further analyze the implications of this data. While our clinical, community, and residential teams were screening all consumers and new intakes with the ACE questionnaire, the training team added content about ACEs and the ACE study to our new hire orientation. CHRIS Kids was not 100% sure where the data or trainings would lead, but we were all excited about leadership’s commitment to blaze new trails.

The results were in…and we were in awe! The results provided valuable insight into maladaptive behaviors and coping strategies, and truly had us asking “what happened” to these individuals. The CHRIS Kids ACE Questionnaire results are detailed in the table below. This table illustrates the ACE scores or exposure to trauma of program participants based on the program setting in which they were receiving services:

The centerpiece of CHRIS Kids trauma informed work is utilizing the impactful findings of the ACE study and the data from our internal ACE assessment of consumers to drive the development and standardization of trauma informed service delivery. The commitment to create organizational change was made and the step-by-step process developed and executed.

The first step was adopting an overarching trauma informed framework that would support all programs and services. The Attachment, Self-Regulation, and Competency¹ (ARC) Framework is CHRIS Kids trauma informed approach, and was selected from other available trauma treatment strategies because it provides a conceptual framework and core principles of intervention for working with youth who have experienced complex traumas, a key characteristic of many youth and families we serve. The framework provides a flexible model of intervention that is developmentally appropriate and relevant for addressing a myriad of trauma exposures within a multitude of service settings.

Building on prior clinical learning collaborative participation with the National Child Traumatic Stress Network, CHRIS Kids clinicians focused a great deal of energy on ensuring that programs utilized evidenced based modalities. Clinical training efforts centered around Eye Movement Desensitization & Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) practice and supervision. Currently, the CHRIS Counseling Center has three (3) trained EMDR clinicians and six (6) certified TF-CBT clinicians. This clinical focus allowed for the creation of trauma treatment protocols (e.g., a consumer with an ACE score of 6+ is seen by a therapist within 24 hrs and psychiatrist within 72 hrs). Transition Aged Youth services adopted the Transition to Independence Process (TIP) model for use with housing, transitional living, and clubhouse programming.

The complete change process entailed the following:

 INTERNAL

1. Change Team Creation – “Trauma STARs” organizational leadership team; project team focused on strategic integration of trauma informed practice across the organization
2. Climate Analysis & Organizational Assessment – focus groups & team meetings to increase communication, assess culture, and address questions; comprehensive self-assessment of how “trauma informed” we were; this allowed for alignment of resources and directions of focus
3. Revisions to Infrastructure – adoption of CHRIS Kids “Trauma STARs” guiding principles (Safety, Trustworthiness, Awareness, and Relationship Driven), vision statement revisions, policies, hiring practices, training content & development, adoption of the Attachment, Self-Regulation, and Competency (ARC) Framework, specific trauma focused clinical training, treatment, and supervision  
4. Training – course content revisions and the development of trauma informed course work; comprehensive ARC Framework training for all employees; Trauma STARs train-the-trainer program, Trauma Assessment & Trauma Informed Best Practices for Working with Transition Aged Youth courses, and Creating Trauma Informed Organizations
5. Integration Strategy – the “Sell, See, Support” strategy is used to train program staff and leaders to utilize skills/concepts, construct visual cues/representation, and assist with coaching and supervising team members through the integration of trauma informed practice
6. Evaluation & Monitoring – ongoing team meetings to communicate successes, address challenges and barriers, and assess additional ways to infuse practice strategies across the organization

CHRIS Kids is also dedicated to advocacy for trauma informed practice. As we were indoctrinating ourselves internally, we were equally committed to engaging our community and state leaders in conversation for change.  The goal was, and still is, to talk to whoever will listen…

EXTERNAL

1. Advocacy – participation on legislative committees charged with leveraging change in the child welfare system
2. Training – providing training to partner agencies and other community stakeholders through partnerships with the Division of Family and Children Services (DFCS)
3. Presentations – conference and corporation presentations

CHRIS Kids implementation of trauma informed practice continues to evolve since our organizational commitment in early 2013. We are pleased with the initial strides, but know that work must continue to increase community awareness of the impact of adverse childhood experiences. We plan to contribute to trauma informed practice strategies across the state of Georgia by engaging in continued advocacy efforts, research studies, and ongoing training partnerships. Change never felt so right…

1 Kinniburgh, K. & Blaustein, M. (2005). Attachment, Self-Regulation, and Competency: A comprehensive framework for intervention with complexly traumatized youth. A Treatment manual. Boston.