It's a first, and it may help answer the question that seems to have stopped the medical community from integrating trauma-informed and resilience-building practices based on ACEs research: "So, now that we know someone's ACE Score, what do we do????"
By next March, 14 health clinics lucky enough to be chosen to participate in the initiative will have some good ideas.
In the world of large organizations, this initiative came together at lightning speed. Last year, the assistant director from the SAMHSA-HRSA Center for Integrated Health Solutions, who has since returned to direct practice, struck up a conversation with a project officer at Kaiser Permanente.
You’re the one that lit the fire so long ago, she told the project officer. She was referring to the CDC-Kaiser Permanent Adverse Childhood Experiences Study, one of whose co-founders is Dr. Vincent Felitti, who at the time of the study directed the revolutionary Health Appraisal Center at Kaiser Permanente in San Diego.
What are you doing about integrating trauma-informed care into your organization? she asked.
Long-story-short: Connections were made and, at a meeting hosted by the National Council for Behavioral Health, council leadership and Cheryl Sharp, senior advisor for trauma-informed services, provided information about the work they have been doing around trauma-informed learning communities.
“The National Council launched its first trauma-informed learning community in 2011,” says Sharp. “Since then more than 250 organizations have participated in six national learning communities and 10 state or regional learning communities, most of which are one year long.”
Organizations that have participated include youth and family servicing agencies, community behavioral health organizations, addictions programs, juvenile justice agencies, and primary care settings. The Kaiser and National Council partnership is the first learning community specifically targeted at health clinics.
“The project was developed in partnership with Kaiser Permanente,” says Sharp. “We are looking at this as a pilot project. We want to inform the field, so we’ll be doing a significant evaluation piece to see if this can impact outcomes for the adult population in a short space of time. We are also looking at how we are able to make the culture-change among health care providers to use trauma-informed approaches.”
Applications are due April 24. Only 14 organizations will be accepted – and those must be primary care settings or health care settings that are part of Kaiser's seven regions across the U.S. and that already have “behavioral health partnerships included,” says Sharp. “Their system doesn’t have to be perfect – it means if someone assesses positive for trauma, there should be a response for that screen. Organizations will be providing brief interventions as well as Seeking Safety as an evidence-based best practice. The centers will be assessing their organizations and working to make the culture shift that is so important when moving towards a trauma-informed culture.”
More details about the program are here. Online applications should be submitted here.
Selections will be announced on May 11.
For more information, the National Council will hold two webinars this week – one from noon – 1 pm ET on Wednesday, and one from 3-4 pm ET on Thursday.
The learning community requires a serious commitment in terms of changing systems and of time. Over the nine months, there will be two face-to-face meetings, individual coaching calls, webinars, and quarterly data submissions.
At least three representatives from each organization selected will attend a one-day training in Seeking Safety on June 8. The training will be conducted by Dr. Lisa Najavits, who created the program.
On June 9-10, participants will do a deep dive into how the nine-month initiative will be structured, and what will be expected of them – that their health clinic will become a trauma-informed organization. That means examining policies and procedures through a trauma-informed lens, educating their staff on childhood adversity and trauma-informed care, changing hiring practices, etc. (Here’s a description of how San Diego Youth Services participated in a National Council trauma-informed learning community.)
“They’ll work with our faculty who’ve been doing trauma-informed culture change for a long time,” says Sharp.
The initiative couldn’t come at a better time, because experience and research have shown that if someone’s showing up in a clinic for any medical condition that’s been difficult to treat, such as hypertension or diabetes, or people are having difficulty adhering to treatment advice, or are at risk prenatally, “you’ve got to look at trauma,” says Sharp.
Among the questions they’ll ask: With screening, education and change in practice, is there a change in emergency visits and doctor visits? Do patients develop more trust in their health care providers?
The last face-to-face meeting will take place at the March 2016 National Council annual conference in Las Vegas.
Everyone who’s participating in the initiative is looking forward to watching how it plays out. “Nothing like this has been done before and we are excited to watch how it unfolds”, says Sharp.
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