Partnering for Excellence Model: Walking the Trauma-Informed Talk

I wrote about my personal experience at the Partnering for Excellence conference earlier this month. Here, I write as an activist observing attempts at system change utilizing ACEs science and trauma-informed approaches. Please share your ideas, brainstorms and observations about what you see happening (or not happening) in organizations or agencies you rely on, work at or run.

I’ll admit, as an activist, I’m often in fight the system mode. I approach even do-gooders with defensiveness. Why?

Because trauma survivors have not been invited to the table for decades even when it’s to have a conversation about what trauma survivors need.

We need a lot because we’ve been through a lot. Many of us have had little in the way of compassionate and competent care that is affordable, accessible or appealing.

I often go into conversations or talks needing to make one or all of the following points:

• Adverse Childhood Experiences (ACEs) have long-term consequences.
• Developmental trauma impacts adults even after childhood has ended.
• Trauma survivors know best which treatments do and don’t work, what our 24/7 needs are in and outside of clinical settings and how to speak for ourselves about our past and present experiences.

These ideas are obvious to some but seem radical to others. I’ve been to a3-day conference in Boston on trauma, traumatic stress and treatment effectiveness where :

• Trauma survivors were referred to as “them” rather than “us”
• ACEs were mentioned once in passing
• Not one self-identified trauma survivor spoke as panelist, presenter, guest or was even represented as a vendor.
• Where trauma survivors are referred to only as patients not parents, professionals or people.

The Partnering for Excellence (PFE) conference, held last month in North Carolina was different. Shockingly different. It was a conference that walked the trauma-informed talk.

PFE is an initiative started in 2012 which and is described as seeking to “strengthen public-private partnerships in child welfare to enhance quality of care and significantly improve child functioning and well-being outcomes.” That’s the description given in the bio of the Project Director, Jenny Rahilly Cooper.

Cooper herself described the overarching goal of PFE more spefically at the conference as follows:

“To Redesign how the Child Welfare and Child Mental Health systems interact so they can:

Provide trauma informed services and improve family outcomes

Reduce high-end services

Prevent children from being taken in to DSS custody.”

PFE is funded by Benchmarks: An Alliance of Agencies Helping Children, Adults & Families, located in North Carolina. Benchmarks is sponsoring the project investigators, Katie Rosanbalm and Christina Christopoulous, who are from the Center for Child and Family Policy at Duke University.

Rosanbalm and Cooper presented at the conference to an audience of about 150 people from the Department of Social Services (DSS), managed care mental health organizations, various advocacy groups as well as trauma survivors who have used “the system” being discussed.

The PFE model is being piloted on a county level, so far, and the two most important parts of the program, in my view, are these:

1. The focus on training all who come into contact with kids referred to DSS about trauma’s impact and the evidence-based treatments for trauma (another article will someday be about if evidence-based and effective are the same).
2. The length, depth and type of screening now done when children have been referred to DSS. Instead of one 50-minute assessment, as those referred to DSS, through the PFE counties, get a Trauma Informed Comprehensive Checklist Assessment (called a “TICCA”) which is much more thorough.
   1. Children spend three to five (it sounds more like three) hours with birth or foster family as well as a social worker and mental health provider.
   2. The mental health provider must use the TICCA and has become trauma-informed.

Assessments are done in a trauma-informed way and those who work with kids and families understand trauma, trauma symptoms and trauma treatment. Read more.