Interest in trauma-informed care (TIC) is growing rapidly in the United States and internationally. In the 60 Minute segment on this topic, aired Sunday, March 11th, Oprah Winfrey and Dr. Bruce Perry described trauma-informed care and gave examples from Saint A’s agency. Oprah stated that the story of trauma-informed care “has had more impact on me than practically anything I’ve ever done.” She added “…it is so important to me, and I believe to our culture, that if I could dance on the tabletops right now to get people to pay attention, I would…”
It appears that trauma-informed care has finally hit the main stream. For those of us who have been doing this work for years, it is so exciting and rewarding to see the rest of the world begin to understand the importance of TIC and ACEs Science (ACEs refer to the large body of research on adverse childhood experiences).
But, as people start to pay attention, we also have a problem. We don’t really know if trauma-informed care works. It totally makes sense in so many ways. It provides an answer to our concerns about the ways that survivor clients have historically been treated. We see light bulbs go off for people (like Oprah) when we talk about it. But, there is virtually no robust empirical evidence that TIC changes outcomes in survivor clients or the agencies that serve them. Theory is ahead of science in this area.
A major reason why there is no evidence is that we do not know how to measure trauma-informed care in an organization or an individual. How can an agency measure whether trauma-informed care in fact works better than other approaches, unless it can measure the extent to which it is providing TIC? Is an organization trauma-informed if it has adopted key TIC implementation strategies? Is it trauma-informed if consumers or staff perceive it has certain characteristics? Is it trauma-informed if it uses certain evidence-based practices?
The Traumatic Stress Institute (TSI) of Klingberg Family Centers has begun to address this issue. After much thinking, discussion with other experts and engaging in a partnership with Tulane University, we created the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. The ARTIC is one of the only psychometrically valid measures of TIC that exists. It is a measure of professional and para-professional attitudes favorable or unfavorable toward TIC. Our thinking is that since staff attitudes are an important driver of staff behavior, and that the moment-to-moment behavior of staff is a critical factor in successful implementation of TIC, staff attitudes would be an important thing to measure. We also believe that such a measure is an easy, cost effective, and efficient way to help organizations determine if they were moving in the direction of TIC.
In the two years since the ARTIC Scale was launched, 128 entities ranging from the mental health authority overseeing 25 counties in rural Pennsylvania to the Chicago Public School system have purchased the groundbreaking measure. It has even been translated into Japanese.
Organizations and schools are using the ARTIC to assess readiness for TIC implementation. They use it to measure change as a result of interventions. Use of the ARTIC helps to prevent the backsliding of TIC that commonly occurs, and to determine which staff need additional training and supervision related to TIC. The Traumatic Stress Institute has developed resources to help staff take action to change their attitudes towards ones that are more trauma-informed.
With reliable data over time, the field can demonstrate to the world that focusing on what happened to people rather than what’s wrong with them does produce effective, lasting healing.
For more details, and to obtain the ARTIC visit www.traumaticstressinstitute.org/artic-scale, and to learn more about the Risking Connection Curriculum and Whole System Change Model of the Traumatic Stress Institute, email info@traumaticstressinstitute.org.
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