Earlier this year @Dawn Daum wrote to us when she was ready to share ACEs science with people in the organization she works in to make a case for moving towards more trauma-informed care for the benefit of the staff and those they serve. She was frustrated because almost all the training and resources she found were geared towards schools, clinical staff or to organizations working with children and families rather than ACE-impacted adults in the workplace and who are clients. Where could she find research, data, and support to make a persuasive case for trauma-informed change at her organization?

A few weeks earlier we had heard from @Lisa Wright, the community manager of the Greater Richmond (VA) Trauma-Informed Community Network wondered if we had an official proclamation defining what it means when a person, staff or organization says, “We’re trauma-informed.” Lisa has formed a trauma-informed task force, community network, and provided some ACEs science 101 training and hosted screenings of Paper Tigers and Resilience. She’d searched for and helped create some assessment tools and said she’d mostly been self-taught and supported by countless individuals who guided and helped her. She sounded like the expert on all things becoming trauma-informed to me.

When Dawn and Lisa’s requests came in I was pretty green in my role at ACEs Connection. I was still trying to get clear on what being or becoming trauma-informed even means for an individual, a team or an agency providing services. I turned to my go-to person, @Gail Kennedy, as I do when I had a question about all things related to ACEs or trauma-informed anything and confessed that I wasn’t sure how to help Lisa or Dawn and where exactly to send them within ACEs Connection Network.

Gail was like, "Yes! Totally! Exactly!”

I was like, “What? Huh?”

She explained that we were getting more questions all the time about the nuts and bolts of becoming trauma-informed, as well as how to handle the hurdles that came up for individuals and organizations in the process.

What she shared that I was slow to get is that there is not and never will be a simple one-sentence answer. There is not and won’t be a simple one-size-fits-all solution, either.

This work is about systems change, and that requires us to be flexible, patient, responsive and aware of ourselves and others — not just once, but all the time. The process can be confusing, exciting and challenging, and the results profound, paradigm-changing and positive.

What we remembered is the resource that people need most is more access to each other. Maybe Dawn needed someone like Lisa who could encourage, relate and share shortcuts and suggestions? Maybe Lisa needed to remember how much and how far she had come and that she has become a leader who can guide others even as she keeps learning?

So that's the back story. Here is the start of our efforts for this new community. Everyone is welcome, whether you’re on day one of learning about these trauma-informed concepts or knee-deep into implementing them.

Our Community Description Is…

Resilience at work. What does it mean to be trauma-informed at work? How is it defined and assessed? How do we measure success? What policies, protocols, and training exist? How does becoming trauma-informed change us and our work? We share the nuts and bolts of becoming a trauma-informed organization and our struggles, questions, and successes, too.

 Our Community Managers

Here’s a bit about volunteer team of community managers (who will each introduce themselves more later this week).

Lisa Wright, LCSW, RPT-S, CTP (right in above photo), Greater Richmond SCAN (Stop Child Abuse Now) as a rauma-focused treatment program coordinator. Lisa received her master’s degree in social work (MSW) from Virginia Commonwealth University (VCU) in 1993, is a licensed clinical social worker, registered play therapy supervisor, certified trauma practitioner and a certified therapist in trauma-focused cognitive behavioral therapy (TF-CBT). She has devoted her career to providing individual, group and family therapy for children, adolescents and adults in outpatient mental health centers. @Lisa Wright has specialized training and experience in treating trauma, sexual abuse, and sexual behavior problems. She uses expressive therapies in her work, including play, art and sand tray. She is also one of the coordinators for the Greater Richmond Trauma-Informed Community Network. Also, Lisa has served as an adjunct faculty member since 2007 for the VCU School of Social Work.

Melissa McGinn, MSW, LCSW (middle in above photo), is currently Greater Richmond SCAN’s community programs coordinator and coordinator of the Greater Richmond Trauma-Informed Community Network. Melissa is responsible for the management and coordination of all SCAN’s prevention programs, training, and consultation on becoming a trauma-informed organization. @Melissa M. McGinn, LCSW has been an adjunct professor and field liaison at Virginia Commonwealth University for over 10 years. Most recently Melissa worked at the Virginia Department of Social Services, where she re-established the Child Welfare Stipend Program at four universities across the state. Melissa spent the first 14 years of her career as a child and family therapist specializing in the treatment of complex trauma, working primarily with children in the child welfare system, in community-based and outpatient settings.

Dawn Daum (left in above photo), Care Manager at Transitional Services Association, Inc (TSA); a non-for-profit residential, care management, and substance abuse recovery support service provider in Saratoga Springs, NY, is leading the agency’s initiative to implement trauma-informed care practices into all services provided by the organization. Dawn provides Keynote presentations and informational talks on ACEs/Trauma 101 and Parenting with ACEs throughout the upstate NY region, and is a member of the Capital Region’s HEARTS initiative working to mitigate the effects of ACEs and promote resiliency in local communities. Dawn is co-editor of the book Parenting with PTSD: the impact of childhood abuse on parenting. Her work has been featured in the Huffington Post, The Mighty and The Establishment. You can connect with @Dawn Daum and on the website: www.parentingwithptsd.com. 

What You Can Expect from this Community

• The nuts and bolts of becoming trauma-informed: Each week, we will share at least one tool, process, reference, resource or policy guide for those starting or implementing trauma-informed initiatives, policies, culture, and protocol.
• Lessons learned & learning: A Q&A each month about one aspect of becoming trauma-informed asked by Dawn, as her organization starts the process and answered by Lisa, Melissa — and maybe you — about lessons learned in the process of those who have been on this journey.
• Curated and new content: New articles and blog posts from all members (that’s you!) as well as our community managers and ACEs Connection team. We’ll share content from ACEsTooHigh.com, ACEsConnection.com and other sites about becoming trauma-informed and helping to create healing communities in our work and workplaces.

Our Core Beliefs at ACEs Connection...

At the foundation of any trauma-informed/resilient-building organization is ACEs science. ACEs science comprises:

1. The epidemiology of ACEs. The CDC-Kaiser Permanente ACE Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with four ACEs— including living with an alcoholic parent, racism, bullying, witnessing violence outside the home, physical abuse, and losing a parent to divorce — have a huge risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.
2. Brain science (neurobiology of toxic stress) — how toxic stress caused by ACEs damages the function and structure of kids’ developing brains.
3. Health consequences — how toxic stress caused by ACEs affects short- and long-term health, and can impact every part of the body, leading to autoimmune diseases, such as arthritis, as well as heart disease, breast cancer, lung cancer, etc.
4. Historical and generational trauma (epigenetic consequences of toxic stress) — how toxic stress caused by ACEs can alter how our DNA functions, and how that can be passed on from generation to generation.
5. Resilience research — how the brain is plastic and the body wants to heal. This research ranges from looking at how the brain of a teen with a high ACE score can be healed with cognitive behavior therapy, to how organizations can integrate trauma-informed and resilience-building practices that result in everything from a healthier workplace where fewer people leave, to a drop in health insurance rates because the workforce has become healthier.

There are trauma-informed programs that don’t include ACEs science. They may make significant progress, but they’re unlikely to be as successful as they hope to be if they don’t educate organization staff members and the people they serve.

WHY IS THAT?? Many of these trauma-informed programs never specify what the ACEs are, except to vaguely refer to experiences such as war or physical abuse.

Some focus groups that The California Endowment organized a couple of years ago when they were trying to figure out how to talk about trauma showed that most people think of trauma as an event (e.g., car accident), and, when pressed, physical or sexual abuse. But what we often regard as “normal” experiences — divorce, living with an alcoholic parent, living with a family member who’s depressed, even verbal abuse — aren’t regarded as trauma, even though the ACE Study and subsequent research shows that those types of “normal” experiences have just as much effect on the brain and body as physical and sexual abuse. And now other types of trauma (bullying, racism, witnessing violence outside the home, etc.) are being added to ACE surveys, and they also have health and behavior consequences.

Understanding that losing a parent to separation or divorce, living with an alcoholic, experiencing daily humiliation and shaming, and having a mother who’s depressed is an ACE score of 4, which can lead to physical and mental health consequences that are just as damaging as physical and sexual abuse, witnessing a mother being abused, and having a family member who’s incarcerated is very important to understand. If people don’t understand what trauma is, they can easily come to the conclusion that their responses to trauma are “crazy” instead of normal, that they’re “bad” because they were “born bad”, and can’t change behaviors or health that are the consequence of their ACEs.

It’s important to include information that people in the helping professions bring their own ACEs to their work (and, as we’ve seen, the ACE scores are often higher than the original ACE Study), and that’s directly related to helping those in the helping professions understand what and why different types of vicarious trauma affect people differently.   

A Few Words About Organizational Assessments and Milestones...

The ACEsConnection team recently rolled out a new set of guidelines and tools called Growing Resilient Communities 2.0, which is based on the work that we’ve done over the last couple of years with communities across the U.S.

The part that’s relevant to this community is the Milestones Tracker part of the Community Tracker.

General self-assessment tools exist for organizations, as well as self-assessment tools for organizations in specific sectors, including child-abuse prevention agencies, child/youth/adult/family serving organizations, domestic violence services, healthcare agencies, etc.

After examining many trauma-informed assessment tools for several different sectors, we chose 11 milestones that are common to most, if not all, organizations across sectors. Each milestone represents many changes an organization has implemented. It doesn’t assess how well an organization is doing at each milestone, but if the organization completes all milestones, it is likely that meaningful change is occurring. We’ve organized the categories in the blog directory to include the milestones.

Milestones:

1. ACEs science presentations to any staff — Any employee of an organization has attended a workshop or presentation about ACEs science.
2. ACEs science presentations to all staff — All employees have attended a workshop or presentation about ACEs science.
3. Participates in local ACEs initiative — Organization representatives attend ACEs initiative meetings, participate in workgroups or have signed an MOU with the ACEs initiative.
4. Leadership committed to integrating ACEs science — Organization decision-maker(s) publicly state the intention of, approve a committee to lead and provide resources for the entire organization to become trauma-informed.
5. HR integrates trauma-informed practices & policies — Human resources employees, or people responsible for organization’s human resources function, applies an ACEs science lens to all policies and practices, including hiring, termination, leave, supervision, etc.  
6. Staff receive ACE & resilience surveys — This means that each staff member has anonymously completed an ACE survey to determine their own ACE and resilience scores so that the organization can determine its ACEs burden and resilience foundation. It is important for an organization to do this; it provides impetus for the organization to examine its workplace practices through an ACEs science lens and make appropriate changes, to make sure its workforce is practicing self-care, and to create a physical and emotional environment that is safe and supportive for staff . Anyone who takes an ACE survey should be educated about ACEs science, provided a resilience survey or information about resilience factors, and the opportunity to talk with a peer support specialist or social worker. Employees should not provide their scores to the organization they work for.
7. Clients educated about ACEs science — “Client” also refers to patient, student, prisoner, customer….whomever is served by the organization. They have a right to know the most powerful determinant of their...and their children’s...health, safety and productivity.
8. Clients receive ACE & resilience surveys — This means that clients/ students/ customers/ patients/ prisoners have completed an ACE survey (original or expanded) for themselves. It does not mean that they have provided that information to the organization that gave it to them; it may be for their own knowledge. It depends on the organization. It’s appropriate for a physician to know the ACE score of a patient; it’s not necessary for a school to know the ACE score of a student. However, it would be useful for a school to know the ACE burden of its student body, and gather student ACE scores anonymously. Anyone who takes an ACE survey should be educated about ACEs science, provided a resilience survey or information about resilience factors, and the opportunity to talk with a peer support specialist or social worker.
9. Implements TI practices for clients — Organization has applied ACEs science lens to all practices for clients, students, patients, prisoners or customers, and changed them to become trauma-informed and resilience-building
10. Evaluates TI policies and practices — On an ongoing basis, organization evaluates changes it has implemented, and makes improvements.  
11. Physical environment is trauma-informed — Organization has examined good examples of the trauma-informed physical environments of other similar organizations, and made changes in their own physical environment.

We Want to Hear from YOU!

• How can this community help you? How might help this community?
• What do you wish you knew sooner about becoming trauma-informed and resilient at work? Do you have struggles, strategies, successes and stories to share?
• What’s worked well or best or continues to inspire, amaze and fortify your work?
• What resources have you used, created, dreamed of or lacked that we might need to co-create?
• What does resilience at work mean to you?

We hope you will introduce yourselves to this community and share your wisdom, frustrations, and experiences. Over the next week, the community managers will share more about themselves and this community. We are grateful to them for volunteering to manage this much-needed community.

Questions

If you have any questions about how to share a blog post, comment, calendar event or resource, please ask Lisa, Dawn, Melissa or anyone at ACEs Connection. This community belongs to all of us, and we all benefit with you share your ideas, questions, resources, stories, and expertise.

A Note About the Community’s Name...

We debated what to call this group. While we know that most of us start out by becoming trauma-informed and those are the words most often used, some of us felt that those words are too narrow and limited. We feel it’s not only about being aware of or responsive to trauma but is moving beyond that to a place where we have headed but not quite landed. Will that be called healing, self-healing, learning or resilient communities? Or something no one has dreamed up yet? Of that, we are not sure, and for now, our name is Becoming Trauma Informed and Beyond. Like us, it may change  :-))

Thank You to Jane Stevens! 

A heartfelt thanks to @Jane Stevens for founding and publishing ACEs Connection and ACEs Too High. So many individuals and communities have and will learn about ACEs and ACEs Science because of you. So many of us gather daily to "prevent ACEs, heal trauma & build resilience." in ourselves, families, communities. - and at work. Thanks for your leadership, vision and devotion to this movement. And thanks for your serious assistance writing and editing this blog post, too.