Community Connections
Creating Cultures of Trauma-Informed Care
The Creating Cultures of Trauma-Informed Care (CCTIC) model engages the system or organization in a culture change, emphasizing core values of safety, trustworthiness, choice, collaboration, and empowerment in every facet of program activities, physical settings, and relationships.  Implementing cultural shifts of this scope requires the full participation of administrators; supervisory, direct service, and support staff: and consumers.  CCTIC begins with individualized consultation to ensure adequate system-wide support and to tailor the change process to the specific organization(s).  Agencies then designate a workgroup, with staff and consumer representatives, to coordinate the change process.  The workgroup, along with others from the organization, then attend a formal training in trauma-informed care, with interactive exercises designed to stimulate ideas and priorities for systemic change.  From a menu of educational modules, including one focused on staff support and care, the workgroup chooses those most relevant for their particular programs.  Follow-along consultation addresses plans for, and obstacles to, implementing trauma-informed changes.
Creating Cultures of Trauma-Informed Care, developed over the last ten years by Community Connections, draws substantially on Using Trauma Theory to Design Service Systems,  a small (103 pp.) book edited by Maxine Harris, Ph.D., and Roger Fallot, Ph.D. (2001).  Used by state service systems and provider organizations, this work  presents a step-by-step model for state mental health, substance abuse, and other public human service systems, public and private provider agencies, and individual services and programs to become “trauma-informed.”  The model provides guidelines for evaluating and modifying all system and service components in light of a basic understanding of the role that violence plays in the lives of people seeking mental health and addictions services, most of whom have been traumatically impacted by unaddressed histories of sexual and physical abuse and other violence.
The authors and their colleagues have developed materials to accompany the book:  1) a “Trauma-Informed Services Self-assessment and Planning Protocol;” 2) a “Trauma-Informed Self-assessment Checklist;” and 3) a “Trauma-Informed Services Implementation Form.”  The protocol provides a structured model for programs to review and set priorities for change in three services-level domains (informal and formal service procedures; formal service policies; and trauma screening, assessment, and service planning) and in three administrative-level domains (administrative support for trauma-informed change; trauma training and education; and human resources practices).  The checklist is used by programs as part of their initial review and then as a tool for monitoring their progress toward more trauma-informed service settings.  The implementation form guides the specific changes each program establishes as its priorities.  Throughout the review and planning process, the guiding principles of a trauma-informed service system—safety, trustworthiness, choice, collaboration, and empowerment—are highlighted.
For more information about consultation and/or training in Community Connections' approach: Creating Cultures of Trauma-Informed Care, please contact Lori L. Beyer, MSW, Director of Trauma Training at (202) 608-4788 or

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