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Behavioral Sciences
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New Perspectives on Trauma-Responsive Care
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New Perspectives on Trauma-Responsive Care

A special issue of Behavioral Sciences (ISSN 2076-328X).

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 29297

Special Issue Editors

Dr. Nina Esaki

E-Mail Website
Guest Editor
School of Social Work and Behavioral Sciences, Department of Social Work, Springfield College, Springfield, MA 01109-3739, USA
Interests: organizational health; leadership; trauma-responsive organizational change
Dr. Shanti Kulkarni

E-Mail Website
Guest Editor
School of Social Work, College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, NC 28223-0001, USA
Interests: intimate partner violence; dating violence; adolescent child-bearing; trauma-informed service delivery

Special Issue Information

Dear Colleagues,

The Adverse Childhood Experiences study in 1998 (Felitti et al., 1998) spawned significant research and practice focused on how best to provide trauma-informed services. While much funding and emphasis has been devoted to evidence-based clinical interventions, there has also been increasing attention paid to establishing and maintaining trauma-informed organizations and communities. Legislation such as the Family First Prevention Services Act (First Focus Campaign for Children, 2018) underscores the importance of organizational culture in the delivery of evidence-based clinical trauma-informed services.

More recently, we have witnessed increased violence perpetuated against marginalized communities and increased attention being paid to the issue of the historical and current trauma experienced by oppressed groups. There has been renewed acknowledgement of how long-standing structural impediments to equitable treatment under the law can cause profound and intergenerational harm to many of our citizens. Without looking beyond the lens of individual trauma, professionals, organizations and systems risk the re-traumatization of individuals and communities who have experienced trauma resulting from interpersonal, systemic, and structural racism and oppression (Im & Swan, 2021; Koury & Green, 2021).

We welcome contributions on the following potential topics (among others): new and emerging perspectives on mezzo and macro trauma-responsive care (TRC), including thought-provoking manuscripts about factors that are being overlooked in the development and implementation of such interventions; the importance of mezzo and/or macro factors in the successful delivery of micro interventions; studies examining mezzo and macro trauma-responsive practice; thoughts on the current measurement practices of TRC and recommendations for possible improvements; the effectiveness of existing trauma-responsive policies as well as thoughts on those being considered at the state and federal levels; and thoughts about the current availability and focus of funding to develop effective mezzo and macro trauma-responsive interventions and suggestions for improvements. Both research-based, including systematic analyses, and thoughtful conceptual manuscripts that contribute to the development of the field are welcome.

References

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.

First Focus Campaign for Children. (2018, March). Family First Prevention Services Act Bill Summary. Retrieved July 30, 2018 from https://campaignforchildren.org/wp-content/uploads/sites/2/2016/06/FFCC-Short-Summary-FFPSA.pdf

Im, H., & Swan, L. E. T. (2021). Working towards culturally responsive trauma-informed care in the refugee resettlement process: Qualitative inquiry with refugee-serving professionals in the United States. Behavioral Sciences, 11(11), 155. https://www.mdpi.com/2076-328X/11/11/155

Koury, S. P., & Green, S. A. (2021, October). Trauma-Informed organizational change manual. The Institute on Trauma and Trauma-informed Care. Retrieved November 15, 2021 from http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care.html 

Dr. Nina Esaki
Dr. Shanti Kulkarni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Behavioral Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma-informed care
  • trauma-responsive care
  • trauma-informed organization
  • trauma-informed schools
  • trauma-informed program
  • trauma-informed practice
  • trauma-informed community
  • trauma-informed policy
  • healing-centered engagement

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Published Papers (8 papers)

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Research

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14 pages, 292 KiB  
Article
A Relational Workforce Capacity Approach to Trauma-Informed Care Implementation: Staff Rejection Sensitivity as a Potential Barrier to Organizational Attachment
by Tareq Hardan, Emily A. Bosk, Alicia Mendez, Abigail Williams-Butler, Fabrys Julien and Michael J. MacKenzie
Behav. Sci. 2023, 13(8), 652; https://doi.org/10.3390/bs13080652 - 4 Aug 2023
Viewed by 1613
Abstract
This study explores the relationship between staff rejection sensitivity (a psychological concept grounded in histories of loss and trauma) and organizational attachment among mental health agencies transitioning to Trauma-Informed Care (TIC), which is currently outside the focus of most research. Specifically, this study [...] Read more.
This study explores the relationship between staff rejection sensitivity (a psychological concept grounded in histories of loss and trauma) and organizational attachment among mental health agencies transitioning to Trauma-Informed Care (TIC), which is currently outside the focus of most research. Specifically, this study examines: (1) whether staff rejection sensitivity predicts organizational attachment; (2) whether staff turnover intentions account for the association between rejection sensitivity and organizational attachment; and (3) whether those associations hold once taking into account staff demographic factors (gender, race and ethnicity, education, and income)? Around 180 frontline workers in three Northeastern U.S. mental health agencies responded to surveys collected between 2016 and 2019 using the organizational attachment, rejection sensitivity and turnover intention measures, and their previous TIC training experience. Rejection sensitivity was significantly associated with organizational attachment (β = −0.39, p < 0.001), accounting for 6% of its variance in organizational attachment. The relationship between these variables retained significance, and staff education significantly predicted organizational attachment, with higher education predicting lower levels of organizational attachment (β = −0.15, p < 0.05), accounting for 22% of its variance. This study concludes that TIC transitioning mental health agencies’ staff with a higher rejection sensitivity are more likely to express lower organizational attachment and higher intent-to-turnover. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
15 pages, 279 KiB  
Article
Trauma-Responsive Vocational Rehabilitation Services
by Sara Chopp, Dimitri Topitzes and Joshua Mersky
Behav. Sci. 2023, 13(6), 511; https://doi.org/10.3390/bs13060511 - 19 Jun 2023
Cited by 1 | Viewed by 1501
Abstract
Research on the effectiveness of Vocational Rehabilitation (VR) Programs has revealed that VR services are less effective for trauma-affected and Black consumers. For instance, consumers with trauma exposure disengage from services earlier than their non-traumatized counterparts, and Black consumers benefit less from each [...] Read more.
Research on the effectiveness of Vocational Rehabilitation (VR) Programs has revealed that VR services are less effective for trauma-affected and Black consumers. For instance, consumers with trauma exposure disengage from services earlier than their non-traumatized counterparts, and Black consumers benefit less from each phase of VR services compared to others. One midwestern state’s VR program sought to address these disparities by offering trauma-informed and trauma-responsive services that emphasize cultural responsiveness, racial equity, and strengths-based practices. To begin this work, the state’s VR program collaborated with an applied research unit in a public university to establish two work groups: a communications group and a training group. The purpose of the communications group was to build a robust referral network within the VR Division and with other community-based agencies and providers, particularly for low-income, Black consumers. The purpose of the training group was to develop and deliver a training program to support VR professionals in providing trauma-informed and trauma-responsive services. Results from an evaluation of the training indicated that each training module generated for staff both reminders and new insights into ways to effectively work with consumers. Staff expressed that they wanted opportunities to further explore and apply the training content and needed additional, ongoing support to implement what they were learning. In response to staff needs, the state’s VR program is continuing to invest in this community–university partnership by establishing communities of practice for staff and evaluating the effectiveness of the training program. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
13 pages, 1030 KiB  
Article
Expanding the Trauma-Informed Care Measurement Toolkit: An Evaluation of the Attitudes Related to Trauma-Informed Care (ARTIC-45) Scale with SUD Workers in PIMH
by Alicia Mendez, Emily A. Bosk, Amanda Keller, Abigail Williams-Butler, Tareq Hardan, Debra J. Ruisard and Michael J. MacKenzie
Behav. Sci. 2023, 13(6), 471; https://doi.org/10.3390/bs13060471 - 5 Jun 2023
Cited by 2 | Viewed by 3510
Abstract
Human service organizations (HSO) have increasingly recognized the value of employing trauma-informed care (TIC) in a variety of practice settings. Evidence suggests that effectively adopting TIC has shown client improvements. Organizational barriers to TIC implementation, however, exist. To improve TIC practice, the attitudes [...] Read more.
Human service organizations (HSO) have increasingly recognized the value of employing trauma-informed care (TIC) in a variety of practice settings. Evidence suggests that effectively adopting TIC has shown client improvements. Organizational barriers to TIC implementation, however, exist. To improve TIC practice, the attitudes related to trauma-informed care (ARTIC) scale was developed to measure staff attitudes and beliefs towards TIC. The ARTIC has been widely adopted by researchers without evaluating its psychometric performance in diverse practice settings. The purpose of this study was to independently validate the ARTIC scale drawn from a sample of staff (n = 373) who provide services to substance-using parents. Psychometric tests were conducted to evaluate how the ARTIC performs with our HSO population. Results from a confirmatory factor analysis showed poor fit (X2 = 2761.62, df = 2.96; RMSEA = 0.07 [0.07, 0.08]; CFI = 0.72). An exploratory factor analysis was conducted to analyze how the data fit with our specific population, yielding 10 factors. Finally, a qualitative inter-item analysis of these factors was conducted, resulting in nine factors. Our findings suggest that measuring TIC attitudes and beliefs may vary according to field of practice and ethno-racially diverse workers. Further refinement of the ARTIC may be necessary for various services domains. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
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14 pages, 280 KiB  
Article
Institutional Courage in Healthcare: An Improvement Project Exploring the Perspectives of Veterans Exposed to Airborne Hazards
by Katharine Bloeser, Mikayla McAdams, Kelly K. McCarron, Samantha Varon, Lisa Pickett and Iman Johnson
Behav. Sci. 2023, 13(5), 423; https://doi.org/10.3390/bs13050423 - 17 May 2023
Cited by 1 | Viewed by 2370
Abstract
Background: Military environmental exposures and care for subsequent health concerns have been associated with institutional betrayal, or a perception on the part of veterans that the US government has failed to adequately prevent, acknowledge, and treat these conditions and in doing so has [...] Read more.
Background: Military environmental exposures and care for subsequent health concerns have been associated with institutional betrayal, or a perception on the part of veterans that the US government has failed to adequately prevent, acknowledge, and treat these conditions and in doing so has betrayed its promise to veterans. Institutional courage is a term developed to describe organizations that proactively protect and care for their members. While institutional courage may be useful in mitigating institutional betrayal, there is a lack of definitions of institutional courage in healthcare from the patient perspective. Methods: Using qualitative methods, we sought to explore the notions of institutional betrayal and institutional courage among veterans exposed to airborne hazards (i.e., airborne particulate matter such as open burn pits; N = 13) to inform and improve clinical practice. We performed initial interviews and follow-up interviews with veterans. Results: Veterans’ depictions of courageous institutions contained key themes of being accountable, proactive, and mindful of unique experiences, supporting advocacy, addressing stigma related to public benefits, and offering safety. Veterans described institutional courage as including both individual-level traits and systems or organizational-level characteristics. Conclusions: Several existing VA initiatives already address many themes identified in describing courageous institutions (e.g., accountability and advocacy). Other themes, especially views of public benefits and being proactive, hold particular value for building trauma-informed healthcare. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
12 pages, 532 KiB  
Article
The Restorative Integral Support (RIS) Model: Community-Based Integration of Trauma-Informed Approaches to Advance Equity and Resilience for Boys and Men of Color
by Stephanie Duncan, Heather Horton, Richard Smith, Bruce Purnell, Lisa Good and Heather Larkin
Behav. Sci. 2023, 13(4), 299; https://doi.org/10.3390/bs13040299 - 31 Mar 2023
Cited by 4 | Viewed by 3450
Abstract
Mental health and health promotion research and practice have consistently revealed the social and structural inequities that boys and men of color (BMoC) face. Moreover, scholarship highlights the importance of gender, especially the concepts of masculinity and manhood, in understanding inequities that are [...] Read more.
Mental health and health promotion research and practice have consistently revealed the social and structural inequities that boys and men of color (BMoC) face. Moreover, scholarship highlights the importance of gender, especially the concepts of masculinity and manhood, in understanding inequities that are experienced. Providers and community leaders are finding culturally relevant ways to foster healing and restoration while addressing racial trauma and the adverse community environments tied to adverse childhood experiences (ACEs). This article introduces the restorative integral support (RIS) model to promote connectivity through networks and to acknowledge the contextual differences BMoC experience when suffering from trauma and adversities. RIS is a framework used to address adversities and trauma while increasing societal awareness and advancing equity. This community-based, multidimensional approach is offered to enhance individual, agency, community, and policymaking leadership, raising awareness of mental health concerns and trauma while offering a flexible guide to developing safe spaces and support for recovery from ACEs and trauma. This article offers an in-depth appreciation of the real-life contexts within which BMoC overcome histories of adversity and trauma, demonstrating how the RIS model is applied to advance structural transformation while fostering community resilience. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
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Review

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28 pages, 1044 KiB  
Review
Implementing Trauma Informed Care in Human Services: An Ecological Scoping Review
by Daryl Mahon
Behav. Sci. 2022, 12(11), 431; https://doi.org/10.3390/bs12110431 - 2 Nov 2022
Cited by 7 | Viewed by 8235
Abstract
Trauma and toxic stress are growing public health concerns with increasing risks to morbidity and mortality. Trauma informed care is an organizational response that challenges providers to adapt principled based approaches that seek to reduce adverse effects of care and support healing. However, [...] Read more.
Trauma and toxic stress are growing public health concerns with increasing risks to morbidity and mortality. Trauma informed care is an organizational response that challenges providers to adapt principled based approaches that seek to reduce adverse effects of care and support healing. However, there is a scarcity of empirical evidence on how trauma informed care is implemented in systems. A preferred reporting items for systematic reviews and meta-analysis-compliant scoping review based on Arksey, and O’Malley’s five steps model was conducted. Four databases, PubMed, Scopus, Embase and PsychINFO were searched for English articles published since 2000. Studies were included if they reported on trauma informed care delivered by services that support adults and there was some reference to implementation or organizational implications. Of 1099 articles retrieved, 22 met the inclusion criteria. Findings suggest that trauma informed care is being implemented in a range of human services, including at the city/state level. While implementation research is still at an early stage in this field, the findings elucidate several challenges when implementing this approach across systems of care. An ecological lens is used to present findings at the macro, mezzo, and micro level, and these are further discussed with reference to practice, policy, and research. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
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Other

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16 pages, 650 KiB  
Concept Paper
Innovations in Trauma-Informed Care: Building the Nation’s First System of Trauma-Informed Recreation Centers
by Megan R. Holmes, Jennifer A. King, Emily K. Miller, Dakota L. King-White, Amy E. Korsch-Williams, Erica M. Johnson, Tomeika S. Oliver and Ivan T. Conard
Behav. Sci. 2023, 13(5), 394; https://doi.org/10.3390/bs13050394 - 9 May 2023
Cited by 4 | Viewed by 4171
Abstract
Exposure to adversity and traumatic events affects well-being across important domains of functioning, including mental, physical, social, emotional, spiritual, and neurobiological. Situated as a focal point throughout neighborhoods, recreation centers are a prime opportunity to cultivate spaces of safety and healing. However, current [...] Read more.
Exposure to adversity and traumatic events affects well-being across important domains of functioning, including mental, physical, social, emotional, spiritual, and neurobiological. Situated as a focal point throughout neighborhoods, recreation centers are a prime opportunity to cultivate spaces of safety and healing. However, current models of trauma-informed care largely do not map neatly onto the recreation organizational structure and functioning. This paper describes the efforts over the past five years to transform the City of Cleveland, Ohio’s 22 recreation centers into trauma-informed Neighborhood Resource and Recreation Centers (NRRCs)––places where children, youth, and adults can readily acquire the support and services they need in an environment in which trauma-informed care principles are fully embedded in the fabric of the organization’s culture. Phase 1 included transitioning the recreation centers to NRRCs, hiring of trained social workers and counselors to work within the recreation centers, and training all recreation staff about trauma. Phase 2 included development of NRRC trauma-informed standards, development of the Trauma-Informed Progress Tool to track change over time, development of Trauma-Informed Leadership Competencies for Center Managers, and ongoing training for the social workers and counselors. We discuss ideas for future work and lessons learned from each phase. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
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22 pages, 328 KiB  
Concept Paper
A Biocratic Paradigm: Exploring the Complexity of Trauma-Informed Leadership and Creating Presence™
by Sandra L. Bloom
Behav. Sci. 2023, 13(5), 355; https://doi.org/10.3390/bs13050355 - 24 Apr 2023
Cited by 3 | Viewed by 2745
Abstract
A paradigm shift is under way in the human services because of breakthrough knowledge and research in understanding the underlying etiology of physical, emotional, and social problems at the micro-level of the individual, at the meso-level of the family and institutions, and at [...] Read more.
A paradigm shift is under way in the human services because of breakthrough knowledge and research in understanding the underlying etiology of physical, emotional, and social problems at the micro-level of the individual, at the meso-level of the family and institutions, and at the macro-level of the entire society. The three levels of human existence—micro, mezzo, and macro—constitute interactive, interdependent, complex adaptive living systems. The complexity of these problems requires us to use our imaginations to envision health in individuals, organizations, and societies because it does not presently exist. After thousands of years of unrelenting exposure to trauma and adversity, we have all normalized what is a traumatogenic civilization. As a result, we live in a trauma-organized society in ways we are just beginning to understand in this century. This biopsychosocial knowledge base that is drawn upon here has come to be known as “trauma-informed” knowledge because it began with a deepening understanding of the impact of trauma on survivors of combat, disasters, and genocide, but now extends far beyond those specific boundaries. To lead any organization in a time of significant change means leading a revolution in understanding human nature and the fundamental causes of human pathology that are endangering all life on this planet and then helping organizational members develop skills to positively influence the changes necessary. In the 1930s, Dr. Walter B. Cannon, a Harvard physiologist who had named the “fight-flight” response and defined homeostasis, used the word “biocracy” to describe the relationship between the physical body and the social body, emphasizing the vital importance of democracy. This paper is a beginning attempt at integrating the concept of a biocratic organization with that of the trauma-informed knowledge necessary for leadership. Hope lies in properly diagnosing the problem, remembering ancient peace-making strategies, embracing universal life-preserving values, inspiring a new vision for the future, and radically and consciously changing our present self and other-destructive behavior. The paper concludes with a brief description of a new online educational program called Creating Presence™ that is being used in organizations as a method for creating and supporting the development of biocratic, trauma-informed organizations. Full article
(This article belongs to the Special Issue New Perspectives on Trauma-Responsive Care)
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