title: Moving toward trauma-informed practice in addiction treatment: a collaborative model of agency assessment.
abstract: Clients in substance abuse treatment need, in addition to evidence-based and sensitive treatment services in general, a system of care that takes into account the impact of trauma and violence in so many of their lives. In addition, services need to be delivered in a way that avoids triggering trauma memories or causing unintentional re-traumatization. To that end, this article describes an agency self-assessment process that combines a trauma-informed assessment, a NIATx process of "walking-through" and use of the Institute of Healthcare Improvement's Plan-Do-Study-Act (PDSA) cycles, and a user-friendly format. The trauma-informed assessment is designed to address issues of safety of clients and staff members, reduction of re-traumatization, consistency in practice, and client empowerment. It brings a non-judgmental, collaborative approach to process and practice improvement. The article describes how the assessment process can be--and has been--used to develop an Action Plan, including trainings and the identification of "trauma champions"; i.e., staff who will continue to spread trauma-informed changes and new evidence-based practices throughout the agency. As we enter a period of healthcare reform, addressing trauma as an integral part of addiction treatment also allows us to better deal with the totality of our clients' health problems.
authors.affiliation: Prototypes, Manhattan Beach, CA 90266, USA. protoceo@aol.com
authors.forename: Vivian Barnett
authors.initials: VB
authors.lastname: Brown
authors.affiliation: Community Connections, Washington, DC, USA.
authors.forename: Maxine
authors.initials: M
authors.lastname: Harris
authors.affiliation: Community Connections, Washington, DC, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Fallot
mesh_terms: D003299:Cooperative Behavior; D006801:Humans; D012647:Self-Assessment; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D019966:Substance-Related Disorders / Q000628:therapy*; D014754:Violence