A Confirmatory Factor Analysis of the Trauma-Informed Climate Scale: Implications for Theory and Practice

Background and Purpose: This study examined the factor structure of the Trauma-Informed Climate Scale (TICS) with a sample of human service organizations providing a variety of services to children and adults. The TICS is a 31-item inventory consisting of Fallot and Harris’ (2001) five dimensions of trauma-informed care, including safety, trustworthiness, choice, collaboration and empowerment. The factor structure of the TICS was previously explored (Kusmaul, Wilson, & Nochajski, 2015) and found that safety and empowerment contained sub-dimensions. The study also found high correlations amongst the factors, suggesting trauma-informed care may be uni-dimensional.

Methods: Data were collected using a cross-sectional design. The TICS was administered to six human service organizations who provided a variety of services to children and adults. The sample included 641 respondents. The majority of the sample was white (N=460; 71.8%), female (N=430; 67.1%), held either a bachelor’s or master’s degree (N=342; 53.3%), and had an average of 12.72 (SD=9.64) years in human service. Age was collected categorically, with approximately equal number of respondents within the 20-30, 31-40, 41-50, and 51-60 ranges.

Confirmatory factor analysis was conducted using Mplus V7. The hypothesized model contained the seven factors previously identified. In addition, given the strength of the factor correlations previously reported the seven factors were loaded on a higher order factor representing an underlying dimension. Due to missing data and non-normality, maximum likelihood with robust standard errors was the method of estimation.

Results: The initial model resulted in a poor fit (RMSEA = .05; CFI = .89; TLI = .88; SRMR = .04). After allowing one item to cross load and two pairs of residuals to co vary the model fell within limits of acceptance (CFI and TLI > .90; RMSEA and SRMR < .05). In addition, the factors of TIC were strongly correlated ranging from .70 to .98 providing support for the uni-dimensional nature of trauma-informed care. Chrobach’s alpha for the TICS was .94, with scale reliabilities ranging from .62 and .83.

Conclusions and Implications: The findings suggest that trauma-informed care has an underlying single dimension. The seven initial dimensions found by Kusmaul, Wilson and Nochajski (2015) are not necessarily independent or hierarchical in nature, as in Maslow’s hierarchy of needs, and intervention along any of the dimensions may have impact within the other dimensions. The study also provides support for the validity of the TICS to be used in future research. Considering trauma-informed care’s empirical limitations, future research should explore the effects of its implementation on client and staff outcomes.

References

Harris, M., & Fallot, R. (Eds.). (2001). New Directions for Mental Health Services: Using Trauma Theory to Design Service Systems. San Francisco, CA: Jossey-Bass.

Kusmaul, N., Wilson, B., & Nochajski, T. (2015).  The Infusion of Trauma Informed Care in Organizations: Experience of Agency Staff.  Human Service Organizations: Management, Leadership, & Governance, 39, 25-37.