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An improved understanding of the lasting ways trauma impacts healthy development and well-being have increased calls for the utilization of interventions grounded in principles of “Trauma-Informed Care (TIC).” However, little is known about how the attitudes and individual characteristics of the mental health workforce impact the adoption and implementation of TIC. By analyzing staff attitudes about TIC as measured by the Attitudes Related to Trauma Informed Care(ARTIC) with other validated measures of individual staff characteristics such as attachment classification and rejection sensitivity, this work fills an important gap in knowledge regarding staff capacity to implement TIC. We hypothesize that staff with an insecure attachment classification and higher rejection sensitivity will be less comfortable adopting interventions that are consistent with TIC. Additionally, we hypothesize that staff with an insecure attachment classification and higher rejection sensitivity will be more likely to express an intent to turnover at organizations moving toward implementing TIC. Examining how internal staff capacities intersect with the deployment of TIC is critical to supporting effective practice in this area.
Methods
The sample consisted of 196 staff members at four mental health agencies in the Northeastern United States specializing in services for pregnant and parenting teens and -adults with complex substance use and housing needs. Staff were administered the ARTIC to examine the TIC orientation of staff members. Validated scales measuring attachment, rejection sensitivity, and job satisfaction were also used to measure individual level characteristics that are important in implementing TIC.
Results
Secure attachment significantly predicted ARTIC score( =.42,t(192)=2.21, p < .05), controlling for previous trauma training and years working in the field. Higher rejection sensitivity was significantly associated with lower ARTIC scores( =-.40, t(192)=-2.93, p < .01), controlling for previous trauma training and years working in the field. Years working in the field significantly predicted intent to turnover =-.34, t(225)=6.53, p < .001)controlling for previous training in trauma informed care. Finally, ARTIC score ( = -.32, t(192)=-3.22, p < .001), and years in the field (-.02, t(192)=-2.05, p < .05), both significantly predicted intent to turnover. Secure attachment and rejection sensitivity did not predict likelihood to turnover.
Implications and Conclusion
The strong association between staff sensitivity to rejection and attachment style with staff openness to TIC as measured by the ARTIC suggests that organizations need to pay attention to staff relational experiences when utilizing TIC. Staff relational experiences likely impact workforce buy in and readiness to adopt and implement TIC interventions and therefore require organizational assessment and intervention. Administering the ARTIC during the hiring process likely would assist organizations in identifying the staff most appropriate to deliver TIC interventions. Further, identifying staff with insecure attachment styles in the hiring process or after hire, and then providing specific supports to them, such as reflective supervision may enhance service delivery. This research underscores that individual staff characteristics are a critical component of adopting and implementing TIC.