Becoming a Trauma-Informed Organization: Facilitators and Barriers in Implementing Change

Background and Purpose

Trauma negatively impacts an individual’s emotional regulation, relationships, mental cognitions, and brain development.  As the deleterious effects of trauma have become better understood, the need for trauma-informed care in the social services has been increasingly clear.  At its core, trauma-informed care (TIC) makes a key assumption – that any individual in a service agency may have experienced trauma, from administrators to clients.  Becoming trauma-informed is a specific type of organizational change centered on five core values: safety, trustworthiness, choice, collaboration, and empowerment.  Fortunately, many child and family service agencies are adopting a trauma-informed approach.  However, more research is needed to better understand the organizational factors that facilitate and impede this process.  This current study provides a case example of one child and family service agency that has begun this process of becoming trauma-informed.  Using a mixed-methods approach, this study: 1) assessed changes in the agency’s trauma-informed climate, and 2) examined potential factors that influenced the organizational change process.   

Methods

For the initial quantitative phase, a 34-item instrument, the Trauma-Informed Climate Survey (TICS), was administered via email to all staff members at two time points: 2012 (n=160) and 2017 (n=128).  The TICS measures staff’s psychological perceptions of the service environment and represents the five core values of TIC. Cohen’s d effect sizes were computed to compare TICS scale scores between 2012 and 2017.  For the subsequent qualitative phase, 30-40 minute semi-structured interviews were conducted with 7 key stakeholders, all of whom were currently employed by the agency and had extensive experience and insights on organizational operations.  Interviews were audio-recorded and transcribed, and Atlas.ti was used in the analysis.  Using an a priori framework that reflected the main areas of inquiry, the researchers used qualitative description to first code the data and then identify themes and patterns related to facilitators and barriers of the organizational change process.

Results

Each of the five values measured by the TICS increased from 2012 to 2017. All effect sizes were small to medium in magnitude (ranging from .24 to .42). The most notable effect size differences were evident in staff empowerment (Cohen’s d = .40), receiving support for trying new things (Cohen’s d = .42), and staff perceptions of safety in the work environment (Cohen’s d = .39). Results of the qualitative interviews identified the following factors as facilitating an improved trauma-informed climate: creating shared values and norms; having shared responsibility and commitment to promoting positive change; and openness to learning and growth.  Additionally, barriers included staff turnover and internal dynamics (such as the long-lasting impact of merging agencies and cultures).

Implications

In creating sustained trauma-informed climate change within an organization, this case study highlights the importance of having champions at all levels of the agency to provide on-going support as well as accountability. Implications of this study also indicate the need for on-going dedication of resources after the initial implementation phase, and the strategic integration of related agency initiatives and efforts so that the core elements of TIC are enhanced.