Media Wiki - User contributions [en]

Category:SAFE-Law Enforcement and Criminal Justice

2020-02-14T17:59:02Z

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'''Law Enforcement and Criminal Justice '''is one of SAFE Projects six lines of operation, a comprehensive approach to ending this epidemic.  Both Law Enforcement and Criminal Justice need the resources, strategies and partnerships to ensure they can quickly and effectively keep our communities safe. For communities, successful collaboration with law enforcement and criminal justice is the long-term solution to this crisis and the next one.
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=== By the Numbers: ===

*[[File:TakeBack300x300.jpg|right|top|200x200px|TakeBack300x300.jpg]]140,000 people enter drug court annually. 75% of drug court graduates don’t re-offend, compared to just 30% of those released from prisons. (National Association of Drug Court Professionals, 2017)
*The Center for Disease Control (CDC) identified 15,466 fatalities in 2016 resulting from heroin overdoses, but 20,145 fatalities were caused by fentanyl or other synthetic opioids. (Police Executive Research Forum, 2017)
*In states that adopt a naloxone access law, there is a 9-11% decrease in the number of opioid-related deaths.  (National Bureau of Economic Research, 2017)

=== Programs: ===

'''SAFE Pre-Arrest Diversion '''– Pre-arrest diversion and other post arrest diversion programs are key to ending the cycle of addiction and incarceration. Users must be diverted from the criminal justice system and into treatment at every opportunity. SAFE Project encourages police and sheriff’s to adopt pre-arrest diversion programs and join the ranks of SAFE Project stations across the country.

 

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Category:SAFE-Prescriptions and Medical Response

2020-02-14T17:45:28Z

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'''Prescriptions and Medical Response''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. Overprescribing can lead to addiction or death, while stigma remains a barrier to effective treatment. SAFE Project strives to make prescription medicine safer through public awareness, education and stigma reduction. This can be achieved at the community level, and can save lives. Additionally,first responders have been fighting the opioid epidemic longer than anyone – Emergency Medical Technicians and firefighters are often the first on the scene of an overdose. 
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=== Facts & Figures: ===

*After taking opioids for just 5 days in a row, a person becomes more likely to take them long-term. (CDC, 2017)
*Research shows that a combination of ibuprofen and acetaminophen is superior to opioids for treating many types of pain, including acute dental pain. ([https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/Evidence-Efficacy-Pain-Medications.pdf National Safety Council] and [https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain Case Western University], 2018)
*More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else. (CDC)
*More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. (NIDA, 2018). Benzodiazepines can be deadly when used with opioids.
*Among the more than 72,000 drug overdose deaths estimated in 2017*, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. Source: CDC WONDER
*Initial research shows that communities with overdose education and naloxone distribution (OEND) programs have lower opioid overdose death rates. (NIDA 2018)
*In states that adopt a naloxone access law, there is a 9-11% decrease in the number of opioid-related deaths.  (National Bureau of Economic Research, 2017)

=== Programs: ===

'''Naloxone Awareness Program''' – Using our volunteer network, we reach out to pharmacies with a goal of facilitating increased access to naloxone under existing law. By simply asking about the policy for dispensing, we work to increase awareness, readiness to save lives, and reduce stigma. We also ask our volunteers to become educated about naloxone as a first aid measure, state rules for access, and commit to telling people about it.

'''Opioid Risk Campaigns''' – Hospitals and clinics play a vital role in eliminating overprescribing, overcoming opioid dependence, and promoting opioid safety among patients and healthcare providers. SAFE Project works with hospital systems and clinics to develop campaigns that reduce opioid risks through awareness and education.

'''SAFE Meds''' – SAFE increases awareness and safer behaviors around prescription medicines with downloadable fact sheets providing easy to understand information. SAFE Med Facts arm communities and families about safe use, disposal and questions you should ask healthcare providers and pharmacists to decrease risk to yourself and those you love.
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Category:SAFE-Law Enforcement and Criminal Justice

2020-02-14T17:31:33Z

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Category:SAFE-Law Enforcement and Criminal Justice

2020-02-14T17:28:49Z

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Expand Community Support for Families of People with SUDs

2020-02-13T21:01:58Z

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Expand Community Support for Families of People with SUDs

2020-02-13T21:00:27Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:58:13Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:57:08Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:56:28Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:54:45Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:51:30Z

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Expand Community Support for Families of People with SUDs

2020-02-13T20:49:53Z

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Expand Community Support for Families of People with SUDs

2020-02-13T18:01:34Z

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Expand Community Support for Families of People with SUDs

2020-02-13T18:01:10Z

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Expand Community Support for Families of People with SUDs

2020-02-13T17:59:33Z

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Expand Community Support for Families of People with SUDs

2020-02-13T17:54:59Z

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Expand Community Support for Families of People with SUDs

2020-02-13T17:54:13Z

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Expand Community Support for Families of People with SUDs

2020-02-13T17:26:43Z

Genafitz: Genafitz moved page Enhance Support for Families of People with SUDs to Expand Community Support for Families of People with SUDs: clarify content

Enhance Support for Families of People with SUDs

2020-02-13T17:26:43Z

Genafitz: Genafitz moved page Enhance Support for Families of People with SUDs to Expand Community Support for Families of People with SUDs: clarify content

#REDIRECT [[Expand Community Support for Families of People with SUDs]]

Expand Community Support for Families of People with SUDs

2020-02-06T20:59:36Z

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Expand Community Support for Families of People with SUDs

2020-02-06T20:59:10Z

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Become a Trauma-Informed Community

2020-02-06T20:50:05Z

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<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma. '''[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|left|upright|ACEs infographic print 2015.4.5 v2.jpg]]''' The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

'''Adverse Childhood Experiences,''' or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

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== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>
== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
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[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:49:26Z

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<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
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== Root Causes of Trauma ==

'''[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|left|upright|ACEs infographic print 2015.4.5 v2.jpg]]'''Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

'''Adverse Childhood Experiences,''' or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

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== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>
== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:48:58Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>
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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

'''[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|left|upright]]Adverse Childhood Experiences,''' or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

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== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>
== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div> </div> </div> </div> </div> </div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:45:13Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

 

 

 

 

 

 

'''Adverse Childhood Experiences,''' or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref></div> </div> </div> <div class="mw-parser-output"> </div> </div></div></div></div></div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:44:25Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref></div> </div> </div> <div class="mw-parser-output"> </div> </div></div></div></div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:43:32Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frame|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref> </div> </div> </div>
<div class="mw-parser-output"> </div> </div></div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:43:06Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frame|right|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref> </div> </div> </div>
<div class="mw-parser-output"> </div> </div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:41:37Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref>
</div> </div> </div>

<div class="mw-parser-output">
== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:41:11Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref>
</div> </div> </div>

<div class="mw-parser-output">
==   ==

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  
</div>

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:40:42Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref>
</div> </div> </div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:38:52Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

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<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
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== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

 
<div>Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref></div> </div> </div> </div> </div>
</div> </div>
</div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:38:22Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

<div class="mw-parser-output">
<div class="mw-parser-output"><div class="mw-parser-output">
<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

[[File:ACEs infographic print 2015.4.5 v2.jpg|frameless|right|upright|ACES Infographic, Robert W. Johnson Foundation]]Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
<div>Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref></div> </div> </div> </div> </div>
</div>
</div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

File:ACEs infographic print 2015.4.5 v2.jpg

2020-02-06T20:34:00Z

Genafitz: Genafitz uploaded a new version of File:ACEs infographic print 2015.4.5 v2.jpg

File:ACEs infographic print 2015.4.5 v2.jpg

2020-02-06T20:31:27Z

Genafitz:

Become a Trauma-Informed Community

2020-02-06T20:30:28Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

<div class="mw-parser-output">
<div class="mw-parser-output"><div class="mw-parser-output">
== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>
<div>Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref></div> </div>
</div>
</div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:10:49Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

<div class="mw-parser-output">
== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref>

Adverse Childhood Experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref>

Some communities have developed expanded versions of the ACES survey to address issues specific to their region or city. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref>
</div>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Become a Trauma-Informed Community

2020-02-06T20:05:42Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Minimize_Desire_to_Misuse_Opioids|the Zoom Map (Minimize Desire to Misuse Opioids)]] or [[ZOOM_Map-Become_a_Trauma_Informed_Community|ZOOM MAP - Become a Trauma-Informed Community]]  
= Become a Trauma-Informed Community =

To become “Trauma Informed,” it’s necessary for any community to first understand the root causes of trauma. Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical, but may also become delayed or long term reactions include unpredictable emotions, flashbacks, or even physical symptoms like headaches or nausea. The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref name="2015 Position Statement on Trauma Informed Communities, in a letter from the Wilson Foundation to United Way of Greater Rochester on how to create a Trauma Informed Community"> http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>

== Root Causes of Trauma ==

Trauma is especially common in the lives of people with behavioral and/or substance use disorders, according to SAMHSA.<ref>https://store.samhsa.gov/product/SAMHSA-s-Concept-of-Trauma-and-Guidance-for-a-Trauma-Informed-Approach/SMA14-4884.html</ref> For this reason, the need to address trauma is increasingly viewed as a critical component of behavioral health care and part of the healing and recovery process. To become “Trauma Informed”, it’s necessary for any community to first understand the root causes of trauma.  The American Psychological Association defines trauma “..as an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.”<ref>https://www.apa.org/topics/trauma/</ref> Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years).<ref>https://acestoohigh.com/got-your-ace-score/</ref> The survey measures 10 types of childhood trauma; five are personal: physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. The higher the ACES score, the higher the risk of social and health issues -- including substance use disorder. Using the ACES survey as a foundation, communities can see how trauma can result from racism and discrimination, intergenerational poverty, lack of job opportunities, exposure to violence, substandard housing and education, and lack of access to key services.<ref>https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing
</ref> Some communities have developed expanded versions of the ACES survey to address issues specific to their issues. For example, the city of Philadelphia’s Expanded ACE subscale has respondents answer six questions specific to experiences in their communities: witnessing violence, experiencing discrimination, food insecurity, experiencing racism, living in an unsafe neighborhood, being bullied, or living in foster care.<ref>http://sparqtools.org/mobility-measure/philadelphia-adverse-childhood-experiences-phl-ace/

</ref>

== What Is a Trauma Informed Community? ==

The Wilson Foundation of Rochester, NY describes the concept of trauma informed community as “...a strategic approach linking all community sectors together around the effects of trauma, while preventing gaps in services for clients. It is coordinated and collaborative; recognizes that the diversity of the population requires individual responses; uses a common language, measurements and accountability.”<ref>[7]</ref> If a community works to identify the specific drivers of trauma in its own backyard, it can also identify the factors that influence substance use disorder, allowing them to create the appropriate community supports for behavioral health care plus healing and recovery.<ref>http://wilsonfdn.org/wp/wp-content/uploads/2015/03/TIC-position-paper.pdf
</ref>  

== Trauma-Informed Systems ==

The National Child Traumatic Stress Network describes a trauma-informed service system as  one where all agencies, programs, and service providers have a trauma-informed perspective: <ref>https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems</ref> *Routinely screen for trauma exposure and related symptoms. *Use evidence-based, culturally responsive assessment and treatment for traumatic stress and associated mental health symptoms. *Make resources available to children, families, and providers on trauma exposure, its impact, and treatment. *Engage in efforts to strengthen the resilience and protective factors of children and families impacted by and vulnerable to trauma. *Address parent and caregiver trauma and its impact on the family system. *Emphasize continuity of care and collaboration across child-service systems.  *Maintain an environment of care for staff that addresses, minimizes, and treats secondary traumatic stress, and that increases staff wellness.

=== Child Welfare ===

Substance use disorders can affect parents’ ability to effectively care for their children, and is sometimes linked to rises in foster care placement and mistreatment cases. These parents are also particularly vulnerable population, and benefit from a family-based approach to care, ensuring that community services are tailored to children’s needs and are provided in tandem with those delivered to the whole family. <ref>https://nashp.org/wp-content/uploads/2018/09/Children-and-Opioid-Epidemic-1.pdf</ref>

=== School Systems ===

For any community, schools and educators may be the first resource for students coping with traumatic events. And it’s not just teachers in the classroom - it includes administrators, staff, and parents. This environment supports all children to feel safe physically, socially, emotionally, and academically.  When interviewed for a Washington State resource guide for creating trauma informed school settings, one teacher described the issue succinctly: Students who try to focus on academics while struggling with trauma is like “trying to play chess in a hurricane."<ref>https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf</ref>  

=== Healthcare ===

Individuals who have experienced trauma are at an elevated risk for substance use disorders, including use and dependence. A trauma-informed healthcare system understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize those seeking help.<ref>http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html </ref>

=== Justice ===

In a law enforcement setting, a trauma-informed approach starts with the same premise:  understand the physical, social, and emotional impact of trauma on the individual involved in that system. It also requires the understanding that both police officers and other professionals may also be traumatized by a particular event or long-term history of or exposure to violence.<ref>https://www.vera.org/blog/police-perspectives/building-trust-through-trauma-informed-policing</ref>

=== Ensuring Diversity in Trauma Informed Settings ===

ACEs Connection's Diversity, Equity & Inclusion Tool helps communities organize their stakeholders and other contacts to make sure that every part of the community is included, from education to law enforcement to the faith-based community.<ref>https://www.acesconnection.com/g/fairfax-county-va-trauma-informed-community-network/blog/aces-connection-s-inclusion-tool-makes-sure-nobody-s-left-out</ref>

== Successful City Initiatives ==

=== Tarpon City, Florida: Peace4Tarpon ===

Tarpon City, on Central Florida’s Gulf Coast, was the first city in the US to declare itself a trauma-informed community.  Trauma-informed practices have been implemented in small and large ways in a variety of organizations, including an elementary school, an ex-offender re-entry program and the local housing authority.<ref>https://acestoohigh.com/2014/09/17/tarponsprings/</ref>

=== Washington State: Compassionate Schools ===

This Compassionate Schools program has a universal focus - it helps Washington teachers understand fundamental brain development and function, correctly interpret behaviors, while engaging students, families, and the community. It simultaneously uses  strategies that touch students daily -- whether it’s mindfulness activities into everyday teaching and learning, creating a contract with a student for conflict resolution, or creating culture that supports learning.   The program resulted in dropping absenteeism rates, a decrease in disciplinary referrals, plus improved engagement and achievement among students.<ref>https://www.k12.wa.us/student-success/health-safety/mental-social-behavioral-health/compassionate-schools-learning-and </ref>  

= Tools & Resources =

'''ACEs Connection: '''Main information exchange and resources for local, state, and and national ACEs initiatives.[https://www.acesconnection.com/ https://www.acesconnection.com/]

'''Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, Prevention Institute (2015) '''-[https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing]

'''Compassionate Schools,Washington State Office of Superintendent of Public Instruction ('''OSPI)  -- The Heart of Learning and Teaching: Compassion, Resiliency, and Academic Success [https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf https://www.k12.wa.us/sites/default/files/public/compassionateschools/pubdocs/theheartoflearningandteaching.pdf]

'''National Child Traumatic Stress Network Learning Center: '''Registering for this free online learning center provides access to several archived sessions of interest to education professionals. The Schools and Trauma Speaker Series has five archived sessions: (1) Trauma-informed IEPs(2)Evidence-based practices(3) Sudden death on a school campus(4) Trauma-informed understanding of bullying (5) School/mental health partnerships. More resources available.  [http://learn.nctsn.org/ http://learn.nctsn.org/]

'''National Institutes of Health:''' Trauma-Informed Care in Behavioral Health Services, Treatment Improvement Protocol (TIP) Series, No. 57, SAMHSA: [https://www.ncbi.nlm.nih.gov/books/NBK207201/ https://www.ncbi.nlm.nih.gov/books/NBK207201/]

'''Trauma Informed Schools Resource Guide, Wilson Foundation'''  [http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf http://wilsonfdn.org/wp/wp-content/uploads/2015/03/Trauma-Informed-Schools-Resource-Guide.pdf]
</div> </div> </div>
[[Category:SAFE-Public Awareness]] [[Category:SAFE-Full Spectrum Prevention]]

Category:SAFE-Public Awareness

2020-02-06T19:36:32Z

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'''Public Awareness '''is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It educates the public about the disease of Substance Use Disorder and the dangers of prescription opioids and heroin. However, awareness alone does not solve the crisis.

Through Public Awareness, we work to reduce stigma and bias surrounding those in addiction and their families, as well as providing trustworthy resources and advice Our awareness efforts include partnering and engaging with national efforts and community initiatives stem the opioid epidemic.  Our multi-pronged approach includes creating educational resources, media and community outreach, and creating awareness campaigns. Specifically, our focus areas include:

#Leveraging select media, partnerships, and public events to create large-scale opportunities for public awareness.
#Educating communities about prescription drug and opioids, as well as the safe storage and disposal of prescription drugs.
#Creating public education campaigns to help reduce bias and stigma, focusing on substance use disorder as a health concern rather than a moral or criminal issue. Stigma towards addiction and ignorance colors our nation’s approach to drugs, effectively blocking opportunities for treatment and change.
#Educating and training journalists to reduce sensationalism in stories surrounding the disease of addiction, and to fairly cover the epidemic regardless of race, ethnicity, or income level.

=== '''''Changing the Language of Addiction''''' ===

Terms that stigmatize substance use disorder can negatively affect the perspective and behavior of prospective  patients, clients, scientists and clinicians. Stigma and shame can be an insurmountable barrier to treatment for those who need help, as well as their families.

Clinicians, pharmacists, and behavioral health experts especially need to be aware of person-first language and avoid stigmatizing terms. (American Society of Addiction Medicine)

'''Words Matter''' One of the simplest ways anyone can help destigmatize substance use disorder is by talking about it in a non-judgemental way.  Not sure what to say?  SAFE Project highly recommends [https://www.recoveryanswers.org/addiction-ary/#addict ADDICTIONARY, ]created by the Recovery Research Institute.

For example:

*Say  “Person in recovery” instead of “former addict.”
*Say “People with “substance use disorder” instead of “addict” or “junkie.”

=== By the Numbers: ===

*43% of Americans now say the use of opioid prescription pain relievers is a serious problem in their community, up from 33% two years ago. Regarding heroin, 37% say it is a serious problem in their community, 25% regard it as moderately serious, and 33% say heroin is not a problem where they live.*
*57% of Americans have experience dealing with substance misuse ranging from taking a painkiller that wasn’t prescribed to overdosing. 24% say they have an addicted relative, close friend, or that they themselves are addicted to opioids. 40% are or know someone addicted to alcohol or another type of drug. 13% have lost a relative or close friend to opioids.*

''*Statistics above are from the [http://www.apnorc.org/PDFs/Opioids%202018/APNORC_Opioids_Report_2018.pdf Associated Press-NORC Center for Public Affairs Research], April 2018 Survey''

*''25% of rural Americans say that substance use disorder (including opioids)is the biggest problem facing their local community, followed by economic concerns, including the availability of jobs, poverty, a''''nd the economy. **'''''<b>
*'''23% of rural Americans say that substance use disorder is the most urgent health problem currently facing their community, followed by cancer (12%) and access to health care (11%) **'''

*
**''' ''Statistics above from the NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. “Life in Rural America Survey”, October 2018'''''

=== '''Public Awareness Efforts:''' ===

*'''Online content for families including [https://www.safeproject.us/home-page/lessons-learned/ Lessons Learned][https://www.safeproject.us/home-page/lessons-learned/  and ][https://www.safeproject.us/share-your-story/ Share Your Story.]'''
*'''Campaigns including the [https://www.safeproject.us/be-safe/ BE SAFE Campaign.]'''
*'''Partner in education efforts, such as the documentary [https://www.pbs.org/wgbh/nova/video/addiction/ NOVA/PBS  “Addiction”][https://www.pbs.org/wgbh/nova/video/addiction/ , ]'''
*'''Leverage media, public events, & partnership opportunities for public awareness.'''

'''</div> </div>'''
</div> </div> </div>

Category:SAFE-Treatment and Recovery

2020-02-06T19:33:38Z

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'''Treatment and Recovery''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It provides resources, consultation, and programming to strengthen and advance community efforts to effectively respond to substance use challenges.

SAFE conducts and coordinates trainings and events, and seeks to educate on substance use disorders and treatment and recovery best practices. Objectives include:

#Provide education on substance use disorder and best practices for treatment and recovery services
#Support and advance effective treatment and recovery efforts
#Advocate for improvements in treatment and recovery systems and services
#Provide resources on effective and innovative treatment and recovery support practices
#Unify communities to strengthen treatment and recovery efforts

=== By the Numbers: ===

*There are roughly 25-million Americans living in long-term recovery from addiction to alcohol and other drugs. (“Facing Addiction in American, US Surgeon General, 2016)
*Research on alcohol, drug use, and addiction, has led to one clear conclusion: Addiction to alcohol or drugs is a chronic but treatable brain disease that requires medical intervention, NOT moral judgment. (“Facing Addiction in America, US Surgeon General, 2016)
*Women may be more likely to take prescription opioids without a prescription to cope with pain, even when men and women report similar pain levels. Research also suggests that women are more likely to misuse prescription opioids to self-treat for other problems such as anxiety or tension. (NIDA, Substance Use in Women, 2018)
*Daily marijuana use is its highest level since the early 1980s for young adults, with 4.9 percent of college students and 12.8 percent of non-college peers reporting daily use. (NIDA, 2016, “Monitoring the Future”)

===   ===
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==== SAFE Campuses ====

[https://www.safeproject.us/s-a-f-e-campuses/ SAFE Campuses] was designed to create and strengthen efforts to ensure that collegiate recovery programs (CRPs) or other adequate recovery support services are present on every college campus nationwide. The program provides college students with the tools and support they need to succeed in the lifelong journey of addiction recovery. It also provides collegiate institutions with the knowledge and solutions necessary to effectively support students who are in or seeking recovery from substance use disorder. SAFE Campuses promotes healthy living and empowers college students in recovery to be positive leaders on campus and in life.

The '''Collegiate Recovery Leadership Academy<ref>https://www.safeproject.us/campuses/leadership-academy/</ref> '''was created in 2018, through the SAFE Campuses initiative. The goal of the Leadership Academy is to develop and cultivate future leaders from college campuses across the nation. The Leadership Academy is an academic year-long fellowship for any college student who is passionate about the intersection of collegiate recovery, leadership, and service to others. It is open to students who are in recovery, as well as recovery allies.
</div> </div> </div> </div> </div>

Category:SAFE-Treatment and Recovery

2020-02-06T19:32:02Z

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__NOTOC__

Treatment and Recovery is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It provides resources, consultation, and programming to strengthen and advance community efforts to effectively respond to substance use challenges.

SAFE conducts and coordinates trainings and events, and seeks to educate on substance use disorders and treatment and recovery best practices. Objectives include:

#Provide education on substance use disorder and best practices for treatment and recovery services
#Support and advance effective treatment and recovery efforts
#Advocate for improvements in treatment and recovery systems and services
#Provide resources on effective and innovative treatment and recovery support practices
#Unify communities to strengthen treatment and recovery efforts

=== By the Numbers: ===

*There are roughly 25-million Americans living in long-term recovery from addiction to alcohol and other drugs. (“Facing Addiction in American, US Surgeon General, 2016)
*Research on alcohol, drug use, and addiction, has led to one clear conclusion: Addiction to alcohol or drugs is a chronic but treatable brain disease that requires medical intervention, NOT moral judgment. (“Facing Addiction in America, US Surgeon General, 2016)
*Women may be more likely to take prescription opioids without a prescription to cope with pain, even when men and women report similar pain levels. Research also suggests that women are more likely to misuse prescription opioids to self-treat for other problems such as anxiety or tension. (NIDA, Substance Use in Women, 2018)
*Daily marijuana use is its highest level since the early 1980s for young adults, with 4.9 percent of college students and 12.8 percent of non-college peers reporting daily use. (NIDA, 2016, “Monitoring the Future”)

=== Programs: ===

<div class="mw-parser-output">
==== SAFE Campuses ====

[https://www.safeproject.us/s-a-f-e-campuses/ SAFE Campuses] was designed to create and strengthen efforts to ensure that collegiate recovery programs (CRPs) or other adequate recovery support services are present on every college campus nationwide. The program provides college students with the tools and support they need to succeed in the lifelong journey of addiction recovery. It also provides collegiate institutions with the knowledge and solutions necessary to effectively support students who are in or seeking recovery from substance use disorder. SAFE Campuses promotes healthy living and empowers college students in recovery to be positive leaders on campus and in life.

The'''Collegiate Recovery Leadership Academy<ref>https://www.safeproject.us/campuses/leadership-academy/</ref> '''was created in 2018, through SAFE Project’s SAFE Campuses initiative. The goal of the Leadership Academy is to develop and cultivate future leaders from college campuses across the nation. The Leadership Academy is an academic year- long fellowship for any college student who is passionate about the intersection of collegiate recovery, leadership, and service to others. It is open to students who are in recovery, as well as recovery allies.
</div>

Category:SAFE-Treatment and Recovery

2020-02-06T19:25:18Z

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<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
__NOTOC__

Treatment and Recovery is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It provides resources, consultation, and programming to strengthen and advance community efforts to effectively respond to substance use challenges.

SAFE conducts and coordinates trainings and events, and seeks to educate on substance use disorders and treatment and recovery best practices. Objectives include:

#Provide education on substance use disorder and best practices for treatment and recovery services
#Support and advance effective treatment and recovery efforts
#Advocate for improvements in treatment and recovery systems and services
#Provide resources on effective and innovative treatment and recovery support practices
#Unify communities to strengthen treatment and recovery efforts

=== By the Numbers: ===

*There are roughly 25-million Americans living in long-term recovery from addiction to alcohol and other drugs. (“Facing Addiction in American, US Surgeon General, 2016)
*Research on alcohol, drug use, and addiction, has led to one clear conclusion: Addiction to alcohol or drugs is a chronic but treatable brain disease that requires medical intervention, NOT moral judgment. (“Facing Addiction in America, US Surgeon General, 2016)
*Women may be more likely to take prescription opioids without a prescription to cope with pain, even when men and women report similar pain levels. Research also suggests that women are more likely to misuse prescription opioids to self-treat for other problems such as anxiety or tension. (NIDA, Substance Use in Women, 2018)
*Daily marijuana use is its highest level since the early 1980s for young adults, with 4.9 percent of college students and 12.8 percent of non-college peers reporting daily use. (NIDA, 2016, “Monitoring the Future”)

=== Programs: ===

==== SAFE Campuses ====

[https://www.safeproject.us/s-a-f-e-campuses/ SAFE Campuses] was designed to create and strengthen efforts to ensure that collegiate recovery programs (CRPs) or other adequate recovery support services are present on every college campus nationwide. The program provides college students with the tools and support they need to succeed in the lifelong journey of addiction recovery. It also provides collegiate institutions with the knowledge and solutions necessary to effectively support students who are in or seeking recovery from substance use disorder. SAFE Campuses promotes healthy living and empowers college students in recovery to be positive leaders on campus and in life.

Collegiate Recovery Leadership Academies are one program within SAFE Campuses.  In collaboration with the Association of Recovery in Higher Education (ARHE), S.A.F.E. Project is hosting a Collegiate Recovery Leadership Academy in the 2018-2019 academic year. Students who were accepted into The Academy are completing a year long (October-June) recovery-related project on their campus or community with the guidance of a mentor who has expertise in substance use disorder recovery. Accepted students also attended a weekend Leadership Summit in their region.  The Academy will provide students with the information needed to create and strengthen efforts on their campuses and train them to be effective servant leaders.
</div> </div> </div>

Category:SAFE-Family Outreach and Support

2020-02-06T19:21:24Z

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'''Family Outreach and Support''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It provides meaningful advice and a shared community for friends and family members who are coping with a loved one’s substance use disorder, treatment, transition, or recovery. We also partner and engage with grassroots family efforts to stem the epidemic.

The entire family — not just the person in addiction — feels the effects of substance use disorder. SAFE Project helps families, friends, helpers, and caregivers who play diverse roles and may require a variety of supports.  Through events and our website, we share our experiences and insights to instill hope, increase understanding, and strengthen resilience.

=== By the Numbers: ===

*It’s estimated that about 8.7 million children aged 17 or younger lived in households with at least one parent who had a past year substance use disorder (SUD). That’s one out of every eight children in the nation. (''National Surveys on Drug Use and Health 2009-2014'')
*Between 2000 and 2016, the number of children under age 20 living in counties with high drug overdose death rates—defined as 20 or more deaths per 100,000 population—rose from less than 250,000 to nearly 22.6 million, nearly a '''100-fold increase'''.  [https://www.prb.org/a-growing-number-of-u-s-children-live-in-counties-affected-by-the-drug-epidemic/ Population Reference Bureau]
*Teens are significantly more likely to have used nonmedical prescription opioids when a parent has also misused the drugs.  In fact, parental smoking, alcohol use, and marijuana use are all associated with increased use of the same substances by their teens. [https://pediatrics.aappublications.org/content/143/3/e20182354 Journal of Pediatrics, March 2019 ] 
*More than 1/3 of all children placed in foster care because of parental alcohol or drug use are placed with relatives.''  Generations United: The ''[https://www.gu.org/resources/the-state-of-grandfamilies-in-america-2016/ ''State of Grandfamilies in America Annual Report (2018)'']
*From 2004 to 2014, the rate of U.S. infants diagnosed with opioid withdrawal symptoms, known as neonatal abstinence syndrome (NAS), increased 433%, from 1.5 to 8.0 per 1,000 hospital births. ''(Vanderbilt University Medical Center, 2018)''

=== Programs: ===

*Website resources, including Lessons Learned, Share Your Story, and education modules.
*SAFE Project Family Network (in progress).
</div> </div> </div> </div>

Category:SAFE-Family Outreach and Support

2020-02-06T19:21:01Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
Family Outreach and Support is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. It provides meaningful advice and a shared community for friends and family members who are coping with a loved one’s substance use disorder, treatment, transition, or recovery. We also partner and engage with grassroots family efforts to stem the epidemic.

The entire family — not just the person in addiction — feels the effects of substance use disorder. SAFE Project helps families, friends, helpers, and caregivers who play diverse roles and may require a variety of supports.  Through events and our website, we share our experiences and insights to instill hope, increase understanding, and strengthen resilience.

=== By the Numbers: ===

*It’s estimated that about 8.7 million children aged 17 or younger lived in households with at least one parent who had a past year substance use disorder (SUD). That’s one out of every eight children in the nation. (''National Surveys on Drug Use and Health 2009-2014'')
*Between 2000 and 2016, the number of children under age 20 living in counties with high drug overdose death rates—defined as 20 or more deaths per 100,000 population—rose from less than 250,000 to nearly 22.6 million, nearly a '''100-fold increase'''.  [https://www.prb.org/a-growing-number-of-u-s-children-live-in-counties-affected-by-the-drug-epidemic/ Population Reference Bureau]
*Teens are significantly more likely to have used nonmedical prescription opioids when a parent has also misused the drugs.  In fact, parental smoking, alcohol use, and marijuana use are all associated with increased use of the same substances by their teens. [https://pediatrics.aappublications.org/content/143/3/e20182354 Journal of Pediatrics, March 2019 ] 
*More than 1/3 of all children placed in foster care because of parental alcohol or drug use are placed with relatives.''  Generations United: The ''[https://www.gu.org/resources/the-state-of-grandfamilies-in-america-2016/ ''State of Grandfamilies in America Annual Report (2018)'']
*From 2004 to 2014, the rate of U.S. infants diagnosed with opioid withdrawal symptoms, known as neonatal abstinence syndrome (NAS), increased 433%, from 1.5 to 8.0 per 1,000 hospital births. ''(Vanderbilt University Medical Center, 2018)''

=== Programs: ===

*Website resources, including Lessons Learned, Share Your Story, and education modules.
*SAFE Project Family Network (in progress).
</div> </div> </div>

Category:SAFE-Full Spectrum Prevention

2020-02-06T19:10:38Z

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<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
<span id="docs-internal-guid-a8853b34-7fff-8f03-2838-f2530398cd31" style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">'''Full Spectrum Prevention''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic.</span> Its goal is to reduce the number of people engaging in substance use  through the following objectives:

#Advance prevention through applied research, based in evidence-based practice.
#Safeguard the role of prevention of substance use.
#Strengthen community resilience.
#Provide innovative prevention strategies.
#Promote prevention excellence by highlighting local examples that are working exceptionally well.

Statistics show that:

*There is a savings of $18 for every dollar invested in evidence-based prevention strategies.  Cost savings come from reduced medical costs, increased productivity at work and school, reduced crime and better quality of life. (US Surgeon General’s 2016 Report on Alcohol, Drugs, & Health)
*If effective school-based substance abuse prevention programs were implemented nationwide, substance abuse initiation would decline for 1.5 million youth. (National Criminal Justice Reference Center)
*The average cost of a school based substance abuse preventive program to a single student: $9-$27.  The cost to a community for youth who engage in non-medical prescription opioid use: approximately $8,966 per year. (Duke University, 2014)
</div> </div> </div> </div>

Category:SAFE-Prescriptions and Medical Response

2020-02-06T19:04:56Z

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'''Prescriptions and Medical Response''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. Overprescribing can lead to addiction or death, while remains a barrier to effective treatment. SAFE Project strives to make prescription medicine safer through public awareness, education and stigma reduction. This can be achieved at the community level, and can save lives. Additionally,first responders have been fighting the opioid epidemic longer than anyone – Emergency Medical Technicians and firefighters are often the first on the scene of an overdose. 
</div> </div>
=== Facts & Figures: ===

*After taking opioids for just 5 days in a row, a person becomes more likely to take them long-term. (CDC, 2017)
*Research shows that a combination of ibuprofen and acetaminophen is superior to opioids for treating many types of pain, including acute dental pain. ([https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/Evidence-Efficacy-Pain-Medications.pdf National Safety Council] and [https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain Case Western University], 2018)
*More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else. (CDC)
*More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. (NIDA, 2018). Benzodiazepines can be deadly when used with opioids.
*Among the more than 72,000 drug overdose deaths estimated in 2017*, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. Source: CDC WONDER
*Initial research shows that communities with overdose education and naloxone distribution (OEND) programs have lower opioid overdose death rates. (NIDA 2018)
*In states that adopt a naloxone access law, there is a 9-11% decrease in the number of opioid-related deaths.  (National Bureau of Economic Research, 2017)

=== Programs: ===

'''Naloxone Awareness Program''' – Using our volunteer network, we reach out to pharmacies with a goal of facilitating increased access to naloxone under existing law. By simply asking about the policy for dispensing, we work to increase awareness, readiness to save lives, and reduce stigma. We also ask our volunteers to become educated about naloxone as a first aid measure, state rules for access, and commit to telling people about it.

'''Opioid Risk Campaigns''' – Hospitals and clinics play a vital role in eliminating overprescribing, overcoming opioid dependence, and promoting opioid safety among patients and healthcare providers. SAFE Project works with hospital systems and clinics to develop campaigns that reduce opioid risks through awareness and education.

'''SAFE Meds''' – SAFE increases awareness and safer behaviors around prescription medicines with downloadable fact sheets providing easy to understand information. SAFE Med Facts arm communities and families about safe use, disposal and questions you should ask healthcare providers and pharmacists to decrease risk to yourself and those you love.
</div> </div> </div>

Category:SAFE-Prescriptions and Medical Response

2020-02-06T19:00:12Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">
'''Prescriptions and Medical Response''' is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. Overprescribing can lead to addiction or death, while remains a barrier to effective treatment. SAFE Project strives to make prescription medicine safer through public awareness, education and stigma reduction.  Additionally,first responders have been fighting the opioid epidemic longer than anyone – EMT’s and firefighters are often the first on the scene of an overdose.  This can be achieved at the community level, and can save lives.
</div> </div>
=== Facts & Figures: ===

*After taking opioids for just 5 days in a row, a person becomes more likely to take them long-term. (CDC, 2017)
*Research shows that a combination of ibuprofen and acetaminophen is superior to opioids for treating many types of pain, including acute dental pain. ([https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/Evidence-Efficacy-Pain-Medications.pdf National Safety Council] and [https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain Case Western University], 2018)
*More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else. (CDC)
*More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. (NIDA, 2018). Benzodiazepines can be deadly when used with opioids.
*Among the more than 72,000 drug overdose deaths estimated in 2017*, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. Source: CDC WONDER
*Initial research shows that communities with overdose education and naloxone distribution (OEND) programs have lower opioid overdose death rates. (NIDA 2018)

=== Programs: ===

'''Naloxone Awareness Program''' – Using our volunteer network, we reach out to pharmacies with a goal of facilitating increased access to naloxone under existing law. By simply asking about the policy for dispensing, we work to increase awareness, readiness to save lives, and reduce stigma. We also ask our volunteers to become educated about naloxone as a first aid measure, state rules for access, and commit to telling people about it.

'''Opioid Risk Campaigns''' – Hospitals and clinics play a vital role in eliminating overprescribing, overcoming opioid dependence, and promoting opioid safety among patients and healthcare providers. SAFE Project works with hospital systems and clinics to develop campaigns that reduce opioid risks through awareness and education.

'''SAFE Meds''' – SAFE increases awareness and safer behaviors around prescription medicines with downloadable fact sheets providing easy to understand information. SAFE Med Facts arm communities and families about safe use, disposal and questions you should ask healthcare providers and pharmacists to decrease risk to yourself and those you love.
</div> </div>

Category:SAFE-Prescriptions and Medical Response

2020-02-06T18:58:27Z

Genafitz:

<div class="mw-parser-output">
<div class="mw-parser-output">
<div class="mw-parser-output">
Prescriptions and Medical Response is one of SAFE Project's six lines of operation, a comprehensive approach to ending this epidemic. Overprescribing can lead to addiction or death, while remains a barrier to effective treatment. SAFE Project strives to make prescription medicine safer through public awareness, education and stigma reduction.  Additionally,first responders have been fighting the opioid epidemic longer than anyone – EMT’s and firefighters are often the first on the scene of an overdose.  This can be achieved at the community level, and can save lives.

</div>
</div>

=== Facts & Figures: ===

*After taking opioids for just 5 days in a row, a person becomes more likely to take them long-term. (CDC, 2017)
*Research shows that a combination of ibuprofen and acetaminophen is superior to opioids for treating many types of pain, including acute dental pain. ([https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/Evidence-Efficacy-Pain-Medications.pdf National Safety Council] and [https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain Case Western University], 2018)
*More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else. (CDC)
*More than 30 percent of overdoses involving opioids also involve benzodiazepines, a type of prescription sedative commonly prescribed for anxiety or to help with insomnia. (NIDA, 2018). Benzodiazepines can be deadly when used with opioids.
*Among the more than 72,000 drug overdose deaths estimated in 2017*, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (synthetic opioids) with nearly 30,000 overdose deaths. Source: CDC WONDER
*Initial research shows that communities with overdose education and naloxone distribution (OEND) programs have lower opioid overdose death rates. (NIDA 2018)

=== Programs: ===

'''Naloxone Awareness Program''' – Using our volunteer network, we reach out to pharmacies with a goal of facilitating increased access to naloxone under existing law. By simply asking about the policy for dispensing, we work to increase awareness, readiness to save lives, and reduce stigma. We also ask our volunteers to become educated about naloxone as a first aid measure, state rules for access, and commit to telling people about it.

'''Opioid Risk Campaigns''' – Hospitals and clinics play a vital role in eliminating overprescribing, overcoming opioid dependence, and promoting opioid safety among patients and healthcare providers. SAFE Project works with hospital systems and clinics to develop campaigns that reduce opioid risks through awareness and education.

'''SAFE Meds''' – SAFE increases awareness and safer behaviors around prescription medicines with downloadable fact sheets providing easy to understand information. SAFE Med Facts arm communities and families about safe use, disposal and questions you should ask healthcare providers and pharmacists to decrease risk to yourself and those you love.
</div>

Expand SBIRT Program

2020-02-06T18:37:45Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">''Return to  [[ZOOM_MAP_-_Increase_Early_Intervention_for_People_Misusing_Drugs|Zoom Map - Increase Early Intervention for People Misusing Drugs]]''
''Go to [[ZOOM_MAP_-_Expand_SBIRT_Program|Zoom Map - Expand SBIRT Program]]''

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<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Screening, Brief Intervention and Referral to Treatment, or SBIRT, provides a spectrum of care for people with substance use disorder from early intervention to  treatment.</span>

 
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= How does SBIRT work? =

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">It is a popular model because all patients are screened regardless of an identified disorder. This allows healthcare professionals to reach a wider range  of people - not just those who are seeking treatment for SUD or behavioral health. This is especially critical for those who may be at risk for substance use disorder but may not meet established criteria.  Additionally, SBIRT screens for all types of substance use, not just dependencies.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">This evidence based, public health approach is a paradigm shift in substance-use  treatment. Routine screening helps identify and intervene with patients whose use puts them at risk for health issues. [[File:Sbirt-georgia council on substance abuse.png|right|Georgia Council on Substance Abuse Illustration]]</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">SBIRT places risky substance use where it belongs—in the realm of healthcare. It focuses on identifying risky substance use to help prevent the onset of the more costly disease of addiction. Similar to preventive screenings for chronic diseases such as cancer, diabetes, and hypertension, SBIRT is an effective tool for identifying risk levels related to substance use and for providing the appropriate intervention<ref name="Why SBIRT? SBIRT Colorado"> https://www.integration.samhsa.gov/clinical-practice/sbirt/SBIRT_Colorado_WhySBIRT.pdf</ref>.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">By expanding the use of SBIRT and improving SBIRT practices, it can provide critical pathways for people to access treatment earlier.</span>
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= Research on the Effectiveness of SBIRT =

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">A growing body of evidence demonstrates SBIRT’s  effectiveness in creating positive outcomes for those with substance use disorder.  </span><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">A  2017 report<ref name="Screening, Brief Intervention and Referral to Treatment:implications of SAMHSA’s SBIRT initiative for substanceabuse policy and practice">https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.13675</ref> studied eleven multi-site programs of SAMHSA grant recipients each funded for 5 years to promote the use and  implementation of SBIRT. They screened more than 1 million people and reviewed five years of SBIRT research, concluding that its  implementation was associated with improvements in treatment system equity, efficiency and economy, including:</span>

*<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Greater intervention intensity was associated with larger decreases in substance use.</span>
*<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Brief intervention and treatment had positive outcomes, brief intervention was more cost effective for most substances.</span>
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'''Key Findings about SBIRT''':
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<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Adapted successfully to the needs of early identification efforts for harmful use of alcohol and illicit drugs</span></li>
<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Integrates management of substance use disorders into primary care and general medicine</span></li>
<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Improves treatment system equity, efficiency, and economy</span></li>
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== The 6 Characteristics of a Behavioral Health SBIRT Model ==
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<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">SAMHSA supports a research based comprehensive behavioral health SBIRT model which reflects the six following characteristics<ref name="SBIRT White Paper">https://www.samhsa.gov/sites/default/files/sbirtwhitepaper_0.pdf</ref>:</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">1. '''It is brief. '''The initial screening is accomplished quickly (about 5-10 minutes) and the intervention and treatment components indicated by the screening results are completed in significantly less time than traditional substance abuse specialty care. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">2.'''Screening is universal.''' The patients, clients, students, or other target populations are all screened as part of the standard intake process.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">3.'''One or more specific behaviors are targeted.''' The screening tool addresses a specific behavioral characteristic deemed to be problematic, or pre-conditional to substance dependence or other diagnoses. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">4.'''The services occur in a public health, or other non-substance use treatment setting'''.  </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">5.'''It is comprehensive.''' The program includes a seamless transition between brief universal screening, a brief intervention and/or brief treatment, and referral to s care. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">6. '''Strong research or substantial experiential evidence supports the model.''' At a minimum, programmatic outcomes demonstrate a successful approach.</span>
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= SBIRT Related Training =
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== General Training ==

How can communities expand Screening and SBIRT tools? One way is to increase public awareness of the SBIRT approach and the value of identifying people who are at high or may be using substances. 

The NORC  is a public policy and social research organization affiliated with the University of Chicago.  They provide hosted Webinars on Screening, Brief Intervention, and Referral to Treatment (SBIRT) training includes resources for professionals, adolescent SBIRT, workplace/EAP, community stakeholders, and other addiction or behavioral professionals. <ref>https://www.sbirteducation.com/</ref>  NORC provides SBIRT education both in on-demand and live webinars.

 
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== Screening and Intervention Training ==

How can communities expand SBIRT?  According to SAMHSA, one of the benefits of the SBIRT approach is that it is easy to learn relative to other behavioral treatment techniques that may require lengthy specialized training. As such, it can be implemented by diverse health professionals who work in busy medical settings such as physicians, nurses, social workers, health educators and paraprofessionals.

Accordingly, if a community wants to expand SBIRT it may require training of a large number of people. One cost effective option to accomplish this is through the use of technology.

*'''Kognito''' offers and accredited technology-based training<ref>https://kognito.com/products/sbi-with-adolescents</ref> on Screening and Brief Intervention for youth using innovative simulations to provide training and evaluate the skills of those taking the training. The program was developed in collaboration with NORC at the University of Chicago and adopted by more than 40 schools of health professions and state agencies.  Additionally, the Kognito Conversation Platform<ref>https://kognito.com/approach</ref> has an innovative behavior change model that integrates several evidence-based models and techniques, game mechanics, and learning principles. Kognito is listed in the National Registry of Evidence-based Programs and Practices (NREPP).
*'''IRETA '''(The Institute for Research, Education, and Training in Addiction) provides online training for both professionals and the public, as well as free webinars and on-site prescriber education<ref>https://ireta.org/training/overview/</ref>.
*'''SAMHSA''' offers a wide list of general resources for SBIRT with links to technical assistance, online apps, and other research.<ref>https://www.integration.samhsa.gov/clinical-practice/sbirt</ref>
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= The SBIRT Process =

== Screening ==

The very first step of the SBIRT process is screening. Ideally, it is used universally -- whether at an annual physical or other regularly occuring appointment with a provider or healthcare specialist. It uses a quick and simple method of identifying patients who use alcohol or other substances at at-risk levels, identifies use or experiementing, can help identify individuals who use substances at at-risk levels, as well as those who are already experiencing substance use-related issues.

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=== Effective Screening Tools ===

Communities can also enhance SBIRT by incorporating technology through new screening tools. These tools make it easier for health professions to expand initial screenings while opening up a new avenue to engage patients and individuals. Screening tools may include phone apps, tablet-based screening, computer administered screening (available in Spanish) interactive voice response, web based or even text based.

*'''SBIRT Oregon App<ref>http://www.sbirtoregon.org/screening-app/</ref>:'''  The Department of Family Medicine at Oregon Health and Science University designed online resources and an SBIRT app for primary care and emergency medicine settings in Oregon and the U.S.   The patient uses web-based screening app for tablet, phone, or desktop, which quickly screens and assesses patients for substance use and depression, converts answers into chart-ready notes, reads questions out loud for patients with low literacy, and delivers screening tools in English or Spanish.
*'''Screen for Opioid Abuse Risk (SOAR in Ohio, also known as OARS)<ref>https://interasolutions.com/soar-ohio-screen-opioid-abuse-risk/</ref>'''  was developed as a comprehensive self-administered measure of potential risk that includes a wide range of critical elements noted in the literature to be relevant to opioid risk.[2] This 43-question assessment is administered using a tablet and takes about 10 - 12 minutes to complete.  The assessment is instantly scored and a report is available to the prescribing physician that provides a summary opioid risk profile and a multidimensional assessment of risk factors. SOAR also provides depression and anxiety scores that can be used for SBIRT assessments and wellness visits.
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== Brief Intervention and Referral to Treatment ==

After an initial screening, the individual may be referred for a '''Brief Intervention (BI)'''<ref> https://www.integration.samhsa.gov/clinical-practice/sbirt/brief-interventions</ref>, where a healthcare professional engages a patient showing risky substance use behaviors in a short conversation, providing feedback and advice.

According to SAMHSA, commonly used models for brief interventions treatment include:

*Cognitive-Behavioral Therapy (CBT)
*Motivational Enhancement Therapy
*Community Reinforcement Approach
*Solution-focused Therapy
* Models for brief treatment recommended by SAMHSA[3] include:
*Brief Negotiated Interview
*Brief counseling
*Feedback, Responsibility, Menu of options, Empathy, Self-efficacy (FRAMES)
*Motivational Interviewing (MI) techniques

If the patient requires additional services, the healthcare professional may recommend a '''Referral to Treatment (RT''')<ref>https://www.integration.samhsa.gov/clinical-practice/sbirt/referral-to-treatment</ref> — brief therapy or additional treatment to patients who screen in need of additional services.
SAMHSA recommends that referral to treatment is a critical component of the SBIRT process. It involves establishing a clear method of follow-up with patients that have been identified as having a possible dependency on a substance or in need of specialized treatment. The referral to treatment process consists of assisting a patient with accessing specialized treatment, selecting treatment facilities, and helping navigate any barriers such as treatment cost or lack of transportation that could hinder treatment in a specialty setting. </div> </div> <div class="mw-parser-output"><div class="mw-parser-output"> </div> </div> </div>

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= Integrate SBIRT into Other Settings   =

Besides typical healthcare settings, here are many other places where professionals come into contact with people who may be at risk of substance use disorder.   

== Hospitals and Emergency Rooms ==

Individuals with SUDs or just occasional use regularly access emergency care.  Utilizing the SBIRT approach with individuals seeking care can be beneficial. A 2018 study <ref>https://warmhandoff.org/wp-content/uploads/2019/07/Safe-Landing-ED.pdf</ref> examined an SBIRT program in Allegheny County, Pennsylvania emergency rooms, concluding that SBIRT showed the potential to reduce healthcare costs and utilization as measured by Medicaid claims data, and that SBIRT use in the ED can be readily incorporated into existing practice settings.

== Dentists and Oral Surgeons ==

Dentists and oral surgeons can play an important role in SBIRT. In fact, a study in the Journal of the American Dental Association (JADA) <ref>https://jada.ada.org/article/S0002-8177(18)30419-7/pdf</ref> showed that in the late 90's, dentists were the top specialty providers of immediate-release opioids, accounting for 15.5% of those prescriptions. The American Dental Association recommends dentists and oral surgeons incorporate NIDA's "Screening for Substance Use in the Dental Setting"<ref>https://www.drugabuse.gov/nidamed-medical-health-professionals/science-to-medicine/screening-substance-use/in-dental-setting</ref>  to help dental professionals recognize the signs of risky substance use and addiction

== Community Health Centers and Clinics ==

Community health providers provide excellent opportunities for early intervention with at-risk substance users and for intervention for persons with substance use disorders and mental health issues. The state of New Hampshire<ref>http://sbirtnh.org/wp-content/uploads/2016/05/The-Power-of-Best-Practices-Launching-SBIRT-in-a-Community-Health-Center.pdf</ref> was an early adopter of SBIRT in a community setting. By incorporating SBIRT, New Hampshire found that universal screening lowers the barriers to early intervention and treatment, integrated care, and increased positive outcomes for patients.
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== Schools ==

An estimated 310,000 adolescents (aged 12-17)<ref>https://www.samhsa.gov/data/report/2018-nsduh-annual-national-report</ref> misused prescription pain relievers for the first time in 2018 - thats 850 teens every day.  Many states have moved forward to expand SBIRT in school settings. In fact, schools offer a prime opportunity to identify, support, and redirect students in middle school and high school. Massachusetts was one of the first states to require SBIRT in a school setting and is considered a model for school based SBIRT <ref>https://www.communitycatalyst.org/resources/publications/document/Massachusetts-Provides-a-Model-for-Addressing-Students-Risky-Substance-Use-7_6_18.pdf</ref>. Other states now incorporating SBIRT in schools include New York, Pennsylvania, California, Florida and Texas.

A 2017 study <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753915/</ref> found that universal delivery of school-based SBIRT to all students -- not just substance-using students -- actually provides 2 types of prevention. First, it can prevent the onset of substance use by motivating abstinent students to remain abstinent and, second, it can reduce substance use among users by providing education on the consequences of substance use and brainstorming strategies to cut down or quit if the student wishes to do so.

The School-Based Health is currently testing and refining the adaptation of  school-based SBIRT into 17 health care settings in seven states.<ref>http://www.sbh4all.org/current_initiatives/sbirt-in-sbhcs/</ref>

 
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= Integrate SBIRT into Electronic Health Records =

One way to enhance the impact of SBIRT is to integrate information from the process into the Electronic Health Record (EHR)<ref>https://www.indianasbirt.org/ehr-modification</ref>. 

*An overview on this topic, and links to recorded webinars can be found in IRETA's SBIRT and Electronic Health Records Toolkit . <ref> https://ireta.org/resources/electronic-health-record-toolkit/</ref>
*This [https://www.youtube.com/watch?v=faO_bJdNyBQ recorded webinar], provided by [https://ireta.org/ IRETA] and the [https://attcnetwork.org/ Addiction Technology Transfer Center Network], provides a good overview on implementing the integration of SBIRT data into EHRs. 
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= Tools & Resources =

[[TR_-_Expand_SBIRT_Program|TR - Expand SBIRT Program]]
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<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">Gena Fitzgerald</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

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= Sources =

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[[Category:SAFE-Full Spectrum Prevention]]

Expand SBIRT Program

2020-02-06T18:37:23Z

Genafitz:

<div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output"><div class="mw-parser-output">''Return to  [[ZOOM_MAP_-_Increase_Early_Intervention_for_People_Misusing_Drugs|Zoom Map - Increase Early Intervention for People Misusing Drugs]]''
''Go to [[ZOOM_MAP_-_Expand_SBIRT_Program|Zoom Map - Expand SBIRT Program]]''

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<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Screening, Brief Intervention and Referral to Treatment, or SBIRT, provides a spectrum of care for people with substance use disorder from early intervention to  treatment.</span>

 
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= How does SBIRT work? =

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">It is a popular model because all patients are screened regardless of an identified disorder. This allows healthcare professionals to reach a wider range  of people - not just those who are seeking treatment for SUD or behavioral health. This is especially critical for those who may be at risk for substance use disorder but may not meet established criteria.  Additionally, SBIRT screens for all types of substance use, not just dependencies.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">This evidence based, public health approach is a paradigm shift in substance-use  treatment. Routine screening helps identify and intervene with patients whose use puts them at risk for health issues. [[File:Sbirt-georgia council on substance abuse.png|right|Georgia Council on Substance Abuse Illustration]]</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">SBIRT places risky substance use where it belongs—in the realm of healthcare. It focuses on identifying risky substance use to help prevent the onset of the more costly disease of addiction. Similar to preventive screenings for chronic diseases such as cancer, diabetes, and hypertension, SBIRT is an effective tool for identifying risk levels related to substance use and for providing the appropriate intervention<ref name="Why SBIRT? SBIRT Colorado"> https://www.integration.samhsa.gov/clinical-practice/sbirt/SBIRT_Colorado_WhySBIRT.pdf</ref>.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">By expanding the use of SBIRT and improving SBIRT practices, it can provide critical pathways for people to access treatment earlier.</span>
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= Research on the Effectiveness of SBIRT =

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">A growing body of evidence demonstrates SBIRT’s  effectiveness in creating positive outcomes for those with substance use disorder.  </span><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">A  2017 report<ref name="Screening, Brief Intervention and Referral to Treatment:implications of SAMHSA’s SBIRT initiative for substanceabuse policy and practice">https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.13675</ref> studied eleven multi-site programs of SAMHSA grant recipients each funded for 5 years to promote the use and  implementation of SBIRT. They screened more than 1 million people and reviewed five years of SBIRT research, concluding that its  implementation was associated with improvements in treatment system equity, efficiency and economy, including:</span>

*<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Greater intervention intensity was associated with larger decreases in substance use.</span>
*<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Brief intervention and treatment had positive outcomes, brief intervention was more cost effective for most substances.</span>
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'''Key Findings about SBIRT''':
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<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Adapted successfully to the needs of early identification efforts for harmful use of alcohol and illicit drugs</span></li>
<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Integrates management of substance use disorders into primary care and general medicine</span></li>
<li><span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">Improves treatment system equity, efficiency, and economy</span></li>
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== The 6 Characteristics of a Behavioral Health SBIRT Model ==
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<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">SAMHSA supports a research based comprehensive behavioral health SBIRT model which reflects the six following characteristics<ref name="SBIRT White Paper">https://www.samhsa.gov/sites/default/files/sbirtwhitepaper_0.pdf</ref>:</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">1. '''It is brief. '''The initial screening is accomplished quickly (about 5-10 minutes) and the intervention and treatment components indicated by the screening results are completed in significantly less time than traditional substance abuse specialty care. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">2.'''Screening is universal.''' The patients, clients, students, or other target populations are all screened as part of the standard intake process.</span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">3.'''One or more specific behaviors are targeted.''' The screening tool addresses a specific behavioral characteristic deemed to be problematic, or pre-conditional to substance dependence or other diagnoses. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">4.'''The services occur in a public health, or other non-substance use treatment setting'''.  </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">5.'''It is comprehensive.''' The program includes a seamless transition between brief universal screening, a brief intervention and/or brief treatment, and referral to s care. </span>

<span style="font-size:11pt; font-family:Arial; color:#000000; background-color:transparent; font-weight:400; font-style:normal; font-variant:normal; text-decoration:none; vertical-align:baseline; white-space:pre; white-space:pre-wrap">6. '''Strong research or substantial experiential evidence supports the model.''' At a minimum, programmatic outcomes demonstrate a successful approach.</span>
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= SBIRT Related Training =
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== General Training ==

How can communities expand Screening and SBIRT tools? One way is to increase public awareness of the SBIRT approach and the value of identifying people who are at high or may be using substances. 

The NORC  is a public policy and social research organization affiliated with the University of Chicago.  They provide hosted Webinars on Screening, Brief Intervention, and Referral to Treatment (SBIRT) training includes resources for professionals, adolescent SBIRT, workplace/EAP, community stakeholders, and other addiction or behavioral professionals. <ref>https://www.sbirteducation.com/</ref>  NORC provides SBIRT education both in on-demand and live webinars.

 
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== Screening and Intervention Training ==

How can communities expand SBIRT?  According to SAMHSA, one of the benefits of the SBIRT approach is that it is easy to learn relative to other behavioral treatment techniques that may require lengthy specialized training. As such, it can be implemented by diverse health professionals who work in busy medical settings such as physicians, nurses, social workers, health educators and paraprofessionals.

Accordingly, if a community wants to expand SBIRT it may require training of a large number of people. One cost effective option to accomplish this is through the use of technology.

*'''Kognito''' offers and accredited technology-based training<ref>https://kognito.com/products/sbi-with-adolescents</ref> on Screening and Brief Intervention for youth using innovative simulations to provide training and evaluate the skills of those taking the training. The program was developed in collaboration with NORC at the University of Chicago and adopted by more than 40 schools of health professions and state agencies.  Additionally, the Kognito Conversation Platform<ref>https://kognito.com/approach</ref> has an innovative behavior change model that integrates several evidence-based models and techniques, game mechanics, and learning principles. Kognito is listed in the National Registry of Evidence-based Programs and Practices (NREPP).
*'''IRETA '''(The Institute for Research, Education, and Training in Addiction) provides online training for both professionals and the public, as well as free webinars and on-site prescriber education<ref>https://ireta.org/training/overview/</ref>.
*'''SAMHSA''' offers a wide list of general resources for SBIRT with links to technical assistance, online apps, and other research.<ref>https://www.integration.samhsa.gov/clinical-practice/sbirt</ref>
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= The SBIRT Process =

== Screening ==

The very first step of the SBIRT process is screening. Ideally, it is used universally -- whether at an annual physical or other regularly occuring appointment with a provider or healthcare specialist. It uses a quick and simple method of identifying patients who use alcohol or other substances at at-risk levels, identifies use or experiementing, can help identify individuals who use substances at at-risk levels, as well as those who are already experiencing substance use-related issues.

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=== Effective Screening Tools ===

Communities can also enhance SBIRT by incorporating technology through new screening tools. These tools make it easier for health professions to expand initial screenings while opening up a new avenue to engage patients and individuals. Screening tools may include phone apps, tablet-based screening, computer administered screening (available in Spanish) interactive voice response, web based or even text based.

*'''SBIRT Oregon App<ref>http://www.sbirtoregon.org/screening-app/</ref>:'''  The Department of Family Medicine at Oregon Health and Science University designed online resources and an SBIRT app for primary care and emergency medicine settings in Oregon and the U.S.   The patient uses web-based screening app for tablet, phone, or desktop, which quickly screens and assesses patients for substance use and depression, converts answers into chart-ready notes, reads questions out loud for patients with low literacy, and delivers screening tools in English or Spanish.
*'''Screen for Opioid Abuse Risk (SOAR in Ohio, also known as OARS)<ref>https://interasolutions.com/soar-ohio-screen-opioid-abuse-risk/</ref>'''  was developed as a comprehensive self-administered measure of potential risk that includes a wide range of critical elements noted in the literature to be relevant to opioid risk.[2] This 43-question assessment is administered using a tablet and takes about 10 - 12 minutes to complete.  The assessment is instantly scored and a report is available to the prescribing physician that provides a summary opioid risk profile and a multidimensional assessment of risk factors. SOAR also provides depression and anxiety scores that can be used for SBIRT assessments and wellness visits.
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== Brief Intervention and Referral to Treatment ==

After an initial screening, the individual may be referred for a '''Brief Intervention (BI)'''<ref> https://www.integration.samhsa.gov/clinical-practice/sbirt/brief-interventions</ref>, where a healthcare professional engages a patient showing risky substance use behaviors in a short conversation, providing feedback and advice.

According to SAMHSA, commonly used models for brief interventions treatment include:

*Cognitive-Behavioral Therapy (CBT)
*Motivational Enhancement Therapy
*Community Reinforcement Approach
*Solution-focused Therapy
* Models for brief treatment recommended by SAMHSA[3] include:
*Brief Negotiated Interview
*Brief counseling
*Feedback, Responsibility, Menu of options, Empathy, Self-efficacy (FRAMES)
*Motivational Interviewing (MI) techniques

If the patient requires additional services, the healthcare professional may recommend a '''Referral to Treatment (RT''')<ref>https://www.integration.samhsa.gov/clinical-practice/sbirt/referral-to-treatment</ref> — brief therapy or additional treatment to patients who screen in need of additional services.
SAMHSA recommends that referral to treatment is a critical component of the SBIRT process. It involves establishing a clear method of follow-up with patients that have been identified as having a possible dependency on a substance or in need of specialized treatment. The referral to treatment process consists of assisting a patient with accessing specialized treatment, selecting treatment facilities, and helping navigate any barriers such as treatment cost or lack of transportation that could hinder treatment in a specialty setting. </div> </div> <div class="mw-parser-output"><div class="mw-parser-output"> </div> </div> </div>

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= Integrate SBIRT into Other Settings   =

Besides typical healthcare settings, here are many other places where professionals come into contact with people who may be at risk of substance use disorder.   

== Hospitals and Emergency Rooms ==

Individuals with SUDs or just occasional use regularly access emergency care.  Utilizing the SBIRT approach with individuals seeking care can be beneficial. A 2018 study <ref>https://warmhandoff.org/wp-content/uploads/2019/07/Safe-Landing-ED.pdf</ref> examined an SBIRT program in Allegheny County, Pennsylvania emergency rooms, concluding that SBIRT showed the potential to reduce healthcare costs and utilization as measured by Medicaid claims data, and that SBIRT use in the ED can be readily incorporated into existing practice settings.

== Dentists and Oral Surgeons ==

Dentists and oral surgeons can play an important role in SBIRT. In fact, a study in the Journal of the American Dental Association (JADA) <ref>https://jada.ada.org/article/S0002-8177(18)30419-7/pdf</ref> showed that in the late 90's, dentists were the top specialty providers of immediate-release opioids, accounting for 15.5% of those prescriptions. The American Dental Association recommends dentists and oral surgeons incorporate NIDA's "Screening for Substance Use in the Dental Setting"<ref>https://www.drugabuse.gov/nidamed-medical-health-professionals/science-to-medicine/screening-substance-use/in-dental-setting</ref>  to help dental professionals recognize the signs of risky substance use and addiction

== Community Health Centers and Clinics ==

Community health providers provide excellent opportunities for early intervention with at-risk substance users and for intervention for persons with substance use disorders and mental health issues. The state of New Hampshire<ref>http://sbirtnh.org/wp-content/uploads/2016/05/The-Power-of-Best-Practices-Launching-SBIRT-in-a-Community-Health-Center.pdf</ref> was an early adopter of SBIRT in a community setting. By incorporating SBIRT, New Hampshire found that universal screening lowers the barriers to early intervention and treatment, integrated care, and increased positive outcomes for patients.
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== Schools ==

An estimated 310,000 adolescents (aged 12-17)<ref>https://www.samhsa.gov/data/report/2018-nsduh-annual-national-report</ref> misused prescription pain relievers for the first time in 2018 - thats 850 teens every day.  Many states have moved forward to expand SBIRT in school settings. In fact, schools offer a prime opportunity to identify, support, and redirect students in middle school and high school. Massachusetts was one of the first states to require SBIRT in a school setting and is considered a model for school based SBIRT <ref>https://www.communitycatalyst.org/resources/publications/document/Massachusetts-Provides-a-Model-for-Addressing-Students-Risky-Substance-Use-7_6_18.pdf</ref>. Other states now incorporating SBIRT in schools include New York, Pennsylvania, California, Florida and Texas.

A 2017 study <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753915/</ref> found that universal delivery of school-based SBIRT to all students -- not just substance-using students -- actually provides 2 types of prevention. First, it can prevent the onset of substance use by motivating abstinent students to remain abstinent and, second, it can reduce substance use among users by providing education on the consequences of substance use and brainstorming strategies to cut down or quit if the student wishes to do so.

The School-Based Health is currently testing and refining the adaptation of  school-based SBIRT into 17 health care settings in seven states.<ref>http://www.sbh4all.org/current_initiatives/sbirt-in-sbhcs/</ref>

 
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= Integrate SBIRT into Electronic Health Records =

One way to enhance the impact of SBIRT is to integrate information from the process into the Electronic Health Record (EHR)<ref>https://www.indianasbirt.org/ehr-modification</ref>. 

*An overview on this topic, and links to recorded webinars can be found in IRETA's SBIRT and Electronic Health Records Toolkit . <ref> https://ireta.org/resources/electronic-health-record-toolkit/</ref>
*This [https://www.youtube.com/watch?v=faO_bJdNyBQ recorded webinar], provided by [https://ireta.org/ IRETA] and the [https://attcnetwork.org/ Addiction Technology Transfer Center Network], provides a good overview on implementing the integration of SBIRT data into EHRs. 
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= Tools & Resources =

[[TR_-_Expand_SBIRT_Program|TR - Expand SBIRT Program]]
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<span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">Gena Fitzgerald</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>

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= Sources =

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[[Category:SAFE-Full Spectrum Prevention]]