The manner in which fidelity was addressed varied by study. Two studies were identified to be delivered by lay persons 34,37. Several other studies included 20 sessions or more 18,22,23,25,26. The implementation Culturally competent care for LGBTQIA+ youth of CBT varied on the trauma of interest. No studies were excluded on the basis of the quality assessment.
Trauma informed interventions: A systematic review
- Staff buy-in and motivation are essential for change.17,21,25 Sustained TIC changes can be realized through education targeted to all levels of the workforce, including administrative staff, clinical practitioners, and clinical staff (eg, receptionists, security personnel, community health workers).25 In addition, tailoring training to specific staff is important.
- Delivering TIC is a strengths-based approach, which is a method that focuses on abilities, knowledge, and capacities rather than deficits.30 This approach can lead to the broad engagement of patients, especially those in marginalized populations, and can also promote a culturally competent workforce.
- Although TIC is based on evidence, there is some variability about what TIC entails and whether and how it results in desirable outcomes.
- Recognizing the broad impact of trauma on individuals and communities, social workers must engage in case and cause advocacy as interconnected tools, for example, by using case advocacy to protect and empower individuals and cause advocacy to confront the root causes of oppression.
- Intentionally designing and establishing interprofessional groups (eg, members of chaplaincy, occupational and physical health, nursing leadership, psychiatry, psychology, and social services) to provide support to staff who might have been affected by a traumatic event can help to mitigate compassion fatigue, burnout, and secondary traumatization.21
- TTB models how individuals experience social conditions and how these conditions impact individuals’ capacity to undertake behavior changes.
Thinking outside of the box to meet community members where they are is critical to build and leverage a groundswell of support. This leaves community members standing empowered to choose how they want to make meaning of this information and what they wish to do to act upon the knowledge and understanding of how trauma has impacted their lives and the lives of their cared-for ones and neighbors. To build capacity across sectors and to fully tap into the diverse community expertise that will lead to the most effective long-term change, it is vital that all members of the community are equipped with a knowledge of trauma and trauma-informed approaches. Further, it can be useful to build multiple points of entry and a variety of different opportunities for community members to engage, participate, and contribute based on their own unique gifts, capacity, bandwidth, and motivation to change efforts. Traditional community-building models tend to involve some imposition from outside entities onto communities, which can undermine community members’ sense of ownership and miss critical context necessary to implement change efforts that hold promise to make a significant impact (Crockett & Harwood, 2019).
Stress And Trauma
Rather than expecting providers to be experts in every culture, cultural humility encourages them to respect and acknowledge the complexity of each individual’s experiences. However, their limitations in addressing the unique needs of marginalized groups highlight the importance of developing approaches that better account for cultural and social complexities. Standard trauma-informed care models lay a strong groundwork for understanding trauma and creating safer healthcare settings.
This practice counters the effects of trauma, such as intrusive thoughts or anxiety about the future, by training the brain to focus, calm itself, and create a crucial pause between an emotional trigger and a reaction. Trauma-informed teaching recognizes that students, particularly those who have experienced trauma, often feel a profound sense of powerlessness. By explicitly teaching and modeling these skills, educators provide one of the most essential trauma informed teaching strategies, equipping students with tools to manage their internal states and engage in learning. Co-regulation is the supportive process where a calm, regulated adult helps a child navigate distress and return to a state of balance.
It is essential to ensure that staff members who work directly with clients (which could be congregants in faith organizations, children in youth programs or on sports teams, and adults in various community spaces) realize the potential for recovery, recognize the symptoms of trauma, and avoid re-traumatizing their clients. For staff members of organizations that provide community resources to many community members, TIA training designed for direct service providers may help them learn how to interact with people managing (potentially unaddressed) trauma. The expertise required to implement TIAs is significantly less attributable to professional discipline and more aligned with the amount of required interpersonal communication and interactions with people managing traumatizing experiences. The individual (community member), however, may experience the entire situation differently or negatively, regardless of intent from the clinical, research, or program teams. We also turn to community experts to share in the decision-making process about the appropriateness of potential interventions and programs in various community contexts.