SOAR TA Center Webinar Recap Part 2: The Six Key Principles of a Trauma-Informed Approach
By Pamela Heine
August 1, 2017
SOAR Strategies for Implementation at Deborah’s Place in Chicago
Panelists Kim Davidson and Eleni Marsh with Deborah’s Place in Chicago, explained their experiences using a trauma-informed approach within their organization. For instance, they share how being a trauma-informed agency means the SOAR provider doesn’t need to know in detail what the trauma was like for the individual. They share how the Six Principles of a Trauma-Informed Approach have been integrated into their SOAR program. While listening to Kim and Eleni, ask yourself these questions:
Principle 1: Safety
When your safety has been compromised it can be difficult to feel safe. Safety can be both physical and emotional.
- Build strong trusting relationships based on honesty
- This means not always telling someone what they want to hear, but letting them know the truth (even about potential denials, etc.)
- Allow individuals to apply for disability benefits (or at least complete the Medical Summary Report) with those they trust the most
- Don’t ask for more information than you need
- Complete the application/interview in spaces where the participant chooses and feels safe
- Have a conversation at the beginning of the process explaining the information being asked, exploring how they will know if it is too much, and what they need if they are triggered.
- Allow and normalize breaks
- Give options of things that might make the application/interview process more comfortable (e.g., food, drink, movie clips, coloring books)
- CELEBRATE after completing every single step
Principle 2: Trustworthiness and Transparency
When someone’s boundaries have been violated in the past, they may have a difficult time setting them. You want to be very clear about your role and the process.
- Give many opportunities for information to be learned (information sessions, trips to Social Security offices, etc.)
- Clearly explain every step of the application process and everyone’s role
- Explain the positives AND negatives of applying for benefits (decisional balance)
Principle 3: Peer Support
Those that we work with are experts in their own lives. They should have every opportunity to use their expertise and share it with others
- Have forums where others can share their stories of the process
- Give every opportunity for participants to educate you about their life, and not the other way around
Principle 4: Collaboration and Mutuality
All services should be partnerships and every opportunity for autonomy should be honored.
- Give opportunities to cancel/postpone an application throughout the process
- Use Motivational Interviewing to guide conversations (Use the phrase OARS: Open Questions, Affirmation, Reflective Listening, and Summary Reflections)
Principle 5: Empowerment, Voice, and Choice
Traumatic experiences often involve losing one’s voice and feeling like control is taken away. We must restore control whenever possible. Ask fewer questions and listen to more stories!
- Explore the meaning of benefits (positive and negative) for those you serve
- Explore the meaning of disability and fears about the label
- Don’t make participants feel that they have to undergo any treatment they aren’t comfortable with to strengthen an application
- Infuse every step of the process with small activities and interventions that help build recovery and skills (breathing exercises, grounding techniques, self-care plans, etc.)
Principle 6: Cultural, Historical, and Gender Issues
The experience of navigating an oppressive world is also traumatic, and people experience this differently based on their identities.
- Recognize that some traumas disproportionately affect some identities more than others
- Recognize the additional barriers that your participants may face in the application process and advocate to minimize those barriers
Self-Care for You and Co-Workers
Lisa and Kim did not have enough time to discuss self care, but did stress a few key points about the importance of understanding ‘vicarious trauma’ which SOAR providers are certainly at high risk for because they so often absorb the pain of others.
SSA’s New Trauma Listing: 12.15 Trauma and stressor-related disorders
SSA has added a new listing pertaining to Post-Traumatic Stress Disorder (PTSD). PTSD was formerly considered under Anxiety Disorders. The Trauma Listing now reflects diagnostic criteria as present in the DSM-V. When you begin to work with applicants, look back at the webinar and SOAR online course articles to ensure that you are providing all the documentation that Disability Determination Services need to show how the applicant meets the Listing criteria for disability. In addition you can use these tool to obtain all needed information from the applicant by considering the six trauma-informed principles.
The views, opinions, and content expressed in SOAR Voices do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Human Services (HHS). Its contents are solely the responsibility of the authors.