Resick, P. A., Bovin, M. J., Calloway, A. L., Dick, A. M., King, M. W., Mitchell, K. S., et al. Research has also highlighted that experiencing traumatic events tends to increase the chances of experiencing further traumatic events across the life course. In addition, improvements to collection of research data and adoption of standardised outcome measures for evaluation would support a more systemic approach to evaluating the implementation of trauma-informed care. For instance, Trauma Systems Therapy promotes widespread understanding among caregivers in the home, school, and community that a childâs inability to regulate emotions or behavior does not mean the child is âbad,â but rather that the social environment is not meeting the needs of the child in some way. Some of the challenges identified in implementing and embedding trauma-informed care across services and systems are discussed. (2013). Typically, in trauma-informed programs, policies have been created to help children, youth, and staff who have experienced trauma to actively resist any further traumatization. As noted by the American Institute for Research, in order to build a trauma-informed system, commitment at all system levels is required. In Australia there appears to be an emphasis on driving change in the mental health sector. Trauma-informed systems of care are aware of the ways in which programs and organisations can trigger traumatic reactions - or even inadvertently replicate the dynamics of the traumatic events/relationships - and seek to minimise them, and promote environments that facilitate positive affect regulation or "modulation". Research suggests that exposure to adverse, potentially traumatic events in childhood is not uncommon (Anda et al., 2006). Organisational responses to trauma tend to occur on a continuum from basic trauma awareness, to trauma sensitivity, trauma responsivity and through to trauma-informed and/or trauma-specific interventions. In the USA, a range of systems are in the process of adopting a cross-sectoral approach to implementing trauma-informed care and trauma-specific services to support service users (DeCanandia et al., 2014). (p. 266). Trauma-focused cognitive behaviour therapy (TF-CBT) is an evidence-based treatment approach for children who have experienced sexual abuse, exposure to domestic violence or similar traumas.2 TF-CBT features on a range of databases of evidence-based practices, including the California Evidence-Based Clearinghouse for Child Welfare (CEBC) Program Registry. 6 SAMHSA's concept of trauma provides a comprehensive definition that encompasses trauma related to one-off events as well as ongoing adversity: Individual trauma results from an event, series of events or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional or spiritual wellbeing. A systems approach to trauma-informed care means that implementation goes beyond individual practitioner and service organisation change to extend to whole systems that people who have experienced trauma are likely to interact with. Individual responses to traumatic experiences vary widely, with not all exposure leading to negative outcomes. This paper aims to define and clarify what trauma-informed service delivery means in the context of delivering child/family welfare services in Australia. (pp. Melbourne: Child Family Community Australia information exchange, Australian Institute of Family Studies. Policies and service providers must respond appropriately to people who are dealing with trauma and its effects in order to ensure best outcomes for individuals and families using these services. This can manifest through engagement in abusive relationships, poor judgement, or a lack of self-protection. (2008a). Further to this, SAMHSA also provide a range of sample questions to consider when implementing a trauma-informed approach (PDF 789 KB). It is difficult to align organisational change to a specific practice without a shared understanding or vision of what trauma-informed care actually is. Principles of trauma-informed care have been articulated in a range of academic literature and guidance publications (Elliot et al., 2005; Hopper et al., 2010; Jennings, 2004; Kezelman & Stavropoulos, 2012; SAMHSA, 2014). The benefits of creating trauma-informed environments include safer spaces for staff, improved clinical decision-making and building collaborative care networks to help address the needs of the whole person and whānau. SAMHSA's (2014) Concept of Trauma and Guidance for a Trauma-Informed Approach puts forward definitions and a working concept of trauma and a trauma-informed approach in order to develop a shared understanding of these concepts for service systems and stakeholders. (2015, p. 8) outlined the key elements of trauma-informed service delivery. Parents, service providers, and other caregivers trained in TIC learn effective ways to interact with these children, such as helping them cope with trauma reminders (âtriggersâ), supporting childrenâs emotion regulation skills, maintaining predictable routines, and using effective behavior management strategies. Published by the Australian Institute of Family Studies. It is important to distinguish between them but acknowledge the intersection of the two types. view. The reality of the prevalence of traumatic experiences in the general population indicates that trauma is not confined to prevention, treatment and recovery settings but is integral in other systems as well (SAMHSA, 2014). Finally, in examining the need for a trauma-informed approach to care it is pertinent to note that in many cases, due to the co-occurrence of problems resulting from experiencing trauma, individuals may find themselves in multiple systems, cycling in and out of specific services over many years to access, for example, treatment for drug and alcohol addictions, support for employment opportunities and therapeutic services for mental illness. Key components of many trauma-specific treatments are to help individuals to improve self-regulation, safety, security, sense of control and mastery of their environment, and modulate their emotional reactions to traumatic stimuli. Training and guidance for staff on how to respond to acute situations appropriately and feel confident that they are acting in accordance with the principles of trauma-informed care is recommended (Knight, 2015; Muskett, 2014). 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