Trauma-Informed Care Learning Community
Mental Health and Recovery Services Board of Stark County
Executive Summary
October 21, 2015
Overview of the Project and Deliverables for the Learning Community
The Trauma-Informed Care Learning Community for Mental Health and Recovery Services Board
(MHRSB) of Stark County brought together twelve community partners to address core topics
across the National Council’s Seven Domains of Trauma-Informed Care (TIC) and to raise
awareness within the community about trauma-informed care.
The Stark County Board determined that a communitywide educational opportunity would be
necessary to gain interest and buy-in and to generate the applicants needed to make this a
successful project. Cheryl Sharp, MSW, ALWF, senior advisor for trauma-informed services for
the National Council, presented a daylong training on September 17, 2014.
Prospective participants invited by the Board submitted applications to determine their interest
and commitment. A total of twelve teams submitted and fully participated throughout the year.
This also included the Stark Mental Health and Recovery Services Board who should be
commended for doing their own internal organizational work. Teams included:
1) Mental Health and Recovery Services Board of Stark County
2) Coleman Behavioral Health of Stark
3) Crisis Intervention and Recovery Center, Inc.
4) Domestic Violence Project Inc. – Renew Counseling and Recovery Center
5) Phoenix Rising Behavioral Healthcare and Recovery, Inc.
6) Stark County Family court
7) Child and Adolescent Behavioral Health
8) Community Services of Stark County, Inc. (Clinical services)
9) Stark County Board of Developmental Disabilities – (Service and Support Administration)
10) Stark County Job and Family Services
11) Stark County TASC, Inc. - Youth and Adult CM and OP Services
12) Stark Social Work Network
A kickoff webinar for all chosen participants was held on November 19, 2014 to introduce the
teams to the beginning phases of the work and to prepare them for the first face-to-face kickoff
meeting. Teams were introduced to the Seven Domains of TIC that would be addressed over
the course of the year:
1)
2)
3)
4)
5)
6)
7)
Early Screening & Assessment
Consumer Voice Choice and Advocacy
Workforce Development
Evidence-Based and Emerging Best Practices
Safe and Secure Environments
Building Community Partnership
Performance Monitoring and Evaluation
Throughout the year Learning Community, these core topics were addressed in a structured
approach with face-to-face meetings, regular webinars with national experts, group and
individual team (program or department) coaching calls. All participants were given access to
the National Council Trauma-Informed Care List serve, allowing them to exchange information,
resources and tools with over 1,500 actively engaged individuals.
The MHRSB of Stark County designated an oversight Core Implementation Team (CIT) to work
directly with their department/program teams and National Council Staff. Having an active
oversight CIT in MHRSB of Stark County was a key component to the significant success of this
Learning Community.
Each participating organization was required to create a Core Implementation Team (CIT). The
National Council recommended for each organization’s CIT to include:
 One person from top administration or with direct access to administration;
 Program Managers;
 Lead Clinical Supervisor;
 A consumer leader directly affiliated with or employed by the organization;
 A person identified to collect, analyze and disseminate data
 The team might have additional members identified as program trauma champions
however it is advisable to keep the team a reasonable size.
The participating organizations worked diligently to have this complement of team members on
their CIT, and in many cases expanded their teams to include trauma champions. Many of the
CITs developed subgroups in order to gain additional buy-in of their TIC efforts by involving more
individuals across their organization.
The following is a summary of the proposed learning community deliverables designed for
MHRSB of Stark County:
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Teams and staff met for a total of four face-to-face training and meeting days to share
resources and participate in a co-learning facilitated process that is vital to an organization’s
success:
1. One day training on Trauma and Trauma-Informed Care and one day Learning
Community Kick-Off Meeting: On the first day, National Council Staff provided an
overview of trauma and trauma-informed care. The second day engaged the
Learning Community teams in focusing on defining next steps, and developing areas
of improvement within each domain of the National Council Organizational SelfAssessment© (OSA).
2. Mid-year meeting on Implementation Progress and Ongoing Goal Setting with
training topic of choice: National Council provided teams the opportunity to report
on their progress so far and to discuss challenges and barriers.
3. Summit meeting: The Summit Meeting focused on sharing the years’
accomplishments and developing a sustainability plan for the organizations and
greater Learning Community.
All face-to-face meetings met criteria for CEU’s that was provided through the local
accreditation organization
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Three consultation calls (for each team) and two group calls involving multiple
organizations were structured to provide guidance through the National Council’s
Trauma-Informed Care Organizational Self-Assessment© process and the
implementation of tools, policies and procedures.
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Four customized and interactive webinars with experts
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Access to the National Council Trauma-Informed List Serve Community: This list serve is
made up of over 1,500 National Council Trauma-Informed Care Learning Community
members who have been through the process or are currently in the midst of an active
TIC Learning Community. Participants are encouraged to actively seek and exchange
information and resources with each other and National Council staff via this incredibly
valuable forum.
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A vast array of tools, resources and measurements of performance standards specific to
implementation processes and each domain. The following primary implementation
tools were provided, although many other tools were also available.
 Organizational TIC Self-Assessment
 Performance Monitoring Tool that was submitted by teams quarterly
 Implementation Process Guide
 Implementation Planning Guide
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Each team and MHRSB of Stark County received a Certificate of Completion at the end
of the Learning Community.
Below are the activities that were offered to all teams:
November 2014 to September 2015
Item
Date
Webinar – Working with Children and Families
11/17/14
Webinar – Stark County Kick Off
11/19/14
Webinar – Engaging and Listening to Children and
Adolescents
12/1/14
Face to Face Kick Off Meeting
12/2/14
1st Individual Team Coaching Calls
January 2015
Webinar – Culture and Trauma
1/26/15
Webinar – Domain 6: Creating Community
Partnerships
2/17/15
Webinar - Domain 7: Performance Monitoring
1st Cohort Coaching Calls
Webinar – Domain 1: Screening and Assessment –
Stark County
2nd Individual Team Coaching Calls
ABC’s of Trauma-Informed Care
2nd Cohort Coaching Calls
3/2/15
March 2015
4/13/15
May 2015
5/11/15
June 2015
Webinar - Domain 1: Screening and Assessment –
National Learning Community
6/1/15
Face to Face Mid-year Meeting
6/2/15
Stark County Community Trauma-Informed Care
Training
6/3/15
Webinar - Domain 2: Consumer Driven Care
6/29/15
Webinar – Compassion Fatigue
7/13/15
Webinar - Domain 3: Educated and Responsive
Workforce
7/27/15
3rd Individual Team Coaching Calls
August 2015
Webinar - Domain 4: Evidence-Based and Emerging
Best Practices
8/17/15
Webinar – Trauma-Informed Supervision
9/14/15
Face to Face Summit Meeting
9/22/15
Webinar - Domain 5: Safe and Secure
Environments
9/28/15
Key Takeaways from the Summit Meeting – September 22, 2015
Biggest Challenges:
 Time and resources to devote to continue the momentum
 Need to designate trauma person with job description and focused time designated for
this work and cost to continue
 Staff turnover on teams and within organization made it difficult to sometimes keep up
 Competing demands and initiatives
 Working through Electronic Health Record implementation and incorporating trauma
assessment and survey information into the EHR.
 Need for clear expectations of “trauma competency” within managed care coexpectations
 Need to work hard to engage medical community
Lessons Learned:
 Great importance in the awareness of small details (such as paint colors) and how those
details can have a significant impact on the people we serve
 Communication is key to keeping the work moving
 Most important factor to doing the work is creating buy-in and commitment to the
process on the CIT
 Need to pace the process and embrace that this is a marathon and not a sprint
Agency Report Outs Available on PowerPoint Slides from the Summit Meeting
Summary of the Trauma-Informed Care Learning Community progress in Stark County
 All teams created CITs
 Some teams created work groups to further disseminate the work
 Teams completed Organizational Self-Assessment and Performance Monitoring Tool to
mark progress and identify challenges
 All teams made progress in their domains of focus, which translated into progress made
in domains that were not identified as the focus of the initiative
 Staff are learning to change their approach with customers, and are recognizing the
need to meet them where they are at
 Court team developed revised the OSA to meet their court needs, titled the Essential
Components for Trauma-Informed Juvenile Courts. This tool, when ready to be shared,
will inform the field around this work.
Specific progress made in the Seven Domains includes the following:
Domain1 - Early Screening & Assessment
 Increased use of screening tools, including some agencies screening every new
admission
 Inclusion of more trauma-focused questions into chart reviews
 Fully integrated trauma screening and assessment in the HER
Domain 2 - Consumer Voice Choice and Advocacy
 Utilized client feedback surveys and convened focus groups to seek feedback from
consumers and families on how they experience services
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Added youth to CIT
Explored with participants how to meet their needs around smoking while on units
Hired additional peer support
Reduced wait times
Domain 3 - Workforce Development
 Increased involvement from non-clinical staff and other stakeholders, including board
members
 Sent weekly self-care emails to staff
 Sent monthly trauma-informed care emails to staff, including Tip of the Week
 Implemented lunch and learns for staff around TIC
 Surveyed staff about secondary traumatic stress and job satisfaction
 Provided ongoing training to staff
 Increased awareness of sensory needs around building and offices
 Improved communication across all levels of staff
 Updated personnel and hiring policies and procedures to reflect TIC
Domains 4 - Evidence-Based and Emerging Best Practices
 Provided training to staff related to specific populations and trauma-specific practices
o WRAP
o Principles of Trauma
o Culturally sensitivity training
o LGBT training
 Expanded use of Seeking Safety and TREM
Domain 5 - Safe and Secure Environments
 Implemented safety survey for participants
 Implemented environmental improvements (paint, furniture, wall hangings etc.)
 Developed materials on TIC for waiting rooms
 Staff completed environmental scan of organization
 Secured grants for renovations
Domain 6 - Building Community Partnership
 Used the tools to implement TIC in other counties
 Shared TIC information with various community stakeholders
Domain 7 - Performance Monitoring and Evaluation
 Analyzed pre and post OSA and PMTs
 Documented progress made in domains of focus
(See OSA Results slide from Child & Adolescent Behavioral Health)
Input from National Council Consultants following organization report outs:
 Need to increase involvement of person’s with lived experience of trauma and those
who are receiving services when recommending TIC changes needed
 Need for staff/procedure manuals that support TIC – infuse into agency practices – work
collaboratively as a community to try to streamline and work for consistency across the
county
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Will have continued access to private website (archived webinars) and national
community list serve over next year. Consultants are an email away.
It is recommended that each organization do an annual OSA and use PMT to track your
progress as well as continue to use the Implementation Tools provide to maintain focus
Need to add core functions of TIC work into job descriptions such as to QI person to
track data (create dashboards)
Living Room Model for crisis services at Recovery Innovations (60% of their staff are
served by peer support specialists).
Crisis Services will nationally be expected to be trauma-informed. This will ultimately be
a standard of excellence and Stark is ahead of the game.
Passion for the work is a key ingredient
Pay attention to the school to prison pipeline. TIC is one way to interrupt the school to
prison pipeline – compassion will get us further than zero tolerance
Involve staff in the solutions, focus on creative ways to keep staff engaged
Remember that this is true social justice work that will impact the community forever
Momentum Recommendations for Teams
 Leadership that supports and models this work is necessary to support change
 Always be nurturing successors and new champions
 Fold TIC into other initiatives and practices/policies/procedures/by laws
 Integrate TIC into county and organizational strategic plan
 Begin the new year by continuing work on previous domains but start to tackle new
ones to keep the process moving forward
 Tie changes to cost management (Domain 7) – look at what you normally track, i.e.,
treatment retention, reduction in no shows
 What do we want to stop doing, start doing, and keep doing? Recognize when
something is working, when something needs to be changed and keep an eye on
successes. Share successes liberally.
 Stay involved with list serve, alumni webinars, and connections made through learning
community
 Find funding from other systems in the community to support efforts
 Make a video about sustaining the momentum
 Recommend MHRSB to continue with quarterly learning community meetings
 Integrate with other TIC efforts and centralized toolkit in community
Ongoing needs to continue advancing trauma-informed care in organizations and across the
community
 Continued support and tools from National Council
 Continued opportunities to work with other agencies with like-minded goals
 Systems to collect data
 Developmentally sensitive resources (hard of hearing, inability to read)
 Training and continuing education that is flexible and provides resources
 Cross agency collaboration
 Continued involvement in TIC Learning Community to improve coordination of care
 Funding to continue with implementation
 Money for environmental changes and staffing needs
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Training about trauma to people who receive services. Provide information about what
consumers can and should expect with TIC
Maintain continued involvement with Trauma/Resiliency Committee in Stark County