Trauma-Informed Mental Health Service Delivery: Examining Parallel Processes in the School Treatment Program

Within the past 20 years, awareness of the effects of exposure to complex trauma during childhood has grown (Harris & Fallot, 2001a, 2001b; Jennings, 1994; Shaw, 2010). When individuals are exposed to complex traumatic events (Herman, 1992) their lives can become organized around the trauma (Bentovim, 1992). In a similar process, mental health services can also become trauma-organized systems (Bentovim, 1992). Systemic constraints can induce chronic stress, which in turn can limit service providers’ ability to integrate various cognitive, emotional and interpersonal capabilities required to effectively operate systems (Bloom, 2005b). In response to this awareness, many mental health agencies are attempting to develop trauma-informed approaches to treatment. One such approach is called the Sanctuary Model (Bloom, 1997; Bloom & Farragher, 2011), which was based on the philosophy of a therapeutic milieu that requires trauma-informed shifts in organizational culture (Bloom, 1997, 2005b). A children’s mental health agency decided to adopt a Sanctuary Guided Trauma-Informed Practice (SGTIP) throughout its programs. This research represented community-engaged scholarship (Jordan, 2007) with the purpose of determining the extent to which the organizational culture within the School Treatment Program (STP) had become trauma-informed. A comprehensive, contextualized study (Kirby, 2007) using a sequential mixed-methods design (Creswell & Plano Clark, 2011) was undertaken. This study reflects one of the first explorations of organizational culture from varied sources in a children’s mental health agency. This research also provided voice to the experiences of people within the system. Results indicated that although aspects of the Child and Youth Workers’ (CYW) and the classrooms’ organizational cultures reflected commitments associated with the Sanctuary Model, they were not fully trauma-informed. Factors that influenced the adoption were described from the Transformative Knowledge Translation perspective. The perspectives and recommendations may be valuable for other agencies seeking to adopt similar trauma-informed approaches.