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Trauma Definition

Part Three: Suggested Guidelines for Implementation of a Trauma-informed Approach

Guidelines can provide a roadmap to help individuals and agencies get started in the process of implementing a trauma-informed approach. Guidelines can also assist in the development of a change strategy, help identify organizational strengths and weaknesses, and provide milestones to measure progress. While no checklist can cover every possible situation, and measurement metrics will need to vary across settings, a general set of guidelines can be useful as a starting point.

In a trauma-informed approach, change permeates all levels of an organization or system; all aspects of organizational culture are in alignment. While different organizations have varying responsibilities and spheres of influence, the following organizational domains were identified as potentially relevant across a variety of settings.

  1. Governance and leadership: the leadership and governance bodies of the organization support and invest in implementing and sustaining a trauma-informed approach; there is an identified point of responsibility within the organization to lead and oversee this work.
  2. Policy1: there is a written policy establishing a trauma-informed approach as an important part of the organizational mission.
  3. Engagement and involvement of people in recovery, trauma survivors, consumers, and family members in services2: these groups have significant involvement, voice, and meaningful choice at all levels and in all areas of organizational functioning (e.g., program design, implementation, service delivery, quality assurance, cultural competence, access to peer support, workforce development, and evaluation.)
  4. Cross sector collaboration3: there is collaboration between adult and children's services, prevention and treatment, different health and human service sectors, education, legal, child welfare, criminal justice, peer support and community-based organizations representing the diversity of populations served, and military and veterans systems.
  5. Services and interventions: all services and interventions, including screening and assessment, are based on the best available empirical evidence, are culturally appropriate, and reflect principles of a trauma-informed approach; a trusted and effective referral system is in place; and trauma-specific services/interventions are acceptable, effective, and available for individuals and families seeking services.
  6. Training and workforce development: training on trauma and how to respond to it is available for all staff; a human resource system incorporates trauma-informed principles in hiring, supervision, staff evaluation; procedures are in place to support staff with trauma histories and/or those experiencing significant secondary traumatic stress from vicarious exposure to highly stressful material.
  7. Organizational and community multiagency protocols: organizational procedures and community cross agency protocols reflect trauma-informed principles, including collaborations with other agencies.
  8. Quality assurance: there is ongoing assessment, tracking, and monitoring of trauma-informed principles and effective use of evidence-based trauma specific interventions.
  9. Financing: financing structures are designed to support a trauma-informed approach (e.g. staff training, appropriate facilities) and evidence-based trauma-specific services.
  10. Evaluation: measures used to evaluate service or program effectiveness reflect an understanding of trauma.
  11. Physical environment of the organization: investments should be made to ensure that the physical environment promotes a sense of safety.

Applying trauma principles to all organizational domains is the "heart" of a trauma-informed approach. Organizations are encouraged to examine how a trauma-informed approach will benefit all stakeholders; to conduct a trauma-informed organizational assessment and change process; and to involve clients and staff at all levels in the organizational development process. SAMHSA plans to adapt these suggested guidelines into a matrix worksheet that organizations and systems can use to plan and assess the implementation of a trauma-informed approach. Examples of matrices from various sectors will also be made available.

Tell us your views on suggested guidelines for implementation of a trauma-informed approach.

  1. Guarino, K., Soares, P., Konnath, K., Clervil, R., & Bassuk, E. (2009). Trauma-Informed Organizational Toolkit.
  2. Wilson, C. & Conradi, L. (2010). Managing traumatized children: A trauma systems perspective.
  3. Ibid.


Last updated: 12/10/2012