In serving more than 20,000 adults, adolescents and children since 1981, CHRIS Kids has always understood the importance of dealing with trauma, agency leaders say, incorporating that principle into all of its programs, policies, procedures and processes to prevent those who have suffered adverse childhood experiences from being re-traumatized.
But based on the notion that trauma-informed care is necessary to providing long-term sustainable improvement in functioning for its clients, especially those involved in the child welfare and juvenile justice systems, the agency updated its organizational vision in January 2013 to formalize this approach: “To improve our community by providing children, adults and families with high-quality, trauma-informed behavioral health services and support systems.”
CHRIS Kids starts from the standpoint that traumatization is analogous to diabetes or alcoholism, CEO Kathy Colbenson said. “You never are non-traumatized. Just like with diabetes or alcoholism, you always have it. You can walk through it, and it can lose its power over you. [But] it’s got to be identified and addressed to lose its power. That’s our journey, in a nutshell.”
As CHRIS Kids began implementing trauma-informed care, the agency leaders realized that the prevalence of adverse childhood experiences (ACEs) is worse than they imagined. The agency has found that 86 percent of youth in its residential treatment facilities had experienced at least four ACEs. Colbenson noted that’s the “tipping point,” according to research, beyond which such poor health, social and emotional outcomes, such as domestic violence, work performance problems or suicide attempts, become overwhelmingly likely.
Using the ACEs framework forces the right questions to be asked, which is a starting point for an organization to collect data, Colbenson said. “Find out who you’ve got in your organization,” she said. “They don’t always answer because they may not be ready. But they’re ready often enough. We have to be careful about how we ask questions: If a child reveals they’re [sic] being abused in their own home … you have to be prepared to take action. That’s why sometimes people don’t ask because then you have to do something, and that ‘something’ can be really hard.”
Given her agency’s focus on kids in foster care, CHRIS Kids has added questions about adoption and housing instability to the standard ACEs list, and Colbenson recommends other agencies custom-tailor the list to their populations as needed. “It’s helping us identify the specific kinds of therapies that have proved most useful in helping people recover from their traumatic events and improve their functioning,” she said.
Doing so requires leadership commitment, Colbenson said, because otherwise even those in the youth field tend to focus more narrowly on teaching their clientele better behavior and leaving it at that. “What we’re doing is saying, ‘I wonder how that bad behavior came to be?’” she explained. “If the child is hyper-vigilant and aggressive, that may have been an appropriate coping mechanism when they lived in a violent environment. None of us have a perfect childhood, and we tend to start viewing the world out of the lens of our own experiences.”