Trauma-informed care training leads to significant gains in knowledge and organizational change

A McLean Hospital study of 598 people across various industries who underwent a two-day training workshop where they learned about trauma-informed care and how to deploy these skills within their organizations, found participants reported significant gains in knowledge of trauma and made improvements to organizational policies, according to a comparison of survey data collected before and after the trainings.

Among those trained, who included nurses, CEOs, academics and corrections officers, post-survey scores increased significantly in four out of five survey measures including self-assessed knowledge and attitudes about trauma, systemwide knowledge and attitudes, awareness of cultural background at work, and skills of training and coaching staff to sustainably build the conditions for safety and mattering.

The study, led by Alisha Moreland-Capuia, MD, director of McLean's Institute for Trauma-Informed Systems Change, published online October 30 in The Journal of Clinical Psychiatry. Dr. Moreland-Capuia designed the "Training for Change" workshops included in the study.

"Because trauma is everywhere and experienced widely, trauma and healing must be everyone's business," said Moreland-Capuia, who also serves as director of Trauma-Informed Treatment, Consultation, and Outreach for the Division of Depression and Anxiety Disorders at McLean, and assistant professor of psychiatry at Harvard Medical School. "Our workshops equip individuals and organizations with the necessary tools for creating and codifying safety, mattering and healing."

Trauma-informed care is an approach that considers the trauma that an individual may have experienced or still be experiencing and offers training and education to facilitate healing and empowerment. An estimated 70 percent of the global population and two-thirds of Americans have experienced at least one traumatic event in their lifetimes.

Moreland-Capuia has dedicated her career to bringing trauma-informed care practices to systems rather than just individuals, to raise organizational awareness and introduce policies and procedures that can avoid retraumatizing individuals and provide them the support and a positive environment needed to thrive. Through her institute, she has conducted trainings with individuals in organizations ranging from small nonprofits to Fortune 500 companies, the criminal justice system, healthcare and academia settings, and local and international political leaders.

Study participants who underwent a two-day "Training for Change" workshop participated in didactic sessions where they learned about cultural responsivity, the biological effects of trauma on the brain and body, and what trauma-informed care is how it can be deployed within an organization. They also brainstormed trauma-specific practices to apply to their respective organizations in smaller breakout groups.

The researchers provided surveys to workshop participants before undergoing the training, and again six months later. These surveys had been validated in previous research studies led by Moreland-Capuia as outcome measures that quantify-trauma informed change in individuals' knowledge and attitudes, as well as in system-wide changes.

The researchers found that while there was a significant increase in scores in four out of the five scales the survey measured, there was not an increase in safety and acceptance at work. Moreland-Capuia notes that research suggests organizational change could take as long as 18 months and suspects such measures might increase with more time. Future studies will look to track participants longer-term to better understand and quantify how the workshops might affect lasting changes and would also look to include larger numbers of individuals from diverse backgrounds and roles within organizations.

Study limitations include the analysis was done only on those who responded to the 6-month surveys, who might have positive views of their organization. For example, a company CEO may be more likely to enact changes rapidly, or a 10-person company could make wholescale changes easier than a 10,000-person company. The researchers added that the majority of those trained were college-educated white women, and for an organization to be trauma-informed, the whole workplace needs to be included.

Trauma has a profound impact on the daily lives and interactions of those who have experienced it, which is why it is crucial that all systems, from workplaces to health care to civic and criminal justice settings, operate with trauma-informed care practices top of mind."

Kerry J. Ressler, MD, PhD, Chief Scientific Officer and Chief of the Division of Depression and Anxiety Disorders at McLean Hospital

"This research provides meaningful data that support that educating members of an organization on trauma-informed care could lead to transformational changes in attitudes and policies, which ultimately may benefit everyone within a given system." added Ressler, who is also director of McLean's Neurobiology of Fear Laboratory and a professor of psychiatry at Harvard Medical School.