Implementing Trauma-Informed Alcohol and Other Drug and Mental Health Services for Women: Lessons Learned in a Multisite Demonstration Project.

Abstract

On the basis of the 9-site, Substance Abuse and Mental Health Services Administration-funded Women, Co-Occurring Disorders, and Violence Study, this article discusses recommendations for implementing trauma-informed mental health, substance abuse, and other support services. These guidelines for best practices represent the consensus of a diverse trauma work group that drew on both cross-site and site-specific qualitative data.

The relationship between childhood adversity and food insecurity: ‘It’s like a bird nesting in your head’

“…Additionally, exposure to violence is largely ignored in food security research despite strong evidence that recipients of Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP), programmes meant to support low-income families with cash, work support and nutrition assistance, report high rates of exposure to individual and community violence (32)(33)(34) . Conventional efforts to address exposure to violence include venues of health care, education, criminal and juvenile justice, child welfare and supportive housing (35)(36)(37)(38)(39)(40)(41) . However, anti-poverty and nutrition assistance programmes are largely excluded from emerging national efforts to create trauma-informed social service systems.…”

Initial Validation of a Subtle Trauma Symptom Screening Scale Embedded in a Needs Assessment Given to Women Entering Drug Treatment

“…As trauma survivors develop a sense of trust and safety with providers and when sufficient time to divulge their specific trauma experiences is allowed, participants may become more willing to disclose their trauma history (Christensen et al, 2005;. By allowing the trauma survivor choices regarding the timing of this personal assessment and control over her recovery process, this important empowering work that can be done to overcome the victimization of trauma experiences can begin Markoff et al, 2005). If a client chooses to not directly report trauma exposure, the Subtle Trauma Symptom Screening Scale can at least alert counselors to the presence of possible trauma symptoms.…”

“…A safe environment suggests that trauma is not to be suppressed or ignored, which could reactivate a woman's experiences of being silenced. Instead, women must retain control over how much and how soon they reveal specific information about their trauma histories (Elliot et al, 2005;Markoff et al, 2005). This suggests that perhaps a subtle screening tool might be more palatable at first to assess trauma symptoms, especially in those who are reluctant to disclose trauma history.…”

“…Leading this change was the Women, Co-Occurring Disorders and Violence Study (WCDVS), a large (N = 2729), multisite, quasi-experimental and longitudinal study designed to identify and develop trauma-informed service systems needed to address the needs of women with both co-occurring disorders and a history of interpersonal trauma (Cusack et al, 2008;Gatz, Brounstein, & Taylor, 2005;Markoff et al, 2005;McHugo et al, 2005;Morrissey et al, 2005). Trauma-informed services typically offer universal screening of trauma and personnel and policies that are sensitive and knowledgeable about trauma and work to place the trauma into a holistic context.…”

Enhancing Drug Court Success

“…Perhaps the unique findings of this evaluation may be due to the success of the leader, rather than the particular groups that were offered. Also, it may mean that these participants had more traumatic life experiences and may have needed more intense psychotherapy techniques for trauma recovery (Markoff, Reed, Fallot, Elliott, & Bjelajac, 2005;Ford, Russo & Mallon, 2007). Recent research emphasizes the need for trauma-informed treatment, given that the lifetime history of physical and sexual abuse for women with alcohol and other drug problems ranges from 55% to 99% (Markoff et al, 2005).…”