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  • 1. Australian WFD and Learning Directions for Achieving Recovery OrientedTrauma Informed Services
    Trauma Informed Care and Practice:
    Meeting the Challenge Conference
    Sydney - 23 & 24 June 2011
    Tina Smith, Senior Policy Officer MHCC
  • 2. Why Pursue WFD and Learning Directions?
    We need to presume the clients we serve have a history of traumatic stress and assume universal precautions by creating systems that are “trauma informed”.
    (Hodas, 2005)
  • 3. Changing culture requires both ……
    Organisational change
    Workforce change
    “Where will the staff with the rights skills and experience come from to deliver trauma informed services?”
  • 4. Criteria for building a trauma informed MHS system (SAMHSA, 2007)
    3/12 criteria relate to WF
    WF recruitment, hiring and retention of trauma informed staff
    WF orientation, training, support, job competencies and standards related to trauma
    Consumer/trauma survivor involvement and trauma informed rights
  • 5. Education and training systems …
    Accredited (AQTF) Trauma? No
    University qualifications
    eg, GP, psychiatry, nursing, psychology, SW, OT
    Vocational qualifications (CS&H Training Packages)
    eg, Certificate IV and Diploma in MH and/or AOD, other?
    MH Peer Worker Competency Development Project
    Non-accreditedTrauma? Yes
    Short courses
  • 6. CS&HISC MH Skills Articulation Project
    Methodology
    VET/Universities & Mapping Reports
    Explored MH qualifications and content at Australian universities
    Policy and Workforce Report
    Interviews and focus groups about job roles/tasks
    79 MHWs (public/community, staff/managers)
    Diverse qualifications and experience
    3 areas (metro, regional, rural)
  • 7. Practice and occupational boundaries in CMH
  • 8. CS&HISC MH Skills Articulation Project
    Findings (Policy and WF Study)
    Supported integration across medical, talking and social rehabilitation approaches
    Identified the need to:
    “Systematically assess the skills and knowledge required to work effectively in the sector, with a view to developing a unified body of psychosocial practice from which to derive an evidence-based workforce strategy”
    Filling gaps in knowledge & skills
  • 9. Inclusion of Trauma in MH WFD Directions in Australia
    Trauma? No
    National MH Strategy, Plan, Standards
    COAG NAP MH 2006-2011
    National MH WFD Strategy/Plan
    Health Workforce Australia (HWA)
    Skills Australia
    Trauma? Yes
    CSHISC Environmental Scan 2011/CIP
    As well as service coordination, PSR & talking therapies to improve responses to people with complex and diverse needs
  • 10. CSHISC Environmental Scan 2011
    “Examine expansion of care coordination roles and skills/practices to support increasingly complex needs, including trauma-informed care and talking therapies. Any development of training package content should be addressed in conjunction with broader community MH WFD objectives and identification of a unified body of knowledge/evidence about PSR/recovery-oriented practice”.
    “This work would inform the existing 2010–2011 work plan proposal: ‘Mental health work – recovery-oriented community mental health and higher-level skills’”.
    What are the competencies needed to deliver trauma informed services?
  • 11. Trauma competencies
    Competence - Definition
    The state or quality of being adequately or well qualified; ability.
    A specific range of skill, knowledge, or ability.
    Knowledge- what we know
    Skills- what we do
    Attitude- how we do it
  • 12. “Criteria for building a trauma informed MHS system” (SAMHSA, 2007)
    3/12 criteria relate to WF
    WF recruitment, hiring and retention of trauma informed staff
    WF orientation, training, support, job competencies and standards related to trauma
    Consumer/trauma survivor involvement and trauma informed rights
  • 13. 1. WF recruitment, hiring and retention of trauma informed staff
    Prioritize staff with training in and/or lived experience of trauma (eg, job descriptions, “trauma champions”)
    Outreach to trauma informed/educated employees
    Advocate for trauma content in education and training
    Incentives, bonuses and promotions for trauma informed staff
    Professional development opportunities to become trauma informed
    Trauma informed/protective OH&S
  • 14. 2. WF orientation, training, support, job competencies and standards related to trauma
    Trauma informed HR for all employees
    … that incorporates relevant skill sets and job standards
    Broad human service involvement (ie, integration & coordination)
    All staff (admin, direct care, management)
    To receive basic education about …
    Prevalence of trauma
    Traumatic impacts
    Dynamics of re-traumatization
    Diversity and trauma
  • 15. 2. WF orientation, training, support, job competencies and standards related to trauma
    All direct care staff (clinical and non-clinical)
    Understanding & responding to complex behaviour/s
    Maintaining boundaries (personal & professional)
    Trauma dynamics and the avoidance of iatrogenic re-traumatization
    Relationships between trauma, MH and life problems
    Vicarious traumatization and self-care
    Specific traumas (issues & approaches)
    Trauma techniques (eg, grounding, recovery skills)
    And … all Training must involve
    people with lives experience
  • 16. 2. WF orientation, training, support, job competencies and standards related to trauma
    All clinical staff (including disaster response staff)
    Evidence based practice in trauma assessment & treatment skills
    Participation on advanced trauma training
    For disaster responders – initial assessment through intervention
  • 17. 3. Consumer/trauma survivor involvement and trauma informed rights
    Involved at all levels of service planning, implementation & evaluation (ie, not just training and peer work roles)
    Trauma informed ISPs developed collaboratively with every consumer and, where appropriate, their involved family and friends
    Rights informed participation agenda (ie, discrimination)
  • 18. Implementation plan for the 4th National MH Plan
    Workforce Development
    Action 25: Develop and commence implementation of a National Mental Health Workforce Strategy that defines standardized workforce competencies and roles in clinical, community and peer support areas.
    Action 26: Increase consumer and carer employment in clinical and community support settings.
  • 19. Trauma competencies
    “Comorbidity Competencies Skills Indicators” (Graham, H. & White, R., 2011)
    Essential Knowledge
    Core Practice Skills
    Specialist Skills/Leadership
  • 20. Trauma competencies
    Essential Knowledge
    Knowledge of the impacts of a history of trauma and the various ways it can impact an individual, family and/or community
    Basic knowledge of impact of childhood abuse and neglect and the links with adult problems.
    Knows that trauma can be associated with complex and diverse health and social issues and unhelpful coping strategies (suicidality, intoxication/self-medication, dissociation, anxiety, excessive anger, self-harm).
    Core Practice Skills
    Specialist Skills/Leadership
  • 21. Trauma competencies
    Essential Knowledge
    Core Practice Skills
    Identifies and responds to mental health issues immediately following a traumatic event, but does not try to engage with the trauma history at this time.
    Is aware of triggers, vulnerabilities or untimely helping that might contribute to re-traumatisation.
    Supports consumers who have been through trauma to access MH treatment, rehabilitation and support services, where indicated.
    Specialist Skills/Leadership
  • 22. Trauma competencies
    Essential Knowledge
    Core Practice Skills
    Specialist Skills/Leadership
    Actively demonstrates a recovery oriented approach to understanding how trauma affects each individual, helping them to discover their own strategies and goals.
    Collaborates with other health and community services professionals involved in the persons’s recovery from trauma.
    Provides education for people seeking healthy coping strategies in response to trauma.
    Facilitates professional development for services to be more trauma informed.
  • 23. Supervision, coaching & mentorship
    Professional development
    Leadership
    Trauma champions
    Healing workplaces
    Organizational/cultural change
    Trauma informed approaches
    are
    Recovery oriented approaches
  • 24. Recovery principles include
    Hope and faith
    Meaning, purpose & direction
    Equality & respect
    Empowerment & self-determination
    Social inclusion and connectedness
  • 25. Summation
  • 26. Mental Health Coordinating Council
    PO Box 668, Rozelle NSW 2039
    Cnr. Church & Glover Streets, Callan Park
    P: (02) 9555 8388 F: (02) 9810 8145
    Email:info@mhcc.org.au Website: www.mhcc.org.au
    Materials available online such as: information; fact sheets; training & workforce development; research publications; the Mental Health Rights Manual; submissions; sector events; current issues and news. www.mhcc.org.au
    Presenter: Tina Smith tina@mhcc.org.au