Trauma Systems Therapy

Disseminating TST December 4, 2009

The development of effective treatments is only a first step (albeit an important one) in ultimately helping children and their families in the ‘real world’.  Another step that is equally important is to disseminate the treatments to providers and provider organizations.  Part of this process is to communicate to potential constituents the value that the treatments can deliver.  One important venue for such communication is at a conference.

Accordingly, TST had a significant presence at this year’s annual meeting of the International Society for Traumatic Stress Studies (ISTSS) held in Atlanta, GA in November 2009.  As stated on its website, ISTSS is “an international multidisciplinary, professional membership organization that promotes advancement and exchange of knowledge about severe stress and trauma.  This knowledge includes understanding the scope and consequences of traumatic exposure, preventing traumatic events and ameliorating their consequences, and advocating for the field of traumatic stress.” 

Coincidentally, the meeting occurred simultaneous with the shooting at Ft. Hood TX.  This tragic event is unfortunately a stark reminder that trauma exposure in the form of interpersonal violence still exists today and that the work we conduct on a daily basis is so essential for our society.

In addition to the regular meeting, Pre-Meeting Institutes were held the day prior.  Two in particular included several presentations by members of our ‘TST Family’.  The first Institute, ‘Building Effective, Self Sustaining Programs for Traumatized Children and Families’, highlighted an innovative program of the Latin American Health Institute (LHI) for unaccompanied minors.  An unaccompanied minor is a child “who has no lawful immigration status in the United States; has not attained 18 years of age, and with respect to whom; 1) there is no parent or legal guardian in the United States; or 2) no parent of legal guardian in the United States is available to provide care and physical custody” (Office of Refugee Resettlement, U.S. Department of Health and Human Services).  The services provided are trauma-informed and melds TST with Project Joy – a model whereby playfulness in the staff and the children they serve is the highest priority and an end in itself; that is, playful engagement is essential in building therapeutic relationships and can serve as a powerful antidote to trauma.  During Project Joy’s exuberant physical play activities, staff and children safely connect, problem-solve, practice effective action, and discover innate capacities for joy and creativity – factors that promote positive outcomes in the face of adversity and that foster the inherent abilities to heal.  Dr. José Hidalgo of LHI (Massachusetts) is its Project Director and who chaired the Institute.  Other presenters included Steven Gross, MSW from Project Joy (Massachusetts) as well as Drs. Heidi Ellis and Glenn Saxe from Children’s Hospital Boston (Massachusetts). 

 The second Institute, ‘The Importance of Organizational-Level Factors in the Delivery of Trauma-Informed Interventions’, expounded on TST’s utility as an organizational model of service delivery over and above its function as a clinical model of trauma-focused treatment.  Specifically, the various presentations focused on several organizational factors that have been identified by the services and intervention research field as key constructs for effectiveness, including an organization’s mission, structure, culture, work attitudes, and climate as well as the notion of an interorganizational domain (i.e., organizations in a given geographical location that are engaged with a particular societal problem or set of problems – in this case, children exposed to trauma and their families).  Members of our ‘TST Family’ who gave presentations represented an array of organizations (i.e., academic health center, county mental health department, residential facility, school-based agency) and discussed how unique aspects of their organizations influenced (positively and negatively) the adoption, implementation, maintenance, and ultimate long-term sustainability of a TST program.  The presenters included Dr. Adam Brown from The Children’s Village (New York); Dr. Bob Kilkenny from Alliance for Inclusion and Prevention (Massachusetts); Susan Hansen, LCSW-R, RPT-S from Ulster County Mental Health Department (New York); and Drs. Heidi Ellis, Glenn Saxe, and Carryl Navalta from Children’s Hospital Boston (Massachusetts).  The take-home message of the Institute was that any trauma-informed intervention is effective only if the intersection of the treatment itself and the organization that provides the treatment is successfully navigated (go to ‘MY SHARED…box’ on the right-hand column of this webpage to upload the presenters’ PowerPoint slides).