This article is adapted from “Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings”. It is featured in the "Future of Homeless Services" Special Issue, guest edited by the Homelessness Resource Center and published in the Open Health Services and Policy Journal.
Trauma among individuals experiencing homelessness is very high. Not only do traumatic experiences often precede homelessness, but the loss of home and experiences on the street are traumatic in themselves. Many adults and children who access homeless services have experienced violence, sexual exploitation or abuse, extreme poverty, a loss of community, family separations, or other tragic events in their lives.
Many homeless service systems are not yet adequately addressing the issue of trauma. In the absence of traumainformed services, individuals may be less likely to trust their providers, may be less likely to take advantage of services, and may even experience re-traumatization.
To begin to take steps toward becoming trauma-informed, the HRC offers some guidelines:
- Don’t start from scratch. There is great variability in how trauma-informed services are implemented. Use a theory-based model or framework to help to ensure consistency across sites and help to begin to build evidence-based practices.
- Avoid any practices that may be re-traumatizing. This applies to all levels of the system, including administrative, provider, and consumer levels. Take the “Trauma-Informed Self Assessment” in the Trauma-Informed Organizational Toolkit.
- Know who you’re serving. Implement systematic screening for trauma histories, using standardized measures. Also, include an assessment of consumer strengths and resources during intake and evaluation. This contributes to the development of a strengths-based model and supports the further development of coping resources.
- Integrate substance use, mental health, and trauma services. Research has found that integration of services is a key factor in improving outcomes. Adopt a holistic approach to each consumer’s needs.
- Include trauma-informed services for children. Programs implementing integrated trauma-informed treatment approaches should include specialized services for kids, to increase resiliency in children and youth.
- Offer trauma-specific services. Because the majority of consumers in homeless service settings are trauma survivors, additional support should be made available. This could include support for victims of domestic violence, or kids who have experienced natural disasters, for example.
- Involve Consumers. Empowerment-based trauma theories emphasize the importance of the active participation of consumers in service programs to help rebuild a sense of control. Examples of consumer involvement include active goal-setting and crisis planning, peer-led services, leadership roles for consumers, and involvement in program design, evaluation, and refinement.
- Evaluate your cultural and linguistic competence. Consumers can feel safe when they don’t feel alone. Make sure, whenever possible, that services are provided in the consumer’s native language, and communication is adapted to cultural differences.
The HRC offers several resources to help programs learn about providing trauma-informed services, including:
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