Introducing trauma-informed care to reduce seclusion and restraint

We will describe “Creating Cultures of Trauma-Informed Care,” a model for changing organizational culture as it was implemented on inpatient units in a state mental hospital. Built on principles of safety, trustworthiness, choice, collaboration, and empowerment, this approach incorporates current trauma-related knowledge into all aspects of program activities, physical settings, and relationships and is directly supportive of attempts to reduce the use of seclusion and restraint. We will outline some of the changes in understanding and practice that are important in shifting from a traditional paradigm to one that is trauma-informed. Specifically, we will describe the model's key services-level changes (service procedures and settings, formal service policies, trauma screening and trauma-specific services) and administrative-level changes (administrative support, trauma education, and human resources practices). Further, we will discuss the role of all levels of staff—administrative, supervisory, direct service, and support staff—as well as clients in devising specific strategies for developing and sustaining a program culture that is consistent with the ultimate elimination of seclusion and restraint. Examples will be provided throughout the presentation.