Trauma-informed care has swept across nonprofit work

Dr. Bill McKinney has a way of determining if he’ll work with another organization or not: they must follow trauma-informed practices. Any community engagement work must take into account the particular traumas of a given neighborhood and its residents. 

Last fall, McKinney, a longtime equity consultant, was named executive director of the New Kensington Community Development Corp., a nearly 40-year-old neighborhood services group focused in Philadelphia’s riverwards. The fit was intentional; in 2016, NKCDC adopted a trauma-informed model.

 “Those are core principles to us. We are unable to fully function with you as a partner if those are not things that you understand and honor,” he said.

Trauma-informed care developed as a highly-specialized medical practice in the 1970s. Stunned by the care of U.S. Veterans returning from the horrors of the Vietnam War, cross-disciplinary medical professionals began developing practices that balanced traditional physical medicine with an understanding of traumatic experiences. This remained a relatively obscure approach focused on war. By the 1990s, new research better identified the trauma associated with domestic violence, poverty, addiction and other widespread social phenomena. 

In the last 20 years, “trauma-informed” practices have spread throughout human services. The intertwined crises of 2020-2021 — and nearly 2022 — brought a proliferation of conferences, seminars, webinars, Zoom meetings and more. It’s common to hear nonprofit leaders across causes using the term.

But just because you can say you did something doesn’t mean you did it right. 

Start with the basic definition, as provided by the University of Buffalo: “Trauma-Informed Care understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize.” 

Social and human services nonprofits, especially those working in marginalized communities, that don’t understand trauma-informed practices risk inadvertently re-traumatizing those very people they’re claiming to help. McKinney says it’s a question of organizational design — who’s leading these nonprofits and who has the power within them? 

Widespread trauma, including more widespread scrutiny of mental health, has been part of the national consciousness for the last near two years. The murder of George Floyd caused depression and anxiety to skyrocket among Black people. At the same time, overt acts of racism and violence during COVID-19 did the same to Asian American Pacific Islander groups. Women of color, transgender people, people who use drugs, and others with lived experience who offer their services to the nonprofit sector face micro-aggressions and blatant discrimination.

“My people have been traumatized for 400 years,” Dr. McKinney said. “We understand it, we know what it is. A lot of times, things only hit the light also once they become a commodity for somebody else and I think that’s what’s happening a lot. We can look at it with the opioid epidemic. The opioid epidemic raised hellfire and everyone’s got to do something when it hit white folks who are from the suburbs.” 

“But before that, I lived through the crack epidemic,” he continued.

It’s clear trauma-informed practices are fast-becoming a foundation of all service work. Engage seriously in these trends. Here are a two places to start:

• A few years ago, the Substance Abuse Mental Health Services Administration produced a guide that many may find helpful, “SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach.” 
• Another effective resource is “Trauma-Informed Philanthropy: A Funder’s Resource Guide to Supporting Trauma-Informed Practice in the Delaware Valley.” The 36-page guide, a collaboration between the Scattergood Foundation, Philanthropy Network, and United Way, gives you everything you need to know, from information about Childhood Adverse Experiences to how to incorporate trauma understanding into your nonprofit structure.

Like other radical challenges to philanthropy, nonprofit and other community work, genuine trauma-informed practice involves continuous improvement, among other things. 

And in 2021 — almost 2022! — expert-driven models can’t supplant more innovative, liberatory, person-led practices. According to Sam Chenkin, who addresses power and equity issues between management and staff as the principal of Reclaim the Sector, things like valid informed consent, compensating people for their time, and not retraumatizing people who offer their lived experience are all on the table. 

“It’s about having people on staff who have enough experience, ideally, from the community that they have an intuitive understanding of what’s going to create safety,” Chenkin said. “For me, as a trans person, what it takes to create safety for telling my gender-related story is very different than what it takes for someone from a working-class background, who’s being asked to share that story or someone who’s Black and is being asked to share about their oppression.” 

“Different things are going to be needed,” she continued.

But more importantly — or equally importantly, really — when your nonprofit adopts a trauma-informed care model, then you need to center persons with lived experience and understand when leaning on them too much becomes retraumatizing. 

To do that, McKinney’s NKCDC uses a train-the-trainer approach, which teaches that traumatized community members with lived experience have much to give while also understanding certain limitations. As Dr. McKinney said, expectations need to be set from the beginning. “If you come in and you just rip the wound off, and then you say ‘I’ll never see you again,’ versus ‘hey, if this is something you’re up for this is as far as we’re going to be able to go with it, but we’re going to be here consistently working with you on that,” he said.

You can’t mention trauma-informed care in your end-of-year report and pat yourself on the back at the office holiday party. Complex ideas like trauma aren’t a fad. Email me if you’re updating your own use of trauma-informed care.