An Integrated Approach for Trauma-Informed Care

***January 22, 2016: Click here to view the new funding opportunity released by the Substance Abuse and Mental Health Services Administration (SAMHSA): Cooperative Agreements to Benefit Homeless Individuals (CABHI)!

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Resiliency and Self-Care in an Integrated System Approach

Resiliency theory has a longstanding history in the fields of psychology and social work. However, as integrated behavioral and medical health treatment models are evolving to address the challenge of integrated care, an understanding and application of resiliency theory in a multi-disciplinary team approach can mean the difference between true treatment engagement and retention versus a failure to engage and continued or exacerbated high-risk care.

The adaptive ability to function and process change is a complex, multi-layered individual phenomenon, impacted by internal as well as external forces. Resiliency theory is a strength based approach, replacing a paradigm of pathology and dysfunction to one of adaptive coping and strength building. Whether encouraging healthy physical exercise for a HEDIS measure or developing measures for coping with the aftermath of violence in a community, resiliency-focused environment is a framework all practitioners and health advocates can apply. With an integrated treatment approach that offers positive coping and adaptive function, there is opportunity in the patient engagement dialogue for positive change, support and awareness; key indicators of engagement and adherence for complex care.

While trauma-informed care (TIC) is a clear evidence-based practice/EBP, the use of resiliency need not be limited to the traditional assessment and treatment for Acute Stress Disorder or Post-traumatic Stress Disorder. At the very least, TIC should be considered for all treatment planning and team collaboration, in order to better understand and synthesize treatment needs. At best, TIC can promote an understanding of the personal processes impacting self-care and treatment outcome. At the macro-level, it is a means to effective change for improved population health outcome with identified goals; at the micro-level, it can be the ability to engage in smoking cessation plans that will change the degree of risk for cancer-related death due to smoking. For the treatment team, it is the ability to understand why and how tobacco smoking is a reaction to stress and when and which stress coping mechanism is required to improve the chance of positive change and treatment adherence. In this way, resiliency theory can improve health knowledge and health literacy. It can be the difference between additional years of life for one's partner, family or friend, or a higher risk of mortality, serious illness and loss. 

Build resiliency understanding into your team process, by providing training on cultural relevancy and congruency in TIC approaches; discuss the varying ways providers can leverage a discussion with the client on change with the understanding that resiliency-building is a foundation of engagement and increased awareness for positive coping. It is also a means to equip your team with the skills to move forward with positive population health outcomes rather than being stymied by their own feelings of inadequacy and stress as a reaction to industry demands for data measures and EBP.