Essentials of Trauma-informed Care:
Creating, Destroying, and Restoring Sanctuary

Trauma-Informed Care, the Crisis in Human Service Delivery Systems
and the Sanctuary Model

Sandra L. Bloom, M.D.

For the last thirty years, the field of traumatic stress studies has been growing rapidly and methods for addressing the needs of trauma-survivors have burgeoned. At the same time, the advancing field of developmental neuroscience has demonstrated the negative impact of trauma, adversity, and toxic stress on the mind and brain of the developing child along with later negative health, mental health, and social outcomes.We now have a scientifically-grounded basis for understanding how exposure to overwhelming stress becomes transformed into a wide variety of physical, psychological, and social symptoms. This knowledge provides all mental health practitioners with a much more effective means of treatment assessment, planning and implementation than we have previously had available.

But in those same three decades, the nation’s mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery often rendering them incapable of ensuring the safety, security, and recovery of our clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems for which our clients seek relief. Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place.

Healing is possible for these clients if they enter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide. These parallel processes among clients, staff, organizations, and communities can be understood within a trauma-informed framework, laying the groundwork for parallel processes of recovery for our caregiving systems as well as the staff who working within them and the clients we serve.

In this presentation, Dr. Sandra Bloom will summarize will describe her journey of becoming trauma-informed and the key things she and her colleagues learned from their adult survivors of childhood adversity and other forms of trauma. She will then summarize what may happen to groups under significant stress and discuss a trauma-informed organizational approach, the Sanctuary Model that helps organizations develop trauma-informed cultures to buffer individuals against the impact of chronic stress.

OBJECTIVES:

• At the end of the session the learner should be able to describe the effects of toxic stress and trauma on the developing mind
• At the end of the session the learner should be able to describe parallel process
• At the end of the session the learner should be able describe the basic elements of trauma‐informed treatment
• At the end of the session the learned should be able to describe the basic commitments of the Sanctuary Model value system

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