Indian Health Service The Federal Health Program for American Indians and Alaska Natives
Trauma Informed Care
While everyone is at risk for experiencing trauma, this is especially true for American Indians and Alaska Natives.
Tribal nations have higher rates of trauma exposure within and across generations, worsened by frequent interpersonal losses and risk for grief, as well as accompanying high risk for post-traumatic stress disorder. Often, trauma survivors can be re-traumatized, especially in the healthcare system where questions and procedures may be perceived as threatening or traumatic. Trauma may also impact co-workers, friends, and families within our facilities and communities.
Trauma touches all aspects of life, including physical, behavioral, and spiritual health.
Trauma Informed Care Project
Understanding the impact of trauma is an important first step. IHS offers training on the impact of trauma and becoming a more compassionate and supportive health care community. The IHS training has been modified and adapted to address the unique experiences of American Indians and Alaska Natives to include historical trauma, the cumulative psychological and emotional wounding across generations.
The goal of the Trauma Informed Care Project is to approach organizational change through five core values:
To facilitate this change, staff training will address four areas.
What is Trauma and what is its impact?
Focuses on the rates of trauma among AI/AN people and the different types of traumas. Addresses impacts of trauma and historical trauma on communities, co-workers, and patients. This training is appropriate for non-clinical staff.
Becoming Trauma Informed
Focuses on the impacts of trauma and historical trauma on the physical, behavioral, and spiritual health of patients and providers. Discusses how trauma may impact patients’ interaction with the healthcare system and the patient-provider relationship. This training is appropriate for health care providers, including physicians, nurses, and ancillary staff.
Focuses on treating trauma and historical trauma, and the complex interaction between them. This training is appropriate for behavioral health professionals.
To ensure that Behavioral Health providers have the tools need to treat trauma, in depth trainings on Trauma Informed interventions will be also available. These will include trainings on Seeking Safety, Target, and CBT models.
Trauma Informed Supervision
Focuses on exploring the impacts of trauma and historical trauma on employees’ performance, coworker relationships, and well-being. This training is appropriate for clinical and non-clinical supervisors at all managerial levels. Upcoming trainings can be found on the Telebehavioral Health Training page.
Access recorded webinars on the Archived Trauma Informed Care trainings page.
Case Consultation Sessions
Integrating Historical Trauma and Trauma Informed Ongoing Assessment and Care in Clinical Behavioral Health Practice (by Dr. Maria Yellow Horse Brave Heart) provides case consultations for behavioral health providers on trauma-related behaviors, ways to work more effectively with patients who present challenges, such as triggers, use of self, transference and countertransference, and how to provide trauma informed clinical care. Register for a consultation
Working with Behavioral Challenges in Patients Who Have Experienced Trauma (by Dr. Jeanne Bereiter) provides case consultations for health care providers on trauma-related behaviors, ways to work more effectively with patients who present challenges, such as lack of follow through with recommended treatment, and providing trauma informed clinical care. Register for a consultation
Learning Collaborative Sessions
Trauma Informed Integrated Care with Pediatric Primary Care - This project focuses on increasing the quality and accessibility of child trauma services by integrating behavior and physical health services in American Indian and Alaska Native communities. Referred to as the Pediatric Integrated Care Collaborative, or PICC, ten pilot sites attend in person and virtual learning collaborative sessions and receive tailored technical assistance for implementation of pediatric trauma informed integrated care into primary care patient centered medical homes.
The goal of the PICC is to harvest best practices for screening for trauma in the pediatric population and engaging families with draft policy recommendations for the Indian Health Service.
The ten selected locations include seven direct service and three tribal sites (*):
- Chickasaw Nation Medical Center Pediatric Clinic, Oklahoma*
- Gallup Indian Medical Center, New Mexico
- IHS Fort Thompson Indian Health Center, South Dakota
- Muscogee (Creek) Nation Department of Health, Oklahoma*
- Northern Navajo Medical Center, Navajo Preparatory School Based Health Clinic, New Mexico
- Northern Navajo Medical Center, New Mexico
- Nottawaseppi Huron Band of the Potawatomi Health and Human Services, Michigan*
- Southern Bands Health Center – IHS Elko Service Unit, Nevada
- Woodrow Wilson Keeble Memorial Health Care Center—IHS Sisseton Service Unit, South Dakota
- Zuni Comprehensive Community Health Center, New Mexico
A new application call will open for ten additional sites in Fall 2017.