Going Down the Mountain Together

I learned to ski as an adult so I will never be great, but I absolutely love it and can hold my own. As my two older kids have long surpassed me in terms of skill level, one of the things I now do when I go on a hard run with them is to let them go first and watch what they do. I look for the path they take, how fast they go, where they struggle, and then make adjustments based on my own strengths and challenges when we ski together.

When Origins Co-Founder Andi Fetzner and I started Origins back in 2017, the trauma-informed movement was still young. Sure, there were organizations and communities who had been doing trauma-informed work for years, or even decades, but it wasn’t quite mainstream yet. One of our observations was that there was an enormous opportunity for others to learn from those who had gone down the mountain first. There was so much wisdom from those early adopters, but there wasn’t much out there that formally documented the learnings–the wins, the struggles, the lessons learned.

Fast forward a couple of years and Andi connected with Eisner Health, a community health center in Los Angeles County. Eisner Health began it’s trauma-informed initiative in 2018 (although the seeds had been planted a few years before it formally began). Eisner Health shared many of the philosophies about trauma-informed care that we hold at Origins–the importance of focusing internally, the role of organizational culture, and the need for a shared language –and we saw an opportunity to partner. We applied for and received a grant from ACEs Aware to share their story and recently published a practice paper with those lessons.

Register here for a free webinar on February 16th from 12-1 pm PT to hear tips from Eisner Health’s journey implementing trauma-informed care, many of which are universal takeaways that can be applied across sectors. The full practice paper will be sent to everyone who registers for the webinar.

Because this mountain is challenging and we don’t need to go down it alone.

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Register here: https://us06web.zoom.us/meeting/register/tZwrdOqorTMqH9VfeeFHMICZ8ryEmzR4hF1S

Lori Chelius, MBA/MPH is a Co-Founder of Origins Training & Consulting. Andi and Lori work with organizations across a number of sectors to build strong foundations based on solid values, build resilience, and provide even better care for the people they serve. She lives in California with her wife, three kids, and their dog, Oliver.

 

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Stories From the Field: Lessons from Eisner Health’s Experience Implementing Trauma-Informed Care

By: Lori Chelius, MBA/MPH

Eisner Health’s journey through implementing trauma-informed care (TIC) began more than six years ago when Chief Medical Officer Dr. Deborah Lerner attended a conference focused on community healthcare and wandered into a session hosted by a social worker who worked for the San Diego Police Department.

The social worker’s story of how TIC had transformed her work planted a seed in Dr. Lerner’s mind, which continued growing over time as she observed real-world challenges with staff, providers, and patients at Eisner Health. Regardless of the people involved, she noticed a similar pattern of escalation and conflict in high-stress situations. For example, a verbal complaint or threat from a patient often intensified quickly, frequently resulting in security having to intervene. In addition, providers sometimes used firm language toward other team members during tense situations, such as when front office staff wanted to add a walk-in appointment into an already crowded schedule. These interactions eroded trust and communication, creating even more of a hotbed for escalations and incidents.

Dr. Lerner observed that the common connection among these challenges was that Eisner Health’s staff members needed more support and tools to navigate stressful circumstances and conversations, as well as skills to help manage those feelings in themselves and their patients.

Dr. Lerner recalled the conference presentation she saw and recognized that TIC could be a way to address these issues on a deeper level and in a sustainable way. Many Eisner Health employees live in the chronically stressed communities that the organization serves, and all staff naturally bring life experiences and stressors to the workplace. By providing more knowledge about stress and tools for managing it, Dr. Lerner hoped Eisner Health could better support its staff, build internal resilience, and improve employee wellness.

As Brene Brene has said, “stories are data with a soul.”

In our recently published project paper, which was a collaboration between Origins and Eisner Health (funded by ACEs Aware), we share the lessons learned from Eisner Health’s experience implementing trauma-informed care, a process that formally began in 2018.

One of these lessons learned was the importance of knowing your “why” (a high-level vision or purpose) before beginning. For Dr. Lerner, her “why” was clear: to better support staff wellness and stress management in order to reduce escalations and improve the patient experience. The COVID-19 pandemic magnified the challenges Eisner Health was already feeling and reinforced the importance of pursuing this plan.

Clearly defining this “why” set the tone for Eisner Health’s TIC implementation and laid a strong foundation for long-term sustainability.

As said by an Eisner Health team member “When we take care of ourselves, that’s when we can provide the best care for others.”

Other top lessons include the critical role of organizational culture, the importance of buy-in, the value of creating a shared language throughout an organization, and recognizing the role of TIC as a foundation for ACE screening.

Sprinkled throughout the paper are stories that capture these and other lessons.

To learn more and download a free copy of this paper, CLICK HERE.

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Lori Chelius is a co-founder of Origins Training & Consulting. Origins helps health care professionals, social service workers, educators, and other leaders integrate a trauma-informed approach into their work so they can build more resilient organizations and communities. She lives in California with her wife, three kids, and their dog, Oliver. Learn more about Origins’ and its online training offerings at www.originstraining.org.

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Webinar: Navigating the Journey Through Implementing Trauma-Informed Care

Trauma-informed care (TIC) offers a way for organizations to start building a resilient organizational culture by understanding the impact of toxic stress and resilience on both patients and staff, then leverage that understanding to improve organizational culture and practices. Within community health, TIC provides a critical foundation for integrating screening for Adverse Childhood Experiences (ACEs).

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Navigating the Storm: We’re in the Same Storm, but Not the Same Boat

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At Origins, we encourage self-reflection as we navigate advocacy during this social justice revolution. While we are all in this storm together, we recognize the reality that we are not all in the same boat. In scrolling through social media this last week, I came upon a poem that speaks to this truth. The author is unknown.

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Facebook Live Video #4- A Trauma-Informed Approach for All!

In this last video, “A Trauma-Informed Approach  For All!” we will wrap it all up and talk about how all of these concepts can be translated into practice in both organizations and communities. We will introduce established concepts from the Substance Abuse and Mental Health Services Administration aka SAMHSA. We will discuss the 4 R’s of a trauma-informed approach- Realize, Recognize, Respond, and Resist Re-traumatization. We will also discuss the 6 principles including Safety, Trustworthiness & Transparency, Peer Support, Collaboration & Mutuality, and Cultural, Historic, & Gender Issues.

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Facebook Live Video #3- What Can We Do About It?

In this third video, “What Can We Do About It?” Andi will offer some concrete practices that you can do to build that resilience muscle and keep yourself in that resilience zone.

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Facebook Live Video #2- What About Resilience?

In this second video, “What About Resilience?” Andi will offer some hope and talk about resilience–what it is and what impacts it.

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Facebook Live Video #1- Is a Pandemic Trauma?

In this first video of this four-part series, Andi talks about what we are all feeling and why during this COVID-19 (aka coronavirus) pandemic. Using the foundational concepts to a trauma-informed approach that are outlined in The Basics, she explains the impact of the collective stress we are experiencing. Adapting an analogy used by Dr. Nadine Burke Harris, Andi talks about the tigers that are lurking around in all our lives right now. She discusses how we adapt and how each of us may respond differently to them. Some of us may react with a fight or flight response; others with a freeze or fawn response–all normal responses to an abnormal situation. She also talks about some of the common ways we might be adapting to these challenging times. (Over-consuming media anyone?)

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Of Mice & Meetings: Bringing Our Whole Selves to Work During the Pandemic

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My wife works for an educational company and her past few weeks have been busy working with schools and districts across California as they face the herculean task of adapting to distance learning for the remainder of the school year. One of my favorite stories from last week comes from a training that one of her colleagues was conducting with a school site. During the training, without skipping a beat, the trainer announced that his daughter had just handed him their pet mice and he was now doing the training with two mice in hand. What I love about this story is that it reminded everyone on the call that the guy who was doing the training is also a dad doing his best to manage his own family life.

For those of us who are lucky enough to work virtually during these unprecedented times, the stories about working remotely and the sudden ramp-up in video calls are often hilarious. Zoom bombs from spouses and kids asking what’s for dinner. People forgetting that the camera is on while going to the bathroom. People showing up to calls in pajamas.

But in addition to being hilarious, these stories are also very humanizing. We are seeing windows into people’s lives that we often don’t encounter in a working relationship. At least one onscreen pet is now pretty standard for any video call (and a welcome addition). 

As someone who has three kids and has worked from home for years, having to manage background noise and distractions (albeit not for an entire workday) is nothing new. But what is new is no longer having to have to pretend that all of this other “stuff” is not going on in the background. Just a few weeks ago, I would desperately search for the mute button if my dog Oliver barked during a call with a client or make sure to prep my younger kids if I had a call scheduled after they were home from school. A couple of years ago when I had a weekly series of early morning virtual trainings with a client on the east coast dead smack in the middle of what is often the noisiest time in the house, my wife graciously turned it into Friday pancakes at IHOP to get the kids out of the house. My wife also works from home and the contortions we have both engaged in over the years to keep the pretense of having everything under control in the background have been sometimes funny and often exhausting. We have both been known to take a conference call from our car when desperate.

To say the least, all of those pretenses are gone. Suddenly, it’s ok to give an authentic answer when someone asks you how you are doing or to admit that the reason you aren’t available at a particular time is because your kid needs your help. And there is something very human about all of it.

I am struck by how many lessons of the trauma-informed and resilience-building movement are so salient right now–the importance of physical and emotional safety, the power of relationships and community to heal. I guess it makes sense–we are all experiencing a collective societal trauma right now.  Dr. Rob Anda, one of the co-authors of the original Adverse Childhood Experiences (ACEs) study, a body of research that is foundational to our understanding of the impact of toxic stress physiology on health and behavior, reminds us that “It’s not just ‘them.’ It’s us.” This is one of those rare moments in time when I think we all truly understand what he meant.

The individual and collective suffering is no doubt real and will likely get much worse. By the end of last week, the number of deaths and infections continued to climb. Health care professionals, grocery stores workers, and other essential workers continue to put their lives at risk on the front lines of this pandemic. People are losing their jobs at an astonishing clip. The dad/trainer with the mice was furloughed from his job for three months (and my wife was reduced to 80%).

But the collective trauma and vulnerability we are all facing has also revealed acts of humanity, both large and small. It has led to unanticipated intimacy in places we may not have expected it. Seeing a toddler unexpectedly pop onto a parent’s lap (and the parent embrace them with a hug instead of shooing them away) during a zoom call is an act of astonishing beauty.

As Brene Brown says, “Imperfections are not inadequacies; they are reminders that we’re all in this together.”

And somehow every puppy that slobbers on a computer screen during a zoom call right now reminds me that we are indeed all in this together.

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Lori Chelius is a co-founder of Origins Training & Consulting. Origins helps educators, health care professionals, social service workers, and other leaders integrate a trauma-informed approach into their work so they can build more resilient organizations and communities. She lives in California with her wife, three kids, and their dog, Oliver. Learn more about Origins’ and its online training offerings at www.originstraining.org.

 

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