After reading about the controversy surrounding the Colorado Department of Human Services (CDHS), it strikes me that the issues illustrate the larger and more pervasive challenges that we face as a system caring for the safety and wellbeing of our most vulnerable citizens.
In 2008, Mount Saint Vincent, a treatment provider for children with severe emotional and behavioral challenges due to trauma, mental illness, abuse, or neglect, moved away from the more traditional behavior modification, contingency-based models in favor of the Neurosequential Model of Therapeutics. It is a strengths-based, trauma-informed, nonblaming approach that we have found to be successful in treating this fragile population of children. Trauma-informed care is an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma.
Fortunately for the citizens of Colorado, CDHS has also adopted the philosophy of employing a trauma-informed system of care at all levels, which is considered to be a nationally recognized best practice. The structure and philosophy to implement such a system has been clearly defined.
But, Colorado’s system of providing human services to its citizens is far more complex than in many other states. We have 64 county and two tribal nation child welfare departments, a dozen mental health centers, three behavioral health organizations, multiple private insurance companies, numerous treatment centers and juvenile correctional programs, and multiple hospitals; it’s a dizzying array of different layers in the overall system.
Because so many organizations are involved, there are competing philosophies, conflicting agendas, and budgetary constraints that come into play. Add to that a culture that favors or even incentivizes specific types of care over others, and the result is a complicated system that sometimes gets in the way of what is in the best interest of the child. So, CDHS is facing a large and complex task in implementing a trauma-informed approach.
Moreover, being trauma-informed is more than just applying this approach; it’s about walking the talk. What we have found at Mount Saint Vincent is that an organization can’t provide trauma-informed care without the organization being trauma-informed itself. I’m sure CDHS is facing the same challenge. It takes a strong commitment to look internally and examine how it is adhering to trauma-informed principles. It also requires ongoing vigilance to maintain the positive change.
What CDHS and the various stakeholders who provide services for vulnerable populations are being presented with is an opportunity: an opportunity to evaluate how they are moving forward with a trauma-informed approach. The adoption of a trauma-informed approach means working more collaboratively and being more cooperative. It means building relationships and establishing trust. And I don’t mean just CDHS; it is our collective job as community, providers, school districts, and citizens to work together in this effort, with the goal of providing the appropriate level of care at the right time, so all Coloradans experience better outcomes.
Kirk Ward is the clinical director of Mount Saint Vincent, a treatment provider for children facing severe emotional and behavioral challenges due to trauma, mental illness, abuse, or neglect.
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