The Trauma and Gender (TAG) Agencies Project has trained 20 agencies throughout Connecticut since 2004 to be gender-responsive and trauma-informed. Highlights of the project include expert consultation, training resources, and consumer and staff involvement.
Gender-responsive care creates an environment through site selection, staff selection, program development, content and materials that reflect the reality of women and men’s lives.1 For example, many groups that address trauma are all male or all female to allow for the distinction in each gender’s specific needs and experiences. Design considerations might include updated spaces that appear more welcoming and less commercial.
In the beginning, the Trauma Initiative was solely focused on educating staff about the impact of extreme stress that overwhelms an individual’s ability to cope, resulting from violence, hate crimes, sexual abuse, and other events. Often linked with increases in substance use, mental health problems, disease, violence, and abuse, agencies in the field typically find high rates of trauma among the populations they serve.
Two organizations eventually came together around the common goal of better service to male, female and LGBTQ (lesbian, gay, bisexual, transgender, questioning/queer) trauma clients. To guide agencies in becoming trauma-informed, the Connecticut Women’s Consortium (CWC) and Department of Mental Health and Addiction Services tapped trauma experts Roger Fallot, PhD, and Eileen Russo, MA, LADC. At the same time, the Women’s Services Practice Improvement Collaborative (WSPIC) was focusing on gender and trauma in behavioral healthcare.
The initiatives make sense. Research on trauma suggests that women are more than twice as likely to develop posttraumatic stress disorder, more likely to experience sexual assault, and more likely to be harmed by a partner or lover rather than an enemy or stranger.2,3 Men and women experience trauma and the barriers to treatment (e.g., child care during treatment times) differently. Stephanie Covington, PhD, recognized for her work in treatment, research, and practice of gender-responsive care, consulted on the WSPIC initiative.
The organizations’ projects, which shared a similar focus on trauma-informed care, were combined to form the TAG Agencies Project. Multiple agencies are selected each year and receive technical assistance and training from Covington, Fallot, and Russo in trauma-informed, gender-responsive care over a two-year period.
Participation by clients and staff is the most important piece of the TAG project. Consumers contribute through feedback, representation on the steering committees, surveys, focus groups, and projects. For example, Advocacy Unlimited, an exclusively peer-run organization performs walkthroughs for the TAG project and gives written feedback. Whereas before training had centered on clinical staff and trauma-specific treatment models such as Seeking Safety, TREM, M-TREM for men, and Beyond Trauma, now training focused on including other staff members that don't typically recieve training (such as maintenance workers) to create the wider systemic changes needed to become a trauma-informed culture.
For example, desk, transportation, and other staff who first greet clients often do not have a context to understand clients’ behavior. After the training, staff is more informed and better equipped to handle incidents.
Focus on Visual Space
Designing and decorating lobbies, rooms, parking lots, and common areas is a visual way to deliver trauma-informed and gender-responsive care. Participants involved in the TAG project started looking at elements of gender-responsive care and the trauma-informed elements of safety, trustworthiness, choice, collaboration, and empowerment.4
For example, when thinking about safety, they focused on lighting an agency’s parking lot and making entrances to reception areas more welcoming. When contemplating trustworthiness, the location of bathrooms for supervised drug and urine testing were examined, and privacy issues around staff conversation areas emerged. Collaborative tools included dedicated avenues for feedback such as bulletin boards and feedback boxes.
One part of the gender-responsive care that came to the forefront was a discussion of LGBTQ issues, especially when trying to serve trauma groups that were all male or all female. Some agencies were able to offer a separate group and to consider updated bathroom and sleeping room policies for the LGBTQ population.