What Does it Mean to be Trauma-Informed? A Multi-System Perspective from Practitioners Serving the Community

The increased awareness of the detrimental consequences of trauma exposure has led researchers to focus their attention in identifying best practices on integrating trauma-informed approaches (TIAs) to child and family services. Yet, terms related to TIAs are often utilized without an adequate definition, and most importantly, without concrete and specific strategies to ensure that services are in fact trauma-informed. Using a multi-methods approach, this project examined important practice considerations that support successful implementation of TIA in school and community-based behavioral health settings. Key informant interviews and electronic surveys were conducted with child and family systems practitioners; interviews inquired about training, current practices, and barriers to service engagement. Data was analyzed, organized, and synthesized in accordance with core domains and specific components proposed by Hanson and Lang’s (2014) trauma-informed care framework. Findings suggest that practice of TIA differed by system and was largely driven by experiential and informal learning experiences. Practitioners also report challenges unique to each system hinder the utilization of screening and intervention best practices. Salient differences included those related to knowledge and accessibility to training, utilization of evidence-based practices, application of screening tools, and availability of resources within their systems. This brings to light the importance of considering both general and system-specific practice mechanism for the successful implementation and sustainability of TIA frameworks. We suggest system-specific strategies to help integrate trauma into services, including prioritizing capacity building efforts within each system by leveraging their natural supports and identifying systems-specific assets for both screening and intervention practices.

     

The case for comparability

We argue that all comparative expressions in natural language obey a principle that we call Comparability: if $x$ and $y$ are at least as $F$ as themselves, then either $x$ is at least as $F$ as $y$ or $y$ is at least as $F$ as $x$. This principle has been widely rejected among philosophers, especially by ethicists, and its falsity has been claimed to have important normative implications. We argue that Comparability is needed to explain the goodness of several patterns of inference that seem manifestly valid, that the purported failures of Comparability would have absurd consequences, and that the influential arguments against Comparability are less compelling than they may have initially seemed.