Trauma-Informed Skills for Supervision: Addressing Staff Trauma and Organizational Dynamics

This podcast episode, hosted by Dr. Dawn Elise Snipes, shifts the focus of trauma-informed care from solely clients to include staff and organizational dynamics. It argues that clinicians, as humans, are susceptible to trauma, including secondary trauma, and that unresolved or triggered trauma in staff can significantly impact their functioning, the organizational environment, and ultimately client care. The presentation defines trauma broadly, beyond just PTSD criteria, as any physically or emotionally harmful event with lasting adverse effects, emphasizing that these effects are addressable. A key argument is that organizations can become "trauma-organized systems" mirroring individual trauma responses, leading to widespread dysfunction.

The episode distinguishes between individual trauma responses, characterized by HPA axis dysregulation, hypervigilance, and fatigue, and organizational trauma responses, where staff collectively identify threats, spread anxiety, and unite in fight/flight/freeze behaviors, often diverting energy from service provision. It highlights that trauma is subjective, varying based on physiology, age, and experiences, and that what is traumatic to one person may not be to another. A crucial nuance is the impact of trauma experienced before age 24, leading to greater alterations in brain structure due to an undeveloped prefrontal cortex. The discussion also differentiates between direct workplace trauma (e.g., secondary trauma from clients) and the re-triggering of past personal traumas within the workplace context.

Practical insights include recognizing problematic employee behaviors (avoidance, insubordination, poor performance) as potential manifestations of trauma or fear conditioning, rather than just poor work ethic. Supervisors are encouraged to be aware of how organizational structures and dynamics can mirror family systems, potentially triggering attachment issues or transference reactions in staff and clients. The podcast advises supervisors not to act as counselors but to empower staff to seek help and understand how their past impacts their present work. It also suggests examining the workplace environment for potential triggers, such as culturally insensitive elements (e.g., exclusive religious music in a waiting room), and fostering transparent communication to reduce anxiety.

The broader implications extend to creating healthier, more effective work environments in helping professions. By understanding and addressing trauma at the systemic level, organizations can mitigate issues like high turnover, reduced productivity, increased errors, and a pervasive sense of unsafety. The concept of "fear conditioning" in the workplace, where negative consequences for speaking up lead to a "don't talk, don't trust, don't feel" culture, underscores the need for leadership to cultivate psychological safety. Ultimately, a trauma-informed approach to supervision and organizational culture is presented as essential for improving both staff well-being and the quality of client care, transforming perceived threats into opportunities and pathology into strength.

Trauma results when someone is exposed to an event a series of events or set of circumstances which is experienced as physically or emotionally harmful and has lasting adverse effects on the individual's functioning mentally physically socially emotionally or spiritually.

90% of clients in a public behavioral health care setting have experienced trauma and that's according to the substance abuse and mental health services administration.

What is Trump traumatic to one person is different than what's traumatic to another person partially based on their physiology but also partially based on their their age their experiences how they process things.

Unfortunately for people who have experienced trauma sometimes they never perceive the threat to be gone they remain in that state of hyper vigilance and feeling unsafe.

Hippocampal shrinkage... is gonna look like an employee who is having difficulty remembering things having difficulty remembering what clients said they get out of session they're getting ready to write their notes they're like I have no idea what we just talked about.

As supervisors we are not their counselors but it is important for us to make sure they understand how their past is impacting them in the present and their work with the clients and empowering them to get help if needed.

In a trauma organized system multiple people with diverse histories have come together to create an organization... The team becomes focused on threat elimination not service provision and you see reduced productivity and more errors.

The takeaway message is the same thing that you get in addicted families don't talk don't trust don't feel and if you say or do anything it'll probably be worse for you in the long run so just shut up and keep your head down.

We want to help staff members see their daily activities... instead of seeing it as a threat it's an opportunity to learn how to run a different program instead of seeing it as a problem see it as a strength.

If staff is stressed out clients are generally stressed if staff is emotionally disengaged a lot of times clients are going to have more difficulty emotionally engaging.