St. Aemilian-Lakeside, Inc. 
Milwaukee, WI
Trauma-Informed Care: Implications for CPI’s Crisis Development ModelSM training helps further promote the trauma-informed assessments and interventions our agency currently uses. In addition, it also ensures that CPI’s Nonviolent Physical Crisis InterventionSM is truly a last resort by offering an additional layer of intervention considerations and strategies before physically intervening with an acting-out child.
The trauma-informed care principles have been heavily incorporated into our Nonviolent Crisis Intervention® trainings at St. Aemilian Lakeside (SAL). Instructors link the principles of trauma-informed care to concepts such as personal space, proxemics, kinesics, Paraverbal Communication, Precipitating Factors, and Rational Detachment. In addition, youth counselors are made aware of the impact that restraints can have on the mental states of the youths in our care. Youth counselors are conscious of the fact that restraints can trigger traumatic memories in residents, memories that often make residents’ behaviors more severe and more difficult to manage.
Together with a service delivery model revisioning process we began in 2007, our trainings have been an important vehicle for driving our trauma-informed care initiatives and practices, and for assessing how we work with clients in extreme crisis. The melding of understanding lower-brain development and Nonviolent Crisis Intervention® principles has changed the atmosphere on the residential treatment units at SAL, though the journey was not always easy.
The revisioning process involved stepping back and making difficult determinations about when staff chose to use physical restraints and what other options we have available to mitigate the risk of restraints being needed to deal with extremely serious behavioral intrusions. Through numerous trainings, youth counselors were guided through facts about how the brain operates and how trauma at an early age can affect the brain’s development.
This knowledge has played a key role in creating a perspective shift for our youth counselors. The shift from the thought pattern of “What’s wrong with you?” to the thought pattern of “What has happened to you?” has taken time, but we all now understand that, in addition to teaching and mentoring residents, our youth counselors must also help to heal the residents. Healing takes time, patience, and consistent application of the proper treatment, and understanding that treatment is a process that enables staff to shift their perspectives of resident behaviors.
The trauma-informed care initiative has also spurred a focus on rhythmic and repetitive activities. By participating in these types of activities, clients have the opportunity to engage in positive, alternative ways to act on their impulses—impulses that, in the past, tended to be more self-destructive and property-destructive in nature. Residents learn how to slow down their heartbeats and breathing, thus developing self-regulation skills with which to better cope with stressors. They also gain opportunities to master tasks, which can lead to higher self-esteem levels. The rhythmic and repetitive activities the residents participate in on a daily basis include basketball drills, riding bicycles, jumping rope, jumping on a trampoline, and much more. For some of the residents at SAL, these activities can be as beneficial as their medications.
A significant component of the positive outcomes we have achieved is our highly focused training process that integrates the umbrella of trauma-informed care principles.