Providing Trauma-Informed Care to Youth at Trillium Family Services in Oregon

Trillium Family Services is Oregon’s largest provider of mental and behavioural health services for young people. Clinical Program Manager Kyle Dolmage shared, “The youth that we serve are Oregon’s most vulnerable population. A lot of our patients have experienced really severe trauma, especially in their first four years of life.”

Creating trauma-informed environments for these patients to heal requires:

• All staff have an in-depth understanding of trauma and its impact on behaviour.
• Staff have the confidence and skills to keep themselves and their patients safe.
• Staff turnover remains low, enabling patients to build and establish trust.

With CPI training, Trillium staff have been able to support patients, create environments where healing can begin, and improve safety for all.

We will look at how the trauma-informed de-escalation training provided by CPI has helped staff support patient care and how you can bring CPI training to your human services organization.

How CPI Training Helps Staff Understand Trauma and Its Impact on Young People’s Behaviour

Trillium offers programs ranging from prevention and outpatient care to psychiatric residential and secure inpatient treatment. While the levels of care vary, most Trillium patients have experienced some form of trauma that is negatively impacting their behaviour.

Dolmage shared, “A lot of our youth have early attachment disruptions so they will display behaviours that test whether or not the adults around them are able to keep them safe or keep the environment safe.”

The range of trauma-induced behaviours exhibited by patients meant that staff needed to be properly trained in trauma-informed de-escalation skills.

Dolmage was familiar with CPI training from a previous job and was confident that Trillium staff would greatly benefit from the skills taught in the courses. “We know that our staff need a lot of tools to keep themselves safe and to keep the youth in their care safe. It is important that we have a comprehensive training program that is effective.”

CPI’s comprehensive de-escalation training includes a focus on:

• Trauma-informed care
• Understanding the brain’s responses during a crisis
• How precipitating factors can impact behaviour
• How to remain rationally detached during a crisis
• How staff’s own behaviour can positively influence the behaviour of their patients

“The whole CPI curriculum promotes early intervention and de-escalation... and that creates the safest environment that’s needed for healing.”

By understanding trauma and how it impacts behaviour, Trillium staff established effective, safe, and proactive strategies to de-escalate and even prevent crisis situations from happening.

How CPI Training Gives Staff the Skills and Confidence to Create Safe Environments

CPI training follows a model called train-the-trainer. This method involves training select staff at a facility to be Certified Instructors, who then provide CPI training to staff when and where it works best.

For Trillium staff, having Certified Instructors who are also staff members makes it easy to reach out whenever questions arise.

Dolmage stressed the value of this CPI training model: “When the staff teams feel connected to instructors and their instructors are accessible, it helps them debrief, problem solve, and feel more supported.”

The comprehensive training also helped establish a common language among staff. “People can think about the behaviours that we see and the emotions we experience in response to them. It helps us maximize productive responses and minimize unproductive ones.”

Every Trillium staff member participates in a weeklong training called Academy Week, which includes CPI training. Staff also regularly discuss topics covered in CPI training during meetings. By involving CPI language, concepts, and ethics in everyday life, the staff have not only created a safer place to work, but an entire culture of safety that supports patients’ long-term well-being.

“CPI’s curriculum definitely increases staff confidence and competence. And it creates a sense of safety for our staff, our teams, and those we serve.”

How CPI Training Equips Staff to Establish Trust with Their Patients

Establishing trust between a patient and a staff member is one of the first steps towards healing. But trust takes time to build. “When you don’t have staff or a team that sticks around and stays committed,” Dolmage explained, “then everything sort of falls apart.”

That’s where CPI training has made a difference.

“CPI is vital for our staff, especially our newest staff. It is a component of keeping them safe, but it is also a philosophy for guiding a big portion of the work that we do. And that creates a mission. It is also a retention tool that keeps people invested in the work that we do despite the difficulties.”

CPI training has helped improve staff retention, giving patients the time needed to build and establish trust with staff and work towards healing.

The average Trillium staff member stays for almost three and a half years. That’s about 2 to 3 times longer than the industry average tenure for behavioural health specialists. As more staff stay at Trillium, it opens the door for real connections to be made between patients and staff. This makes a lasting difference for the more than 14,000 children and families served at Trillium every year.

“I think one of the things that I am most proud of is that we have been able to maintain our capacity throughout the difficulties of the past five years,” Dolmage shared. “And we have expanded to continue to serve this vulnerable population.”