Bright Idea: A Youth Drop-In Center Embraces Trauma-Informed Care
We've been marking National Domestic Violence and National Bullying Awareness Months this October. Many homeless youth have experienced all sorts of violence, and programs that serve them are responding by using "trauma-informed" approaches. We're reprinting this article about how one youth-serving organization made itself a safer space for young people who've experienced violence and trauma.
To Ayala Livny, it just didn’t feel right.
When she was first hired as a front-line case manager at Youth on Fire, a Cambridge, Mass., drop-in center for homeless and street youth, members would confide horrifying stories of violence and loss. And they would look to her for some sort of meaningful response, a connection.
Her typical reply: “You should talk to a therapist.”
“For all of our members, trauma was so front and center in their lived experience, both past and present,” Livny says. “But, not being a social worker, I felt really limited in how I could respond.”
Now Livny knows that she can provide a different answer. As Youth on Fire’s current Program Manager, she has overseen a trauma-informed transformation at the center, overhauling the space, rethinking policies and procedures, and training all staff to recognize trauma responses and triggers. The result is a place where the staff feel more effective and the young people are more comfortable, creating a space for true healing to begin.
Youth on Fire’s transformation was funded in large part by a 2005 grant from the Substance Abuse and Mental Health Services Administration to design a trauma-informed intervention to reduce the progression of substance abuse, HIV and hepatitis infections among homeless young adults. The grant helped pay for invaluable partnerships with experts at the Trauma Center and the Institute for Community Health.
Part of their transformation was an evaluation of the physical space. After talking to experts, they made a number of changes. For example, they repainted the walls a calming blue. They turned the television toward the wall, so the youth couldn’t inadvertently be triggered by something they happened to see on the screen. They added curtains to the cubicle doors of case workers to provide members a greater sense of privacy. And, at the request of the youth, they put a lock on the shower door.
“None of us ever took a shower there, so it never occurred to us that that was a problem,” Livny says. “Often there are really small things we can do that make spaces feel significantly different.”
Choice and Control
They also reviewed policies and procedures to make sure each gave the members the greatest amount of choice and control, which is key to reducing retraumatization. For example, she said they now begin their intake process by telling new members that they don’t have to answer any question they don’t want to. They have found that adding that small element of control makes young people more open and willing to talk.
Member input was key to the transformation process. Young people provided their suggestions through a few initial paid focus groups and then through their regular monthly advisory board meetings. Plus, conversations in the hall. Anywhere, really. “We find that young people love to have their voices heard,” Livny says. “It’s their experience. They want to tell us about it.”
The final component was staff training. Back when they were undergoing their transformation, Livny said it was harder to come by training materials written for front-line staff. Now, she’s says, those materials are all over the Internet, and it’s fairly easy to put together a training on your own.
“Trauma is pretty intuitive,” Livny says. “All of us as individuals have our traumas with big T’s and little t’s. We understand that things happen that affect the rest of our lives.”
A training around trauma triggers and responses can go a long way to giving front line workers the tools they need to understand and respond to the reactions they see. For example, Livny said that they had a member who was storing some of his belongings in a staff member’s office. When he didn’t come back for a while, the staff person moved his stuff into a storage closet. When the member came back, Livny said he “freaked out.” But the staff person knew that what appeared to be a serious overreaction was a result of his feelings of loss of control over his belongings based on his past history of trauma.
Now, trauma is part of the everyday language of the staff. A member’s trauma history is discussed at all case reviews and day-to-day interactions are approached with a trauma lens.
While Livny says that a grant like the one they got from SAMHSA was a wonderful opportunity, a transformation like theirs doesn’t have to be expensive or complicated. For example, there are a number of self-assessments now available online. The Hollywood Homeless Youth Project has e-learning courses and other resources on its website. And the Homelessness Resource Center has trainings and webinars available, as well.
The impact on the staff alone was well worth the effort, she says. They are less burned out, less frustrated. They take things less personally. They don’t feel like their hands are tied or they are helpless.
”In those moments of vulnerability and connection, to be able to say ‘I can handle anything you tell me’ is really profound and really helps us build those safe and permanent connections that young people need,” she says.
Watch a webinar with Ayala Livny about trauma-informed care at Youth on Fire.