Ask the Clearinghouse: Trauma-Informed Early Engagement
Q: Our agency is focused exclusively on trauma-informed care for our clients. How can we ensure that our every interaction with young people is trauma-informed, even in the earliest stages of engagement and intake before they become part of our programs?
A: When you first interact with youth, you want to gather enough information to know how to refer or admit them, but not so much that they feel uncomfortable.
Jerriee Michalicka, transitional living program coordinator for Youth and Family Services in El Reno, Oklahoma, explains, “We don’t ask them at initial contact whether or not they have been physically, sexually, or emotionally abused. At the next phase, there is a paper-based screening where youth can mark types of abuse they have experienced so that they don’t have to speak about it out loud.” At first contact, however, “We want to know where they’re at now, what their needs are and how we can help them to move forward.”
Youth and Family Services staff members are trained to protect clients from bringing up painful subjects unless they feel comfortable doing so. Board members, volunteers, and mentors—anyone coming in from outside—receive the same training as well.
“Often board members or volunteers come through and want to know a young person’s story,” Michalicka says. “If they build a relationship with a young person who chooses to share [his or her] story that’s okay, but [otherwise] we don’t allow them to ask kids about their stories. We tell our youth, ‘Do not ever feel like you have to share your story. If you choose to that’s okay, but don’t ever share more than you are comfortable sharing.’”
Youth workers have to achieve a delicate balance between the need to protect youth from re-traumatization and the need to screen for abuse, trafficking and other sources of trauma, because knowing about those things helps providers offer appropriate services.
For example, if incoming youth at Salt Lake County Youth Services in Utah say they have recently experienced sexual abuse, the agency offers them the option to share their stories in audio and video recordings at the local Children’s Justice Center. Then, youth—or, with youths' permission, their case workers—can share the recording whenever service providers at appropriate agencies need to know what happened.
This is an example of coordinated assessment, a process through which one agency serves as the “entry point” for services, and shares information with other agencies or systems that a young person has contact with. That way, vulnerable young people aren’t asked to share their circumstances over and over again.
"We work under the philosophy that there's 'no wrong door.' We make sure we get [youth] to the right door if we are not the right door," says Roger Gisseman, associate director of Salt Lake County Youth Services.
About three years ago, San Francisco’s Larkin Street Youth Services started using Efforts to Outcome, a Web-based reporting system that shares information across the agency's sites.
“The benefit of an online system is that all staff can access it wherever they are,” says Haley Mousseau, Larkin Street’s associate director of data and reporting, whose team implemented the tool. "It puts information back in staff’s hands."
Larkin Street once used a single multi-part mental health and substance abuse risk assessment across its programs. With the shift from paper to online reporting, the organization was able to create three different levels of assessment: one assessing current needs at entry, a more in-depth one for case management, and an ongoing case management assessment every three months for youth in housing programs. This multilayered approach, Mousseau says, honors young people's trauma without forcing them to relive it by ensuring young people only share personal information as they grow increasingly comfortable with the program.
Learn about other early intake strategies, such as creating a dynamic waiting list, in the National Alliance to End Homelessness’ Comprehensive Assessment Tool.