Ten Tactics to Advance Trauma-Informed Leadership

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Original story posted on: October 4, 2021

Organizations and employers must shift to trauma-informed leadership (TIL) to bolster staff – before there are none left to render care.

Daily articles fuel my concern for a health and behavioral health workforce under attack. The Hastings Center speaks of significant shortcomings of a health system “rooted in an unsustainable financial model, exploiting the physical and emotional labor” of its nurses. Time recently explored physicians concerned for their ability to emotionally, physically, and mentally face the tsunami of patients who need care. Record numbers of social workers are experiencing PTSD or severe grief. A Centers for Disease Control and Prevention (CDC) report revealed high rates of depression, anxiety, and even suicidal ideation for public health workers.

The research validates a chilling reality: organizations and employers must shift to trauma-informed leadership (TIL) to bolster staff – before there are none left to render care.

Collective Occupational Trauma in High Gear

Collective occupational trauma has gripped the workforce. Intense, collectively induced stress is felt by professionals, patients, and the overall population alike, then experienced by frontline practitioners as collective infused trauma. This trauma leads to PTSD and other symptoms if not acknowledged, as well as sleep disruptions (e.g., nightmares, insomnia), diet challenges (e.g., gastrointestinal upset), physical health issues (e.g., headaches, back or joint pain, psychophysiologic disorders), and behavioral health symptoms (e.g., brain fog, motivation issues, depression, anxiety, substance use, suicidal ideation and action). Academic, occupational, and social activities of daily living can become impaired and imperiled. No wonder 80 percent of the workforce is ready to exit the premises.

Trauma-Informed Leadership as an Anecdote for Collective Occupational Trauma

Trauma-informed care (TIC) is a popular clinical intervention with individuals who have experienced or perceived a traumatic experience, whether a single episode or ongoing events. Five principles are intentionally woven into each interaction: safety, choice, collaboration, trustworthiness, and empowerment. Given the high incidence of trauma experienced by health and behavioral health consumers, many organizations have adopted a TIC approach to care.

Trauma-informed leadership (TIL) engages the five principles in supporting the workforce. It shifts that long-held “process and roll” culture, whereby staff work through circumstances, often at the expense of themselves. Instead, a new atmosphere emphasizes nurturing leadership that builds safe, trusting, reciprocal staff interactions, empowering workforce resilience, and ultimately retention. TIL strategies include, but are not limited to:

  • Encouraging staff to “take 10,” whether;
    • 10 seconds to breathe;
    • 10 minutes for grounding (relaxation apps are a must);
    • 10 hours, or a mental health day, to restore resilience;
    • 10 days (it’s vacation time);
    • 10 weeks or 10 months, which can warrant a different conversation and potential job change.
  • Providing attention to staff health, mental health, and well-being; 
    • Monitor for signs of stress: agitation, sadness, frustration, to more profound forgetfulness, chronic illness exacerbation, depression, or anxiety.
    • Decrease behavioral health stigma via discussion and referrals for intervention.
    • Support and model self-care.
  • Engaging in two-way communication; 
    • Don’t just tell staff what to do, but also why
  • Staying visible and accessible to staff;
  • Recognizing that as a leader, you too have limits;
  • Building team camaraderie versus opposing fronts of leadership and staff, or among staff;
  • Providing encouragement when and where possible;
  • Establishing and addressing root causes of retention issues;
  • For virtual roles, ensuring visual interactions with webcams on, where leaders can see staff over the week; and
  • Recognizing that culture shifts are not achieved by a “one-and-done” approach; stay consistent for the long-term win.

TIL is a mandatory practice to address collective occupational trauma. Implementation should be a top organizational priority, before health and behavioral health professionals become the next endangered species.

Programming Note: Listen to Ellen Fink-Samnick report this story live today during Talk Ten Tuesdays, 10 Eastern.

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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