Vicarious Trauma Toolkit Podcast

[Melodye Watson]: Hello and welcome
to this podcast. My name is Melodye Watson and
I am a Project Officer in the Center for Mental
Health Services at the Substance Abuse and Mental Health
Services Administration, also known as SAMHSA. Our conference today is about a new
resource for organizations that serve a wide range of populations and
communities that have experienced trauma. The resource is called the
Vicarious Trauma Toolkit. It’s a free, web-based repository of
resources for organizations to use to address the impact of trauma
on their staff. Here with us today are three people who
developed the Vicarious Trauma Toolkit. We have Dr. Beth Molnar
from Northeastern University’s Institute on Urban Health
Research and Practice. She currently serves as the Principal
Investigator on this project and is a Social Epidemiologist
and Professor. She is also a former volunteer
and current Board President of the Boston Area Rape Crisis Center. We also have Sergeant Christopher Scallon. He is the Critical Incident Stress
Management and Peer Support Unit Director and the Crisis Intervention
Team Co-Coordinator for the Norfolk Police Department. And Gina Scaramella,
who is the Executive Director of the Boston Area Rape Crisis Center, the second oldest rape crisis center
in the country. You can find full bios for our presenters
in the podcast description. Now I’d like to turn things over to Beth,
and welcome to our podcast. [Dr. Beth Molnar] Thank you Melodye,
and thank you for the opportunity to share information about
our Vicarious Trauma Toolkit. It’s a product of three plus years of
collaborative work to bring together to bring together all the resources
we could for first responders and victim service agencies to take
better care of workers. Chris, Gina and I are honored
to do this podcast with SAMHSA and tell you about this new resource that
we hope will make a difference in your organizations and in the lives
of people who work with you. What we’d like to do in this podcast
is share what is driving us as we created the toolkit; how the toolkit
has helped the organizations that Gina and Chris lead; what the toolkit
offers organizations like yours; and what steps you might consider
if you’d like to use the toolkit yourself. Let’s start out by first defining what
we mean by vicarious trauma. So we’re talking about the exposure to
the traumatic experiences of clients or other people being served,
where we might see the aftermath or hear the story about what
happened to them. It may be a newer term for some of you
that are used to calling these on the job experiences something, else like
critical incidents, for example. For the purpose of today’s podcast,
we are defining vicarious trauma as the work related exposure to the
traumatic experiences of others. First responders and victims services
organizations accept this exposure as a regular part of their work,
what we have begun to call an occupational challenge
for these fields and others. This term encompasses exposure to
stories about major single events like the shooting of a police officer
or a mass casualty event like the Boston Marathon bombing or the Newton Connecticut School
shooting where there are multiple victims. It also refers to the chronic daily
exposure to stories about stressors or trauma that you hear from your clients
and from the individuals and families that many of your serve everyday. For example, SAMHSA’s Project LAUNCH
serves families with children 0-to-8 who have experienced
child abuse, homelessness, incarceration of caregivers and
other traumatic events. I am the evaluator for our
LAUNCH project here in Massachusetts and I know that sometimes
the providers of LAUNCH services hear about terrible things that have happened to the families
they are working with. The people you are helping have often
suffered direct trauma, sometimes first responders and
victim service providers experience that too, where a person feels their own life and/or
safety threatened. However, what you are exposed to at work on a regular or all of a sudden
with a mass violence event is what the field calls an indirect trauma
or vicarious trauma. That is the exposure to stories of
traumatic experiences of other people. In this field, this exposure
to other people’s trauma is not what is preventable, but workers negative reactions
to the stories are preventable. This is what the field refers to
vicarious traumatization. The Vicarious Trauma Toolkit
was built to help alleviate these negative consequences by working on ways to prevent them
at an organizational level. So Chris, you’ve been in
law enforcement for more than 24 years, can you give us a couple of examples of what you have seen in
police officers you have worked with or if you don’t mind any impact
you’ve seen on yourself from this exposure to vicarious trauma? [Sgt Chris Scallon]: Absolutely,
I’d love to. First I’d begin with how it started. I started getting into the field of
addressing trauma and first responders after having been exposed
to multiple traumas in my career and prior
to my career in the military. And what I saw was a
significant change in personality. Having been diagnosed previously
with Post Traumatic Stress Disorder and severe depression, I couldn’t see
the change in myself. Rather, other people would react
to the way I was changing or I had changed. So seeing that and not having any resources
to really focus on to try and help myself or help my family or friends try
to address me, started really looking into the various
types of resources that are available. So that was the catalyst for me
becoming a Peer Unit or the Critical Incident Stress Management
Director for my agency. I initiated it because I didn’t want
other officers or first responders to have to go through
what I went through without any help or resources available. And specifically with the violence that we have seen in
law enforcement today, I saw a significant change in how people
involved in deadly force encounters or shootings or having
been shot would seek help. So what I did was, I made it a point
to address or come in contact with everybody and anyone that had
been involved in a critical incident that either been shot or
had not been shot but involved in a deadly force encounter. Specifically, I remember one
of the first ones I came across; an officer, two officers had been
involved in a shooting one of them had been hit, and I remember
dealing with the officer that had been hit for a while and he had
something that was kind of odd and it really speaks to the
power of mental health. He was able to see his wound heal
and as such was able to gauge how well he was coming across. However, the other officer that
was involved that wasn’t shot had not vantage point
to see where he was healing. It seems that he was having a harder time
with it than the officer that was shot. In talking with him and again with the
resources available for the Vicarious Trauma Toolkit,
we started addressing these things whether they be organizations, SAMHSA,
obviously being a significant organization, we start providing help for these officers,
and in looking at what we have done now as opposed to not having
resources prior to that, the significance is astounding. We have
officers coming back to work sooner, we have officers that are not quitting. For me, it’s the fact that “A)” they are
getting the help that they need and they are returning to work healthier, almost a post-traumatic growth,
so for me I’ve seen what happens when we don’t have help and I’ve seen
how helpful the help can be. So for me, that’s the driving point. [Dr. Molnar]: Great, thank you
so much Chris. We often know that working
with traumatized populations can have an impact on
the organization itself. Research from organizational psychology,
for example, shows the effects can include lost productivity,
staff turnover, overall poor organizational health. Gina, you have had more than
20 years leading an agency, the Boston Area Rape Crisis Center,
that serves people all over New England who are survivors of sexual violence. Speaking as someone who
volunteered there at BARCC accompanying people to the hospital
after a sexual assault, I know that there is a lot of attention
paid to vicarious trauma. For example, when I got home from a
hospital call, I had somebody to talk with, monthly there were groups
of peers to talk with, I knew counselors were available
to me if I needed them. All those options were ways that
BARCC took very good care of me as a volunteer exposed to vicarious trauma. Even with that, what kinds of effects
have you seen on people working in your organization over the years? [Gina Scaramella]: Thanks Beth, and I’m
so glad you have that experience as a direct service volunteer. I am sorry to say that even with that,
we have had staff crash and burn over the years and need to
leave the work. In reflecting on this, it was clear
we had done a better job paying attention to the needs of volunteers
than we had to the needs of staff. Even back when I was training myself
to be a volunteer back in 1990, those messages you had talked about
were very purposefully given to volunteers that listening to trauma,
traumatic stories would have an impact, and that we got specific guidance
on how to get support 24/7; and it was a designated topic at many
of our supervision meeting as you said. But unfortunately,
many of these same things were not adequately in place for staff. And although it may be more
subtle in our field than in the other disciplines
such as the police, victim service agencies also expect
employees to take it, without falling apart. The kinds of symptoms and behaviors
we have seen among staff really run the gamut and can depend
on the role and as well of course the personality and temperament
of the staff person. Some examples of vicarious trauma I have
seen were expressed by staff directly in supervision which includes
trouble sleeping, or letting go of a particular story,
for example. Those tend to be easier to deal with. Another way that they come out more
indirectly, through absenteeism or behavior like irritability
or rigid thinking, all the way to a consistent
negative outlook that becomes toxic in the organization. In the past, we’d look at these behaviors
only on the individual level, now with the emphasis on the way the
organization operates to reduce, now we look at it as a way,
how can the organization operate in a way
to reduce these impacts. We look at it not just as an individual
issue, but up at the organizational level and see what levers we can pull
around compensation, around building skills for supervisors
and other policies and practices that can address staff stress and
their experiences being exposed to trauma. It is important to note that when
we began to look at how to intervene from an organizational perspective, we didn’t just look at the positions
where one would expect vicarious trauma would be an issue,
with counselors and advocates for example, but at all of the positions, including
reception staff, finance, communications, and development or fundraising people. Having that shared understanding, that working at a rape crisis
center affects everyone has been a key factor in the buy-in
to address the issue organization wide. We have had a lot of success
in our efforts to date. I believe that focusing on the
organizational level has decreased turnover and increased the quality
of services we are providing. [Dr. Molnar]: Thank you very much Gina. So after hearing these stories
from Gina and Chris, a better question then,
how does it affect us might be how can it not affect us? Dr. Rachel Remen who wrote the book,
Kitchen Table Wisdom, answers that question in her book. Let me read quote from that. “The expectation that we can be
immersed in suffering and loss daily and not be touched by it, is as
unrealistic as expecting to be able to walk through water without getting wet.” One of the things we talk about in the
Vicarious Trauma Toolkit project is, given the work we do, the exposure to the
trauma experiences of others is inevitable, it comes with the job. However we feel strongly after
combing through the research that the negative consequences are not
inevitable but instead preventable. Is there something an organization can do
so while their people might get wet, to use Remen’s analogy,
they will not drown? Our answer is an emphatic, yes. More and more organizations
are taking on the responsibility to address vicarious trauma,
and the first part of addressing it is recognizing that while exposure to the
trauma of others is inevitable, the negative consequences are preventable and actions by the organization
can make a difference. As we built the Toolkit, we saw the ways in which
vicarious trauma exposure affects us, that it can be viewed as
happening on a continuum. For example, doing this work, interacting with people who
has suffered trauma or violence in your communities is hard. With this work comes a change
in world view that is inevitable. It is your care and commitment,
empathy and empathic engagement with people and communities that helps
you make a connection, create safety, express understanding to a person
or people you are helping. It’s hard to do this work and not
be changed by it. Beyond this inevitable shift in world view, there has been a spectrum of
possible responses. We have categorized them into
negative, neutral or positives. Workers can move along this
spectrum of reactions to their work in either direction, from case to case and/or through
prolonged exposure. This is a brand new way to
conceptualize how we are impacted by our exposure to our clients or
people we serve through their trauma. Vicarious traumatization is
the term, as I mentioned before, that the literature uses to talk about
the negative impact on workers, considered to be the result of
the cumulative exposure to victim trauma stories
and information or mass trauma events as
we mentioned earlier. It was originally coined by
McCann and Pearlman back in 1990. Possible vicarious traumatization
symptoms can include, as Chris and Gina gave
examples of earlier, a decline in job performance, morale,
behavioral changes, anxiety, relationship or marital problems,
grief reactions, depression, suicidal ideations, a diagnosis of PTSD
is also possible as Chris mentioned. An important recent change in
psychiatry is that the DSM-5, the manual used by mental health
clinicians when making diagnoses, included indirect trauma
as a qualifying event for clinical diagnosis of PTSD in its
most recent version. While the fields have focused on this more
negative end of the spectrum, the VTT project has made efforts to
highlight there is a spectrum of responses, and that those are dependent on many
other factors in one’s life and in one’s workplace. For example, a good place to strive for
is workers will be resilient, and not have any negative
consequences of doing this work. We think of this as a neutral
or healthy reaction. Organizational support,
staff resilience, experience, other types of support
and coping strategies, these can help workers manage the
traumatic material they hear in healthy and resilient ways. Last but not least are
potential positive responses, which a small body of research
and practice has labeled compassion satisfaction,
vicarious resilience, or transformation. These describe the pleasure workers
get from a job well done, about the meaning of our contributions
to the people we serve, for the greater good of society. It might also be a deepening sense of
gratitude that workers have for life, a greater sense of hope or meaning. The Vicarious Trauma Toolkit starts
from this position then. Vicarious trauma, the exposure to the
traumatic experiences of others is an occupational challenge that can pose
real risks but its impact can be prevented, so while workers might get wet,
but they will not drown. So in the past, taking care of how
the work impacts us was seen as something the individual
was responsible for. It was all about self-care and often
pressure was or is put on individuals to do that on their own time. Gina, you have been out in front of an
organizational approach to this for a good long time. Can you give us a few examples of how
instead of reminding our people to go practice self-care,
an organization might help them via strategies at the organizational level? [Ms. Scaramella]: Sure.
One of the things is that when someone comes in and
exhibits some of these behaviors, you have to be in response mode. You have to care for them as an individual
and address the behavior you are seeing. So working from an organizational lens,
most often involves more planning because you need to bring in an
organizational prevention framework and an organizational response framework. I have mentioned some of the preventative
things we do as an organization. High quality supervision,
adequate compensation, etc. But there are also organizational level
responses that need to be planned. For example, do you have policies
and practices to guide staff if they can see concerning behavior
in their colleague? Do you have resources available to staff
for confidential crisis support? When someone is seeming
tired or a little fried, is the supervisor looking at their
vacation time with them? In my experience it turns out
more often than not, that they are behind in taking a break. Having these pathways laid out in ways
that are well communicated, allow your staff and their supervisors to
respond and access resources as early as possible. Addressing issues quickly, prevents
more harmful results such as that person who becomes
negative or toxic in the work environment. Having both organizational
prevention policies in practice as well as response practices in place,
is a significant part of building your organizational capacity to address
vicarious trauma. [Dr. Molnar]: Thank you. Now Chris, could you give us an
example of a way or ways that your police department has
implemented healthy practices? [Sgt Scallon]: Yea, absolutely. We’ve done several practices but I’ll focus
on one for the purposes of the call. We implemented yoga specifically
for first responders and a lot of people would initially think,
wow, yoga, what does that do? When we initially quoted the
Kitchen Table Wisdom, we’re walking through water,
and each call we get is another chance for us
to walk through water. What we have done, yoga instills,
and this is just one aspect of it, it gives us the ability to understand
and learn how to center ourselves and for law enforcement folks or for the
fire department, or any first responder, a lot of times when you go
to a significant call or you’re getting ready to go
to a significant call, you do what’s called a tactical breath,
and that’s just centering yourself, getting yourself prepared to do
what you need to do. Well, yoga provides a medium for us to
understand and learn how to successfully calm ourselves before we arrive
to a call. Now, understanding you’re never going to be 100% peaceful
going into a very high emotional, high stress call, but it gives us
that pause and the ability to center ourselves so that when we go,
we are making better decisions, we’re acting less on emotion and
more on tactical observations. So for us, it allows us to at a minimum,
keeps us healthy because anybody that’s worked as a first responder
understands that being healthy is something you have to strive to do,
you can’t just go through your job without or your profession without
actually focusing on that. So, being balanced, both in mind and in
body, allows us to serve the communities a lot better and more healthy,
and with better responses, so we’re not seeing, as everyone
has seen on the news, every 4 seconds there is a video
of an officer responding inappropriately or being taken out of context. For us, it’s important that we
make our response as if it was our first response
of the day and we understand what is going on
and we’re making the best decisions. Now again, working in law enforcement,
it’s not always pretty. We work in an atmosphere that is
surrounded by violence and sometimes it requires violence to
address these situations. However, if we’re going in there with a good mind,
good head on our shoulders, we’re going to decrease
injuries to officers, we’re going to decrease injuries to
individuals we come in contact with, and we are also going to be providing
better service because we are going to be mentally healthy and physically
healthy as well. So for our agency, in looking at
the Vicarious Trauma Toolkit, we looked at various yoga,
first responder related resources. We found a few and implemented them
by having one of our wellness coordinators trained to be a yoga instructor. And again, the cost versus reward
was so weighted on the reward side that we could not, not do it. So now we have every Monday, in the
morning, and we hope to increase it, yoga classes available for anybody who
is working and we hope to increase it by making it available to for all
different shifts, because unlike most professions, sometimes we go into work at midnight, sometimes we go into work at
6 in the morning, sometimes go in at 6 at night,
so having that resource available at one of our precincts is
just phenomenal. So that’s just one, very small
aspect of how we’ve been able to incorporate a resource found on the
Vicarious Trauma Toolkit. [Dr. Molnar]: Great, thank you Chris. Now we’re going to switch gears
and tell you about how the Vicarious Trauma Toolkit came to be. So the Office for Victims of Crime
who funded this project, did a large needs assessment called
The Vision 21 Report. That is available on the OVC website
( if you’re interested. One finding was that field
of first responders and victim service providers
needed an accessible, central repository of resources, and they needed those resources to be
evidence-informed wherever possible. To meet that goal, our Project Team
created the Toolkit in several steps. First, our local and national partners
sent out a survey from us to over 80,000 members
of their email lists. We received a respectable
8,000 responses from across the nation and across all the
fields our team represents. We were able to both get an idea how
people are addressing vicarious trauma, either formerly or informally, and we also did our first ask. We asked the respondents to send us
any policies, programs, trainings or any other materials
that they were using to address this occupational challenge. We received about 200 materials this way. We sent out requests to the field again and received more materials
later on in the process. We vetted all that we received
and shared them with our partners to assess whether or not to
include them on the Toolkit site. A second step was we began
a systematic review of both the research literature
and available websites. We used a tool from the
Centers for Disease Control and Prevention, or CDC, to rate the research literature on a continuum of evidence and
we used a tool from the journalism field to rate the websites on their usefulness. We can tell you from our research that
no intervention to take care of workers exposed to trauma has the
gold standard of evidence behind it, a randomized controlled trial
of effectiveness. However, several interventions
have been evaluated with studies that meet a lower bar what our
ratings deemed promising. We held two summits in Boston
to go through lots of the work we did along the way and to
move us along to next steps. So everything in the Toolkit is marked
with our ratings from the journalism tool to let you know how evidence-informed
each of the pieces of research literature or websites are. In all, we designed a resource that
serves not just victims services but EMS, fire and rescue, and
law enforcement, and lots of professionals who are associated with those fields, including especially mental health
providers who work in all of them. Representatives of those fields partnered
with us and were involved in every aspect of the Toolkit’s development. Once we had a draft ready,
we piloted a draft toolkit in seven different communities,
all in different states, where teams made up of those
four intended disciplines gave us important feedback. We went to each pilot site and
collected data via focus groups and key informant interviews. Those data helped us identify gaps and ways that the resources
could be even more useful. We ended up creating sixteen new tools
that were developed with our partners that were reviewed and/or tried out
at the Boston Area Rape Crisis Center that Gina directs and by other partners. All are available on the website
to download and to use. The final step was to deliver all
500 vetted evidence-informed resources to OVC eleven months
before its scheduled release for its contractors to build our website. The VTT was released in April, 2017 during
National Crime Victims Rights Week. The Vicarious Trauma Toolkit is now
available free and online. The Toolkit is first of all, a wonderfully accessible
repository of resources. The nearly 500 items fall
into four categories. Number 1: Recent articles in
full text or as abstracts, if copyright rules prevented full text. These full text articles can be
downloaded from the Toolkit, a feature many users who like to keep
up on current research told us they liked. Number 2: Resources from the field
gathered in our national survey and subsequent requests
where we asked organizations to give us policies and practices they are
using now to address vicarious trauma. Number 3: Websites and Podcasts. Number 4: New tools to fill gaps,
sixteen in all. So we’ve talked about the VTT being
this great repository of information but we learned organizations need
more than a great set of tools. Organizations told us they wanted to know
which tool to use when, and also know what their goal was
doing this work. For example, a questions we got frequently was when did they know they were
finished addressing vicarious trauma? A tool we created specifically for the VTT moves organizational approaches forward
by providing a theory-based assessment of where they are in a pathway to
becoming vicarious trauma-informed. Helping to identify both
gaps and strengths. Once gaps are identified then people can go
to the Toolkit and find ways to improve. We call this tool we created the Vicarious Trauma-Organizational
Readiness Guide, or VT-ORG. Using this tool, Toolkit users can chart
their progress toward reaching the goals becoming vicarious trauma-informed. As we mentioned before, this goal is not
a destination but a journey, and thus the assessment can be repeated
in order to measure progress as well. The question then is how
does an organization become vicarious trauma-informed? The answer is the evidence
informed foundation we created for the VT-ORG. The VTT project team reviewed
research literature from the fields of public health,
medicine, psychiatry, law, social work, criminal justice,
clinical and organizational psychology, other social sciences, among others, to see what makes an organization healthy. We came up with five areas
of organizational health that were adapted to address
vicarious trauma in the assessment tool. The five areas are: Number 1:
Leadership and Mission Number 2: Management and Supervision Number 3:
Employee Empowerment and Work Environment Number 4:
Training and Professional Development Number 5:
Staff Health and Wellness For each area of organizational health, the VT-ORG poses a series of statements
with examples of policies or practices that translates a research into
an organizational strategy. Employees are asked to rate
the organization using a Likert Scale for each statement from rarely to often. A few examples from Leadership and Mission
are on the scale of rarely to often: Leadership models, values, and promotes open and respectful communication
among staff. Or another example: Leaders model a healthy work/life balance. Two examples from the
Management and Supervision section are: Supervisors are readily accessible
to support staff members following a critical or acute incident. The second one: Performance evaluations include
a discussion of organizational and individual strategies to minimize
risk for vicarious traumatization. In a vicarious trauma-informed
organization, we want these healthy practices
to be taking place often or always. If the VT-ORG results show
that they occur never or rarely, that is an indication to go to the Toolkit and find resources to build capacity
in that area. Once agencies have identified
where their gaps are, they can search the Toolkit by
that organizational strategy to find tools that help build capacity. Each discipline has its own version
of the VT-ORG assessment tool, downloadable on the Toolkit, where language was slightly altered to
match language used in that discipline. You can download the VT-ORG for your
discipline directly from the website, distribute it to your staff, ideally have everybody fill it
out at all levels, anonymously, and then you can calculate the results. The scores on each section give you
an idea of gaps and strengths. We talk about the VT-ORG being a
good opportunity for organizations to see where they are now on the path
to becoming vicarious trauma-informed and to track progress as
they do the work to improve. That’s important so organizations
don’t feel overwhelmed or feel like they’re starting from scratch. They can also see some of the things
they’re doing now and how those fit into the frame of the five areas
of organizational health and track how much progress
they’re making in each area. Now I’m going to ask Gina and Chris
to share from their experiences of using the Toolkit. First of call Gina, BARCC was one
of the first organizations to conduct the VT-ORG survey.
Can you tell our listeners how you utilized
our assessment tool, the VT-ORG? [Ms. Scaramella]: As you said Beth,
I do want to really underscore that having the opportunity to see
how many things that you are already doing to address vicarious trauma
is really helpful and energizing. And with that, of course,
there will be areas to improve. For us, the results of the VT-ORG
showed ten things that we were doing really well in,
so we celebrated. We saw those five areas of
organizational health that you mentioned. And then we found ten things that we were
not doing well in. We dug into how the staff were
seeing those ten things, how was it that we were not doing well
in those things from their perspective using two focus groups. From there, we took those
ten things we were the worst at and all of the examples that the
focus group provided us of why we were bad at that, and developed a plan for using a smaller
group to figure out how to address them. In our organization,
that group is called the Council, and it’s four people who
are charged to identify ways that it might improve in those areas
using the Toolkit. The four people on the Council represent
different areas of the organization and come from different disciplines. So as an example of what the Council did, in one area we came in short in,
which was work/life balance, under the Leadership and Mission section
of the VT-ORG tool, we have learned from the focus group
was that some people felt that leaders didn’t model a good work/life balance. Staff were not clear if they
were expected to be here at 7:00 AM and not leave until 7:00 PM or they
wouldn’t be seen as a good employee. Others were concerned that when their
supervisor emailed them at 11:00 PM, were they supposed to answer that email or not be seen as an
‘on top of it’ employee. Others felt that the social media
platforms that the organization uses meant that they were missing out
on important things that they weren’t on Facebook, for example. So it was really rich
to have this focus group and see how people were
thinking about that. So the Council decided to put together
a staff guidance document on workplace balance through the lens of preventing and addressing
vicarious trauma. In the guidance document,
we tried to make explicit the expectations on things,
for example, texting. So for texting, in that section we
articulated that texts are seen as an urgent form of communication
and that staff should instead look for the least intrusive option for
communication that fits that situation. Another example was focusing on
a different part of work/life balance was the use of mental health days
as sick days. We’ve always struggled with
the message to staff about this. One the one hand, as a
vicarious trauma-informed organization, we want people to feel
they can use their accrued time to take care of their mental health
and well-being. On the other hand, we have had staff
who take that to mean that it’s okay to leave colleagues
in the lurch if their self-care happens on a day that they were leading
a training or something like that, and it took a lot of dialogue
to articulate what it was that we were trying to say that would
reflect the culture we were aiming for that is both attentive
and understanding to the individual but remembering they are part of a team
and an ambassador for the organization. In terms of implementing the
guidance in an ongoing way, it will be reviewed with staff when
they are newly oriented at BARCC. We have a diverse staff so it was
really important that we articulate things in a way that was clear so everyone
has the opportunity to be successful. The next thing our Council is going
to work on is what to do when a staff person observes
concerning behavior in a colleague. We want them to have an understanding
of how they can express it directly to their colleagues or bring it up to a
supervisor or manager. This one falls under the Management
and Supervision and Employee Empowerment areas of the Organizational Health Outline
in the Toolkit, wish me luck. [Dr. Molnar]: Great, good luck. Can you share with us if
there were any surprises from the VT-ORG assessment survey? [Ms. Scaramella]:
Yes. As I mentioned earlier, one of the things
that we not doing well on, was leaders modeling good
work/life balance. When I saw that in the survey results, I thought it was only
managers and directors that people were referring to. And what we learned in the focus groups was that it wasn’t just
administrative leaders but leaders of our volunteer groups who
are seen as never being allowed to be off because the programs run 24/7. [Dr. Molnar]: That fits very nicely
into how we’re talking about addressing vicarious trauma as a journey,
not a destination. Sometimes it’s good to pick something
easy to get you started so you don’t feel like you have such a big task
ahead of you, is there anything specific you did to get yourselves started? [Ms. Scaramella]: We did. I guess I would
go back to what you said earlier which is to not discount the things
you’re already doing well and give yourselves credit for that and a new way of thinking about
why you’re doing that. You probably wouldn’t have any staff if you weren’t already doing
some things right. Some examples may be that you already
have annual performance reviews and raises. Maybe you have annual events that your
staff love, or you have a special way of handling
the summer or holidays that you’ve developed. Looking at these things you do
as a matter of policy and practice that fit into the VT-ORG is
an affirming first step and will give you energy to address
the more difficult steps. And as a reminder, and I always
have to remind myself this, look in the Toolkit for resources before
your reinvent the wheel. If there’s not something
you can use in total, there are resources that
can help your thinking. For example, we plan on using the Vermont
Network’s communication guidelines tool in the Kit to help us with our next
piece of work that I mentioned about staff who are concerned about the
behavior of colleagues. [Dr. Molnar]: Great, thanks. You do a lot of training about
vicarious trauma, did to Toolkit help with that? [Ms. Scaramella]: Yes, it did a lot. We’ve been able to bring the Toolkit
and some of the work we have done to organizations we have partner with,
from college campuses and high schools to community organizations. These resources have had a huge influence. We’ve seen people adopt the perspective
inside the victim services field, including an upcoming book
that Judith Herman, who authored Trauma and Recovery,
is writing. I know she is referring to
the Toolkit in her book. We’ve used the resource
outside of our field such as with one of our partners, a disability rights and resources
organization. We’ve provided them with a training
we put together on vicarious trauma and shared materials from the Toolkit. We’ve also added more about
vicarious trauma to our internal trainings for
volunteers and staff. [Dr. Molnar]: Excellent. So we described the Toolkit as being
a great repository of materials, all 500 items in the compendium
have been vetted for the disciplines that they apply to. There’s a dynamic search engine and filter, so you can search by discipline
or by type of resource, such as the policy or topic area,
like peer support . In the VTT, we introduce the concept
of the way the organization addresses the impact of this work
as to become vicarious trauma-informed, that the goal they hopefully
set for themselves, often its led by a champion
of the organization. Chris is a champion who works tirelessly
to get funding and other types of attention
paid to what the officers and other police department staff
in Norfolk need. Chris, I know in your role
as Peer Support Coordinator for the Norfolk Police Department,
you’re always looking for resources for your own agency. You often get called into help other
law enforcement agencies trying to address vicarious trauma, particularly in communities where there
has been an officer death or officer involved
shooting, and you’ve done a lot of searching
through the compendium. Will you share some examples of how
you’ve been using tools in the Toolkit? [Sgt Scallon]: Yes, absolutely. It’s interesting the thinking
not too long ago was that as long as you’ve been involved in some
traumatic event or critical incident, that would give you the
prerequisite to be a peer which obviously if you do 4 seconds
of research will tell you, no that’s not what you need to become
a good peer. While it does help to understand what
somebody else is going through, you really need a good basis of how to
address somebody who is in crisis, you’ve just been involved in a
critical incident, a shooting, or you’re dealing with folks at the
aftermath of an officer being killed. What I decided was, being lazy by nature, I said why am I going to
reinvent the wheel? Let me go look at the Toolkit,
see what’s available for us. When I was initially starting or creating
the Peer Support unit, I said, well I need to get
training for peers. I need to understand what people
in our area or in our region are doing so I initially looked at resources
that mirrored general orders or policies for different law enforcement agencies
on how they are establishing, what the protocols are for being a peer. And what I found was a handful of
policies that I basically took and mirrored and used as
our own policy that addressed critical and stress management,
and peer support. What was interesting was that
I found that while I was looking for that, I came across a policy from
an agency within Virginia that addressed veteran reintegration,
and I thought, wow, we have a lot of veterans
working in our agency and it was never anything that
was on my radar, that we also have veterans coming in that have maybe just done a tour in
Afghanistan or Iraq or overseas someplace. And so, what I found was that in looking
for what makes a good peer, I really didn’t know what I didn’t know,
and that was I’m having to find peers that could adequately address individuals
in crisis, but more specifically, I’m going to have to try to integrate
peers that have combat experience to help address the combat veterans
returning to work. So it was a happy kind of circumstance,
while looking for this standard “peer”, I determined and made privy to the fact
that there are peers that need to be specific within
our discipline, but more importantly, with life experiences that
other officers may be encountering. That goes to speak to, say
an officer involved in a shooting. That by itself is a critical incident, however what if that officer had
been previously in combat, and that starts generating a lot of
or triggering a lot of past experiences? I need to have a peer that’s
well versed in military combat as well as in law enforcement. What I did was, I again stole the
information from another agency that’s already doing it,
that seems to be working, and I said I’m going to also integrate
a veteran’s reintegration program. So in other words, if a veteran is
involved in something, or rather a veteran is not even involved
in something but is returning, this goes to the prevention of it
as opposed to addressing a problem after its already happened. I want to put that officer with another
combat veteran to ride with so they can kind of feed off each other and I can get a good and accurate
account of what this veteran is doing or how he or she handling him or herself. When we do that, we’re mitigating
the inevitable stress that he or she is going to experience
on going to a call. And further going through the resources
and trying to implement the policies, I became exposed to a significant problem in the military, which was
military sexual assaults. On several occasions I had
encounters with officers who had previously been assaulted,
both male and female, sexually in the military, Interestingly enough,
when he or she goes to a call that is by nature a sexual assault,
we can see that as being a trigger. So here I am, looking for what
I just thought was, hey, you work in law enforcement,
fire services or EMS and you need to be a peer,
you need to know what we do. What I started to discover was, not only do you need to know the
profession of the discipline, but you also have to be well versed
in the trauma that an individual may or may not have been
exposed to in the past, so those significant traumas find
themselves as military service, or as sexual assault and also working
as a first responder, law enforcement, or fire, EMS. So for me, the Vicarious
Trauma Toolkit enabled me to address issues that I did not know were issues
before they came up. So for me, it’s been invaluable to help
or to provide resources for an individual that I know will be experiencing a
critical incident or some significant amount of stress and addressing that and having something in place
prior to that happening. So I don’t have to wait for
the car accident, I can get everything set up. I equate it to the fire department
that responds at an airport. They don’t wait for the plane to crash,
they prepare themselves. This plane is going to be coming in,
it’s having some difficulties. Let’s have everything on standby. I essentially took that sort of thinking
to say let’s not wait for the bad stuff to happen,
we know it will, let us be prepared for it. That’s how, in my opinion,
how I’ve been able to incorporate all the resources from the
Vicarious Trauma Toolkit into actual practice. [Dr. Molnar]: Thank you Chris. I’m so
glad to hear the VTT helped you go so much deeper than what you started
out to do, that’s amazing. [Sgt Scallon]: Yes. [Dr. Molnar]: Great. So as we get
to the end of the podcast, I want to mention that we’ve all heard
a lot lately about having to be trauma-informed in all our interactions
with the people we work with. So what I want to point out here
is that we’re posing here that being vicarious trauma-informed
is also very important. A vicarious trauma-informed organization
is one which: Number 1: Recognizes potential
negative consequences of the work being performed. Number 2: Proactively addresses that
impact through policies, procedures, practices and programs, as you’ve heard in many of the examples today
from Gina and Chris. We hope that you will find that the
Vicarious Trauma Toolkit with its robust compendium of resources, including research, weblinks,
actual policies and procedures from similar organizations,
video testimonials, and our newly created tools will help you
become more vicarious trauma-informed. [Ms. Watson]: Awesome. I have learned
so much today from our presenters. This is Melodye again. As I listened to you all talk about the
Vicarious Trauma Toolkit, I thought about some of the programs that
I work on at SAMHSA. One in particular which is called, ReCAST,
and that stands for Resiliency in Communities
After Stress and Trauma. What this grant really focuses on is
community members coming together with local government and other
community-based providers to really address trauma
in the community, particularly in communities
that have experienced civil unrest and often times that civil unrest is due to
strained relationships with law enforcement but some of these communities also
are dealing with historical trauma, also just dealing with complex trauma
from being very violent communities and so just listening to you all,
I was wondering for programs like ReCAST and other programs at
SAMHSA; Beth, what’s your recommendation on how
people should get started with the VTT? [Dr. Molnar]: Great question
Melodye, thanks. The VTT Project Team has really been
heartened by the response we’ve received and so we hope that those of you
listening to this podcast will find resources that will help
you and your staff. There are two ways to get started. First of all, remember that the Toolkit
is a free online accessible collection of materials, so go exploring. Like Chris just talked about,
get started by going to the part of the Toolkit that
speaks to your discipline. We have separate ways
you can enter the website, for EMS, for fire and rescue,
for law enforcement, for victim services, or you can search by allied
professionals, like chaplains, or dispatchers, or mental health, and just see what resources have been
vetted for each of them. You can use the filters, the
dynamic search capability built into it, to search by topic and see what
research, resources, or websites fall under the subject you’re interested in and maybe that will take you on pathways
to deeper topics as Chris just exemplified. If you search, for example, by child abuse,
or officer involved shooting, or peer support, you’ll find
lots of items you can download and you can start to create
your own library of tools. Secondly, if you’re ready to start
down the road to becoming more vicarious trauma-informed
as an organization, and want to build capacity in the five
areas of organizational health, we have a new tool coming out called, the Blueprint for a Vicarious
Trauma-Informed Organization, that will basically take you through
the steps you need to get there. So here’s some tips from our upcoming
blueprint on how to get started. Number 1 is getting leadership onboard. Gina’s account as an Executive Director
of what BARCC has done offers a good testimonial on the importance
of addressing vicarious trauma. She knows the work impacts her people and she’s already led a number of
organizational efforts. She sees the idea of becoming a
vicarious trauma-informed organization as another way of meeting her goal
in taking care of her people. So, who’s the Gina in your organization? Who in your organization needs to give
the okay for your organization to become vicarious trauma-informed? Are there others who can be
the champion for your organization going down this road as we’ve heard
from Chris’ efforts? The Toolkit has a number of resources
for you to help start that conversation. For example, we’ve made a tool called
Making the Business Case, which spells out in a two-page document, why it’s important from an
organizational standpoint to address vicarious trauma. We’ve also created three-minute video
testimonials that are on the website; one for first responders,
one for victim services. Those sum up the case for becoming
vicarious trauma-informed very quickly. A second strategy is to form a
vicarious trauma-informed workgroup as the Council that Gina described. One of the things that happens
all too often is that resiliency champions often work in isolation. So taking an organizational approach
requires an organizational effort. Get a team together to
coordinate your efforts. Gina talked about how so many of the
initiatives they were focusing on are human resources related so be sure
to have a HR person in the group. There’s also a set of guidelines for
vicarious trauma-informed organizations that discusses what HR looks like,
just do a search by Human Resources to get that tool that we created. If you have a Behavioral Health Manager
or Peer Support Leader like Chris, you want them in your workgroup. Recognize that there are
leaders in your organization who may not have a Manager title but
garners support from others. Get that group together and
get ready for the next step. So then the next step is to conduct
the VT-ORG assessment. Download the VT-ORG for your discipline,
distribute it throughout your agency, the management and
line staff all take the survey. The blueprint has a scoring packet
that you can complete with a customized Excel worksheet
that automatically calculates an average score for each area
of organizational health for you. You can look at the area where your
organization has challenges, and as Gina’s organization did,
be with the working group to decide how and when
to address the challenges. You can then go to the Toolkit and
search it by that organization strategy where you have challenges or
more broadly, find tools that can help. The Blueprint will be on our
Northeastern website and distributed via our email mailing
list by the last quarter of this year. But get started now, explore the VTT,
look at the VT-ORG and the suggestions it offers about what a vicarious
trauma-informed organization does and get started on the path
to helping your people. On behalf of Gina Scaramella,
Sergeant Chris Scallon, and myself, I thank you for the opportunity talk
about our Vicarious Trauma Toolkit. If you have any questions or would like
to be added to our email mailing list, please email us at
[email protected] [email protected]
Thank you. [Ms. Watson]: Thanks so much Beth
and thank you also to Chris and to Gina. For our listeners, I’d just
like to share the web address for the Vicarious Trauma Toolkit. So please log onto There you can find the
Vicarious Trauma Toolkit and all of its wonderful resources. So again, thank you to our presenters
today and I’d also like to thank Karen Kalergis who helped us
coordinate this podcast for our listeners today and our colleagues at the Department of Justice in the
Office of Victims of Crime. Thank you so much for listening.

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