Trauma-Informed Care and the Stress of COVID-19

We are all under noticeably increased stress in this time of the COVID-19 virus changing our lives. We have many things to attend to, from the practical to the personal to the emotional. Our organizations are confronting immediate and longer term challenges from closed programs, potential layoffs, and financial uncertainty.

Where does trauma-informed care fit into all this? Is it something we put aside until life returns to normal? Or does it contain the central principles that will help us get through this time successfully? No surprise, we believe the latter!

We know that you all are working hard to care for your clients in the best way that is currently possible. And you know that as the clients’ anxiety rises, their thinking brains become less engaged, and their behavior becomes more dysregulated. We need all our skills to help clients regulate and relate, become calmer and more connected. As always, this is achieved by warmth, validation, flexibility, structure, hope for the future, humor, and being part of a connected community.

And who can best provide that for our clients? A calm and regulated staff. We know that a person becomes regulated by connection with another regulated person. So, what can we do in our agencies to use trauma-informed knowledge and principles to help our staff?

Our staff are frightened. We all are. They legitimately see their jobs, their team and their clients as a potential source of fatal danger. We need to have strong connections available when they first need them, to decrease the necessity for other methods of defense. How do we do that? Risking Connection foundational trauma training uses the acronym RICH© to describe the essential parts of any healing relationship: Respect, Information, Connection, and Hope.

We respect our staff by assuming their good intentions and their desire to provide good services to our clients. We seek out and listen to their ideas. We are flexible and compassionate. We understand the stress our staff may be under from needing to provide childcare, as well as care for the elderly in their family, or having reduced paychecks. We validate their fear and concern as we believe they are each doing the best they can. We can remind them of resources available to assist them with self-care, such as by holding virtual mindfulness events.

Information is essential in holding off panic. Predicting and preparing staff by providing vital regular information keeps fear at bay. We must provide many means of dissemination. Here are some ideas:

• One agency has a constantly open Zoom conference room staffed by administrators so employees can come in at any time and ask a question
• Another has started a private Facebook group for staff
• Some are using group-texting apps
• Regular check-ins at a certain time every day help some agencies
• Written email blasts at the same time, twice a day help keep up with quickly changing situations

Another application of information is that administration is seeking out the latest knowledge in this ever-changing situation, and sharing it with staff. This includes information about the disease itself and precautions, as more becomes known. It also includes learning and sharing about ever changing rules and external structures. Have HIPAA rules been loosened? What is unemployment covering and how to apply? Any information can help decrease anxiety. There is a lot of misinformation being spread, so staff will appreciate hearing from someone they trust.

Maintaining connection is our strongest source of strength in these times. How can we increase our points of contact when social distancing is the new norm? What channels can we establish through which people can share their struggles, their triumphs, how they are taking care of themselves, their humor?

• Go out of your way to check in with staff groups, especially any that are still coming into care for clients, or are remote
• Encourage staff to share humorous videos or jokes
• Remember that your goal is to remain as engaged, open, and reassuring as possible with staff

This is hard, because administration has a lot to do in this crisis. But, if staff don’t feel connected now, administration will have a lot more to do later.

Consequently, it is important for administrators to have their own system for checking in on each other.  At a time of crisis, staff look to leadership to act in exemplary ways. This can be exhausting. However, if leadership is modeling self-care and connection, they will more likely get exemplary behavior from their staff.

And then there is hope. How can we honestly convey our hope and conviction that we will get through this, that we are in this together, and that we will take good care of each other and our clients?

• Share positive stories
• Point out extra effort the staff is making so it is clear that you are noticing
• Compliment anyone you see washing their hands, reaching out to a client virtually, teaching others to use a tele-health app, or doing an especially good job in cleaning

We all know that when we are frightened and anxious we are more vulnerable to “the gravitational pull to the punitive,” as Traumatic Stress Institute Director Dr. Steven Brown likes to say. This is certainly true of our staff in relation to our clients, and can also be true of supervisors, managers and administrators towards staff. We need to take deliberate action to prevent backsliding during this time.  Instead, let’s use the principles of trauma-informed care to strengthen our bonds, and thus use humanity’s most powerful defense against fear: our connection with each other.