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Why > Trauma Informed Services
“Reducing Workplace Violence means Increasing Workplace Safety
through Positive Behavior Supports”
Trauma Informed Services
Trauma can come in many forms. One form is what The Mandt System® terms “acute episodic trauma,” which is the result of some type of disaster over which the person has no control. Natural disasters, automobile accidents and fires are examples of this type of trauma.
The more common use of the term has to do with interpersonal violence, such as abuse and neglect. The National Association of State Mental Health Program Directors (NASMHPD) and the National Technical Assistance Center (NTAC) have studied this form of trauma for over 15 years and are the leading experts in North America on the prevention of trauma. A study was published by the Centers for Disease Control in 2000 called the Adverse Childhood Experiences (ACE) study. As overwhelming as the study is, more overwhelming is data from NTAC indicating over 85% of all patients in psychiatric hospitals have experienced some form of interpersonal violence.
“Observer violence” is the term used to describe what happens when people see harm being done to others. One individual in a developmental center saw his best friend die as a result of a restraint. He ran away from the center, and when he was “caught” was placed in seclusion. One woman reported that when she was restrained, it felt to her as if she was being “raped again.” The interventions we use to keep people safe can, in fact, re-traumatize individuals.
The longer people are held in restraint, the greater the likelihood that the restraint will be perceived as a traumatizing intervention. It is impossible, in our opinion, to restrain someone until they are calm, especially in a floor restraint. When people are restrained on the floor, their perceived risk of injury is extremely high, and they will struggle against the restraint. This often results in staff increasing the pressure of the restraint, raising the risk of injury even higher. This is one of the reasons 15 states, as of January 1, 2009, have either prohibited or restricted the use of floor restraints in many human service settings. The Mandt System does not teach a floor restraint in any of the programs we teach.
People do not de-escalate in restraint, they do not calm down; rather, they become exhausted. The harm done can be physical, emotional and psychological. Time limits are an important part of reducing the risk of re-traumatization, and are in effect in developmental disability and mental health settings in Pennsylvania (10 minutes), California Developmental Centers (5 minutes), New Hampshire (5 minutes), and Delaware (5 minutes).
