GENDER-RESPONSIVE AND TRAUMA-INFORMED WORK WITH INCARCERATED WOMEN: AN IACFP INTERVIEW WITH DR. STEPHANIE COVINGTON: PART III

GENDER-RESPONSIVE AND TRAUMA-INFORMED WORK WITH INCARCERATED WOMEN: AN IACFP INTERVIEW WITH DR. STEPHANIE COVINGTON: PART III

IACFP: We’re always looking for ways to streamline interventions and provide effective services in shorter periods of time so we can provide services to larger numbers of folks over time. Does the idea of “trauma informed services” facilitate that kind of intervention?

SC. First, I would like to juxtapose the concepts of “trauma-informed services” and trauma-specific services. Trauma-specific,” meaning you’re providing some kind of intervention for a trauma survivor, whereas “Trauma-informed services” is based on the idea there is so much abuse, violence, and trauma in the world that anyone who works with people—doctors, nurses, school teachers, correctional officers—needs to become trauma informed so that when they go about their daily work they’re not reactivating the trauma and making things worse. Trauma-informed means teaching people what trauma is, what general responses are, and helping people have coping skills, both the person who is the employee as well as the person they may be working with.

The best example I can give is a dentist I have worked with. She realized that the dentist’s office has a lot of triggers for people who are trauma survivors. So she has become “trauma informed.” We need to be educating staff working in the institutions about trauma.

The other thing I’ve done, I have written Beyond Trauma, which is an 11-session intervention which is used in a lot of correctional institutions. I’ve just taken that and reduced it to 5 sessions, particularly for domestic violence shelters and jails and prisons because it’s a very short and brief intervention that can actually be facilitated by non-clinical staff. Many places need shorter, briefer interventions. Hazelden will have this available in June.

I think the concept of “trauma informed” is really important and useful language. When you look at what it is, fundamentally it means we’re providing better services.

You might be interested in knowing that Roger Fallot and Maxine Harris wrote a book several years ago called Designing trauma-informed systems of care, published by Jossey Bass. They’ve done a lot of work in this area It’s a critical component in training helping professionals. The concept is useful in the training of doctors, nurses, teachers….and correctional staff.

IACFP: What do you think are some of the most important considerations for staff providing this kind of service?

SC: I think people really need to understand what abuse is and what trauma is. I think that’s true for both staff as well as the people who are participating in services. We see many women in denial of experiences that have actually been abusive. I think staff also often don’t know what trauma is, and many of them come from backgrounds of abuse and have experienced trauma, and their method of dealing with it has just been to “wall it off.”

The women and the staff need to know what typical responses are, and that all of a sudden some behavior could be the result of something that’s happened in the past. When staff understand this then they have the capacity to respond differently. And I think staff also need to have coping skills for how to deal with difficult situations, and the women themselves need coping skills. So all three of these things are critical.

We find with correctional officers you get a certain amount of resistance, but one of the things we’ve found most useful in getting their attention is using the ACE study (The Adverse Childhood Experiences study) which has 10 questions. I have them answer the 10 questions for themselves as well as a typical woman they might work with. This is a very powerful tool from a study of 17,000 people—Kaiser, an HMO in San Diego, asked 10 questions to 17,000 people, based on early childhood experiences before age 18. They found if people had a score of 5 or more on this 10-question scale, these were the people at highest risk for alcoholism, obesity, smoking, and injecting illegal drugs. If they had a score of 6 or more, it (these risks) decreased their longevity by 20 years. The highest impact was on mental health. The same study was taken into the California prison. If a woman had a score of 7 or more, it increased her risk of having mental health problems by 980%.


Look for the work of Vincent Felitti and Robert Anda for additional information on this. .

When correctional officers take this questionnaire…they begin to listen more about the women. Then we talk about being “trauma informed.”

Check back tomorrow for Part IV of V.

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For members who would like to follow up on any of the points in our interview, feel free to go to Dr. Covington’s website for additional information. It is www.stephaniecovington.com. I urge members to visit both her website and learn more about trauma-informed services. For publication information regarding publications by Dr. Covington, members can also visit the Hazelden website at www.hazelden.org