Here & Now

Look Ahead: Mental Health Expert On Trauma-Informed Care

Frederica Freyberg:

Next, in our look ahead, the roll-out of a specific kind of care for a specially-affected population. Wisconsin First Lady Tonette Walker spoke about it at last week’s State of the State address.

Tonette Walker:

We call our initiative Fostering Futures. Fostering Futures is about creating hope by advancing principles of trauma-informed care across Wisconsin. Let me give you an example. If a child is belligerent and angry as he meets with his child welfare worker, we used to say, “What’s wrong with that child?” But with trauma-informed care, we teach people to ask the question, “What happened to that young person?” Instead of labeling the child as good or bad, this approach moves us to better understand what could be causing the behavior. Just so we’re clear, we know there still have to be consequences for their actions, but shifting to trauma-informed perspective gives us access to more tools for success and better outcomes.

[applause]

Frederica Freyberg:

First Lady Tonette Walker is on the steering committee of Fostering Futures, as is Elizabeth Hudson, a licensed clinical social worker with the Wisconsin office of Children’s Mental Health. Elizabeth, thanks very much for being here.

Elizabeth Hudson:

Oh, thank you so much. It’s a great opportunity.

Frederica Freyberg:

First just very briefly, what is trauma-informed care?

Elizabeth Hudson:

It's a good question and it’s a big concept and it’s very hard to sort of distill it down. But simply put, it is a principle-based culture change process. Many people have a sense that it is an intervention or a therapy, but actually it’s giving people information about what happens after exposure to stress that is toxic in our bodies and then with that knowledge how do we need to change how we are in relationships, whether it’s service relationships or community connections, et cetera.

Frederica Freyberg:

So how do you change? I mean, what is the thing that you do with trauma-informed care that’s different from what the people who have experienced this stress or this adversity might have found before?

Elizabeth Hudson:

Right. So I loved that Mrs. Walker used that phrase “it’s not really what is wrong with you; it’s what’s happened to you.” So before, we would probably be — and I was part of this system of, you know, being a professional therapist — have a label to identify a belligerent child with. And it might be a label like oppositional defiance disorder or reactive attachment disorder. And instead of being very proscriptive and medicalizing situations, with trauma-informed care we take a more I would say compassionate look, a less clinical look at behaviors to say, “Why does this behavior make sense? Why would a child who is being interactive with someone like a child welfare worker have a very negative reaction?”

Frederica Freyberg:

Does the sheer acknowledgment of that on the part of people like yourself help these people behave differently?

Elizabeth Hudson:

Well, it’s been one of the sort of great advances in having people with lived experience lead this movement in many ways, because those folks who have experienced early trauma or early adversity know how that’s impacted them, but they’ve never had the ability to share that as part of their medical history or as part of why they become involved in child welfare, other areas. So this has allowed them to give voice to what has happened and then we are now better able to figure out how to be effective.

Frederica Freyberg:

So this is a statewide initiative, and the First Lady talked about county workers being trained up and state workers. Are there other states across the country approaching this as a statewide initiative?

Elizabeth Hudson:

That's the key phrase, a statewide. There are states that are doing pockets of activity and have been. I’d say it’s been very popularized within the past four years, but it’s taken quite a bit of time for it to become generally acknowledged. And in Wisconsin, because we had for four or five years a really wonderful grassroots movement, we now have the partnership with leadership in state government and infrastructure that has such power to create social change now adopting this as something that they want to do. And that is very unique in the nation. And we’re being recognized as such.

Frederica Freyberg:

Well, more reporting to do on this. Elizabeth Hudson, thanks very much.

Elizabeth Hudson:

Thank you.