Nurturing a caring community: Stone Belt implements IU trauma-informed care certificate program

Trauma may be more common than you think. Over half the nation’s adult population has reported experiencing a traumatic event in their lifetime, and more than two-thirds before they were 17, according to the U.S. Department of Health’s Substance Abuse and Mental Health Services Administration.

Though not everyone who experiences a traumatic event will have lasting effects from it, those who do may find it difficult to be in some situations, triggering an overwhelming stress response. This type of lasting impact is more likely to affect members of the LGBTQ+ community and those with prior traumatic experiences, lower income, lower cognitive abilities, smaller support networks, and combat exposure.

Being aware of these facts and other factors of trauma while interacting with people in a clinical or organizational context is the basis for an approach known as “trauma-informed care” or TIC.

The IU Center for Rural Engagement, in collaboration with the School of Public Health-Bloomington, and the School of Social Work, is now offering a free, virtual, self-paced, certification course in trauma-informed care.

“Trauma is quite prevalent across the human experience,” said John Keesler, an assistant professor in the School of Social Work who collaborated with Alex Purcell at the School of Public Health to develop the certification program. “TIC training can help to increase awareness and understanding at an accessible level and doesn’t require advanced degrees.”

With more than 20 years of experience working with people with intellectual and developmental disabilities, Keesler authored the premier article on the integration of TIC and intellectual and developmental disabilities in 2014. Keesler said that TIC is about creating an environment that is conducive to wellness and healing rather than stress and toxicity.

“Every organization has its culture and climate, its beliefs, its values, its feel,” said Keesler. “When you walk into a place, you know what it feels like to be there, and sometimes you walk through the door and you’re like, ‘I don't want to be here.’”

Keesler piloted the trauma-informed care professional development certificate with Stone Belt, a south-central Indiana-based service provider for individuals with intellectual and developmental disabilities. Stone Belt supports its clients with a variety of resources, including therapeutic services, employment placement, apartment and group home residence, wellness and fitness activities, and a thriving arts program.

He worked with Stone Belt’s chief executive officer, Leslie Green, to provide the training to the staff and collect feedback from them. “Leslie was more than gracious to get her staff involved to participate,” said Keesler.

Green said she was happy to work with Keesler on the training because trauma is prevalent among the people she serves in her work, and she hopes to create a trauma-informed culture at Stone Belt.

“Trauma-informed care has come up as a topic of conversation in our field,” said Green, “because we support individuals who are more likely to have experienced trauma in their lives than the person who doesn't have a disability.”

With Keesler’s help, she offered the training to an initial 25 members of the direct support staff and collected feedback from them about the course in written comments. She says that feedback was positive, and staff who took the training were glad they did.

Green said the training taught her personally much more about TIC than she knew before. “Going through the training, I got a much more in-depth idea of the five principles and how those are applied,” she said. “It gave me a chance to think about that in our own workplace. Do we have trust, collaboration, empowerment; are these part of what we do?”

She said that she wants to do more than have her staff complete the training; she wants to create a culture of trauma awareness at Stone Belt that would impact interactions not only with clients, but between the service providers and other employees.

“One of the main things that catches people's attention, and that's a really key component, is instead of saying, ‘what's wrong with you?,’ you ask, ‘what happened to you?’,” said Green. “I think that just that little piece of awareness itself is a game changer for how people interact, not only with the people we support, but also with each other and with their supervisor.“

Keesler noted that organizations supporting people with intellectual and developmental disabilities have high rates of burnout and turnover, and these effects were exacerbated by COVID. Preliminary research has associated TIC with increased job satisfaction and decreased burnout, and the results of the pilot study demonstrated a shift in the language used by staff and increased sensitivity to recognizing and responding to the impact of trauma with TIC.

To further her goal of a trauma-informed culture, Green recruited staff who left meaningful feedback on the training to form a trauma-informed taskforce that meets monthly with Keesler to discuss the culture of trauma-informed care at Stone Belt and methods to improve it.

As part of the taskforce, Green and Keesler conducted an agency-wide survey to assess the trauma culture at Stone Belt.

“We had a 60-percent response rate,” said Keesler, "which [Green] said was the highest the organization has ever had."

“We had a meeting to discuss results and begin to brainstorm some viable strategies to create a better work environment for their employees, with the anticipation of increased longevity among employees and better outcomes for individuals that they support," said Keesler.

One of those individuals is Mikaela, a Stone Belt client since 2018. She participates five days a week in their arts program.

“I love it, and we do amazing things there,” said Mikaela. She uses mixed media, including pastels and watercolor and acrylic paints to create her art pieces that she shares with and sells to the greater community.

Mikaela currently resides in a group home managed by Stone Belt. She finds safety in the environment Stone Belt has created, she said, “knowing that staff are there for me, they are there to protect me no matter what happens. And I’ve got my friends there, and they make me feel safe, too.”

When confronted with challenges and worries, Mikaela knows she can count on the Stone Belt team to help. “They will talk to me and calm me down. My staff are really good at doing that. I really like my staff. They are awesome.”

She is looking forward to moving into a Stone Belt-supported apartment that would give her more independence in the future.

“Stone Belt is an amazing community to be a part of,” she says.

This April, Leslie Green is retiring from her role as CEO at Stone Belt after 42 years.

“I think, really, as the capstone for her tenure at Stone Belt, this was a nice send-off for her,” said Keesler.

Green’s successor, Bitta DeWees, is already part of Stone Belt’s trauma-informed taskforce, and Keesler is continuing to collaborate with the organization on follow-up evaluations and next steps.

“One person can use trauma-informed care, but ultimately it is meant to be an organizational shift in culture,” Keesler said.

The free Trauma-Informed Care Professional Certificate Program is available to any individual or organization interested in increasing understanding of trauma and applying TIC principles in their community. The series, hosted on IU’s Public Health and YOU platform, includes foundational curriculum and three specialized modules to explore and apply TIC to youth, veterans, and people with intellectual or developmental disabilities. Visit go.iu.edu/ticpd for more information.