Listen to the fantastic talk on “Sanctuary Model” delivered by Dr. Sandra Bloom (1.5 hours) and type your most take-away message in your discussion board

Read through the case study by Handran and post your response to the questions in the case.
Background Information

The high level of trauma in the United States is shocking, and the
current systems of care set up to assist victims of trauma can not only re‐traumatize the clients seeking services, but can also take a toll on helpers. Burnout, trauma and stress are serious problems that can have negative consequences on individuals, agencies, and societies (Cooper & Cartwright, 1994; Goleman, Boyatzis, & McKee, 2002). Bloom (2006) claims that agencies can be susceptible to stress or trauma just like individuals can become stressed, and entire agencies can actually become unhealthy and start to show the same types of symptoms as their clients.
Within the past decade, certain organizations have taken great measures to change service delivery so that it is more “trauma informed”. The concept of a trauma informed system is to provide evidence based practices that not only deal with the trauma of the client but also ensure that these interventions do not cause further harm. Harris and Fallot (2001) claim that to “envision a trauma informed service system would require a ‘vital paradigm shift’” (p. 3). Despite the ever‐growing trauma literature, many social workers practice in agencies that do not extend the notion of trauma informed service to the staff. Although there is much scholarly research on the role of leadership in the areas of government and business, there is little literature on the role of leadership in the field of social work, particularly in the area of trauma work (Mary, 2005; Rowold & Rohmann, 2009; Riggio & Smith‐Orr, 2004). In addition, little is known on the role of leadership and organizational culture and their effects on staff burnout and compassion fatigue. To begin this paradigm change we would need not only to modify the way services are delivered to participants, but also to create organizational adjustments that affect the individuals who work the front lines in delivering these services.

This case study might be used in a leadership or organizational social work course. The first goal of this case study is to have students recognize how individual and organizational components can lead to
caregiver burnout and compassion fatigue. Burnout can not only have a negative impact on social workers, including the possibility of them exiting the field permanently, but can also lead to the delivery of services that are ineffective or harmful to clients. In order for students to recognize the difference between trauma informed versus trauma organized organizations, the second goal of this case vignette is to assist students in understanding the importance of creating safety in the workplace not only for clients, but staff as well. Creating safety in an organization is everybody’s responsibility, and is crucial in order to decrease burnout and compassion fatigue and increase the effectiveness of client services. This case study uses a multi‐person standpoint so the student may view the situation from multiple characters’ viewpoints.

Program HOPE is a community based agency that started in 1995 due to the increasing homeless population. Program HOPE provides advocacy, housing, and housing supportive case management services to homeless single men, women, and families. Although homelessness may appear to be the main reason people seek help from Program HOPE, many of them suffer from complex issues, including mental health issues, substance abuse, lack of employment or underemployment, and lack of adequate resources to gain self‐ sufficiency. During the past decade, Program HOPE has grown from a
small grassroots organization to a mid‐size non‐profit that has a current staff of 15, including case managers, therapists, and administrators.

Situation #1
Dakota is a 42‐year old motivated woman who serves as Program
HOPE’s Homeless Services Coordinator. She is a very hard worker and her efforts have helped Program HOPE become a successful agency. Dakota started working for HOPE in 1998 as a case manager assistant. When Dakota started at Program HOPE, she did not have a college degree, but she was able to return to school part‐time while working at Program HOPE. Dakota has worked her way up from case manager assistant to a supervisory position, and now she supervises all of the service providers at Program HOPE. Dakota and her siblings experienced homelessness as children after her mother left their abusive father.
Program HOPE is not a large enough organization to have a human resource department, so Dakota takes on the responsibility of ensuring that Program HOPE runs smoothly each day. Although Dakota is not officially in charge of ensuring that duties are covered when
people call in sick to work, she often takes on the responsibility to ensure that clients are not left without the provision of services they need. Dakota usually helps resolve co‐worker conflicts, and reports problems and issues to the Executive Director. In addition, Dakota oversees the case management services and housing programs provided through Program HOPE.
Recently, Dakota has begun to see that workers are stressed at Program HOPE, as she was forced to mediate a few squabbles between staff members in the past month. In addition, Dakota has noticed more staff calling in sick and being short and impolite to one another as well as to clients in the program. Sometimes Dakota feels torn between the front line staff members and the director of Program HOPE, and although she knows that her boss is stressed, she sometimes feels like he doesn’t understand how hard the front line staff works. She tells the director that the staff are overworked and need to see fewer clients, but the director tells her that if they do not enroll enough people into the project they may lose funding.
Last week, the Homeless Commission called the director and scheduled an urgent meeting. There have been rumors that the commission has to cut programs due to budget cuts. During this meeting, the commission stated that they would also be looking at case management files as a quality assurance practice to ensure that the funded project at HOPE is doing what they are funded to do. Dakota feels like some of the case managers are struggling with keeping their charts complete and up‐to‐date. Dakota worries that the charts will not be up to the Commission’s Standards.
Dakota is trusted by many of the staff members at Program HOPE, as she advocates for them to the Director and tries to help them whenever she can. Many staff members have told Dakota that they are stressed and that they sometimes do not know how to handle situations when a client discloses certain hardships to them, including terrible things that have happened to them in the past. Dakota told the director six months ago that she felt staff needed more training on how to interact effectively with trauma survivors, but there was not any money in the budget to fulfill this need.
Dakota feels overworked and that she does not have enough time during the day to finish all her work. In the past, Dakota would go for walks during her lunch break, but lately she has worked through lunch in order to get everything done. She has felt a lot of anxiety
lately, and feels that although her wheels are moving really fast, she is not getting anywhere.

1. Identify some of the problems that Dakota and Program HOPE
2. What strengths can you identify about the situation?
3. What are some possible solutions that might help Dakota’s situation and help Program HOPE become more trauma informed?

Situation #2

Ralph is a 52‐year‐old man who has served as Program HOPE’s Executive
Director for over 10 years. Although HOPE has flourished compared to other non‐profits in the area (due to the economic downturn in the past two years), Ralph has been forced to deal with cuts in funding. Grants are becoming ever more competitive; local governments are slashing financial assistance for housing programs, and fewer contributors are providing charitable donations. Ralph has felt extremely stressed lately and worries about the future of the agency.
Ralph is very vision‐orientated and really cares a lot about working with the homeless and the future of Program HOPE. The main problem is that he is rarely available, as he serves on various boards and commissions, attends various community meetings, and goes out of town for national conferences in order to keep money flowing into the agency. Lately, Ralph has been very worried about the future of the agency and the fact that he may have to lay off a couple of employees due to recession stress and dwindling community resources.
Last month, the yearly report that was to be sent to theHomeless Commission was incomplete and emailed in late. Ralph received a letter stating that their funding was in jeopardy as a result of its tardiness, and he become very irate after receiving the letter. Although the problem was a result of miscommunication, Ralph partially blames a couple of staff members for not turning in the report on time. While confronting the staff members, Ralph cussed and told them that “if they lose the funding it would be their fault and they would have to start looking for another job.”

1. Identify some of the problems that Ralph and Program HOPE
2. What strengths can you identify about the situation?
3. What are some possible solutions that might help Ralph’s situation and help Program HOPE become more trauma informed?


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