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The Family Centre


In 2013, the Family Centre (TFC) in Edmonton began collaborating with five other agencies to provide drop-in, single-session mental health counselling (DISSC) in multiple locations. This cooperative effort removed barriers to service and enabled people in crisis to get help quickly. In 2018, TFC lost $100,000 in funding. But despite this setback, the organization managed to increase access to mental health care by an impressive 30 percent, delivering an additional 2500 hours of service!

This 78-year old organization is an exemplar of how creativity, innovation and collaboration can lead to improved service delivery within existing resources. By thinking creatively together and letting go of “the way we’ve always done things”, new possibilities were imagined, and innovative approaches were adopted. In this story, we share some highlights of TFC’s success and lessons learned based on conversations with CEO Pauline Smale.

The Family Centre (TFC) in a Nutshell 

The TFC has a legacy of supporting mental health in the community, beginning in the wartime 1940s. This includes traditional 50-minute counselling by appointment alongside extensive mental health supports provided by therapists, youth workers and social workers in peoples’ homes, schools and community centres. TFC also enjoys a long history of fruitful partnerships with other agencies. In the mid-1990s, for example, TFC partnered with the United Way of the Alberta Capital Region, Big Brothers, Big Sisters and FCSS in an initiative called Partners for Kids (PFK). PFK focused on working together to ensure that three inner city schools serving vulnerable children and families had access to mental health supports. Some “key facts”:

  • TFC has provided services for children and families in Edmonton since 1942, including extensive supports for mental health in the community.
  • 90 percent of services are delivered in the community – homes, schools or other community organizations.
  • 240 full time staff and 100 contractors and affiliates. · 20,000 families served each year.
  • Three main areas of service delivery:
    • Collaborative Service Delivery – TFC works closely with Edmonton Child and Family Services to determine what supports children and parents need for a strong family. Every family with Child and Family Services involvement in North-Central and East Edmonton works with TFC.
    • Community-based services – TFC provides extensive support to families, schools and communities; a major component of this work is related to mental health.
    • Social enterprise work – TFC generates revenue by providing employee assistance programs, interpretation/translation services and educational workshops/programming

Drop-in, single-session counselling (DISSC) offered in partnership across six organizations

In 2013, TFC took a leap and added free drop-in, single-session counselling (DISCC) to its repertoire of services. You might wonder how a single counselling session can be helpful, but there is ample research-based evidence to support the practice. A study recently conducted in Ontario, for example, found that clients who accessed walk-in counselling improved quicker and were less distressed four weeks afterward, compared to clients receiving traditional counselling. Walk-in clients highly valued the accessibility afforded by DISSC and were frustrated by lengthy waits associated with the traditional model. Furthermore, single-session walk-in counselling has the potential to reduce emergency room visits, reduce long waiting lists and eliminate costly “no-shows” for traditional counselling appointmentsi.

Despite this evidence, DISSC has typically not been a strong focus in therapist education and is still a somewhat novel approach in actual practice.

Pauline: “If you read the research and if you talk to people coming out of therapy and counselling (educational) programs, drop-in counselling is still very, very new. Although it has been written about for 20 to 25 years, and there’s lots of evidence that it works, it’s still not something that’s highly trained to in academia.”

And, TFC folks were a bit skeptical, too. They believed in the research but wondered if it would really work in practice. They had to convince themselves that it would.

Pauline: “It took a lot of faith, initially…Faith was hard. Would people come? Would we upset people if they had to wait?… So, we just didn’t really believe in it. So, we had to learn how to do that. How to believe in it.”

To quell these anxieties, TFC implemented a comprehensive monitoring effort. But we’ll come back to that later. First, we want to talk about the unique staffing model for DISSC, partnerships established by the TFC to deliver DISSC more broadly, and issues encountered in implementation.

Unique staffing model

An innovative aspect of the DISSC partnership program is its staffing model. Counselling is cost-effectively provided by highly trained intern therapists in their final year of their master’s or PhD degree. These interns provide counselling services at all six partnering organizations but TFC provides the infrastructure for supporting them, including intense training and clinical supervision. The TFC internship provides a rich learning opportunity and thus is highly coveted by interns. Each year, TFC receives hundreds of resumes to fill about 34 positions.

Pauline: “We’ve become a real pipeline for students because the experience is so rich. They get to work in community; they get to work in schools; they get to do traditional therapy – 50-minute hours; drop-in therapy; and, on site crisis-oriented supports. So, it’s a very rich sort of experience for them… They’re in their seventh to eighth year… they’re really skilled. They’re already prepared. However, the training model and the supervisory model is pretty intense as well. Every five hours of work that they do, they have to have one hour of supervision. Our infrastructure has to be able to support that. It’s a big commitment.”

A group of intern mental health therapists. Photo courtesy of The Family Centre

Epiphany: Why not increase access to DISSC by partnering with other agencies?

While planning for DISSC, it occurred to TFC leaders that, rather than delivering DISSC just at TFC, why not increase access by partnering with other agencies throughout the city?

Pauline: “We were viewing ourselves as an agency that was really good in collaborations and partnerships because we had done several – including Partners for Kids…and Collaborative Service Delivery with Children’s Services. So, we’d worked with groups of people to provide services in a good way. And so, we thought, ‘Why wouldn’t drop-in, rather than just doing it ourselves and having people come here, why wouldn’t we work with a variety of other organizations… to spread out the accessibility into the community?’”

And so, since 2013-14, TFC has been running drop-in single-session counselling (DISSC), for free, through a partnership between TFC, Boys and Girls Clubs Big Brothers Big Sisters of Edmonton and Area, Canadian Mental Health association – Edmonton Region, Edmonton John Howard Society, Pride Centre of Edmonton, and the Seniors Association of Greater Edmonton (Sage). By offering free drop-in counselling at all of these organizations, access to counselling services has increased considerably.

Implementing DISSC: “Learning on the fly”

DISSC presented some new challenges to TFC and partners – Would people come? How could we market it? How could we get people to use the different locations offering DISSC, not just TFC? Would people wait for a session if they couldn’t get in straight away? How could they be kept engaged while waiting? Implementation required a lot of problem-solving and “learning on the fly”. Here are some of the challenges encountered and how they were addressed.

Marketing DISSC

Marketing DISSC was an early concern. One idea generated during a collective brainstorming session was to place sandwich boards advertising DISSC in front of partnering agencies.

Pauline: “Part of the issue we were having was around marketing and making sure that everybody didn’t come to The Family Centre because they knew us… Our numbers were high and …some of the other agencies were low. And so, we tried a lot of things…Then, in a collective discussion it just [came out]: ‘What about a sandwich board?’… It was one of several strategies, but it was one of those that, ‘Really? A sandwich board for counselling? It’s kind of weird. Do you think

people will do it? Does it increase stigma? Will people be embarrassed to come in?’ And we thought, well it can’t hurt to try, right? So that’s what we did, and it really had an impact. That was something we got feedback on right away and now we have it on bus stops, too.”

Learning to set limits

We can’t be all things to all people. Not fully confident that people would use drop-in services, TFC decided to “welcome the world in” by offering coffee and food. That worked, but then a lot of people started coming for the food, not the counselling. A big learning was that TFC couldn’t be all things to all people.

Pauline: “This was a big, big learning: One of the things we thought we needed to do was welcome the world in, because we were really worried that we wouldn’t reach those who needed us. So, we had coffee and snacks out and we let people sit there for hours reading the paper. We started to get a lot of people that really weren’t coming for counselling.
So, we had a lot of tension because we want to help people who are distressed and if they’re sitting here drinking coffee for eight hours, we feel good about that. However, we needed to realize we were not the right service for everyone, especially those who were not yet ready for counselling …A big learning for us was that, as much as we might like, we can’t do everything… We can’t help everybody with everything.”

Keeping people engaged while waiting for their session

Another concern was whether or not people would wait for their drop-in session. To address this concern, TFC’s IT person set up a texting and chat program so agencies could suggest that people go out for a coffee while waiting, and then the agency would text them if a session came up earlier.

Pauline: Then technology helped us, too. [Our] IT guy was able to help us with texting and chat… so that we could say, ‘Go for coffee and if something comes up sooner than an hour-and-a-half, we’ll text you and you can pop by’. So that kind of stuff we learned how to do.”

Doubts erased: DISSC works!

The early doubts about whether DISSC would work quickly evaporated. Findings from extensive monitoring efforts (see below) have been overwhelmingly positive and access to service has increased:

Pauline: “With our drop-in, what really pushed me hard wasn’t just what we had read but once we heard people consistently say, ‘I went in nine months ago and I made a plan and I’m doing it’. I’m sitting here thinking, ‘Man, I can’t stop eating chocolate for three days and you made a plan nine months ago?’ Something’s happening! How is that happening?”

…The feedback that we receive from the people we serve is so profound. The distress levels are immediately dropped in one session. The long-term impacts, when we do our follow up contact with people after a year… we’re getting positive effects in over 85 percent of the people we see. You can’t deny that it works. It’s like your brain thinks, ‘One session, how can that possibly do anything?’ But when people tell you that it’s working and you’re measuring their distress levels using valid, reliable tools, you know it works.”

One of the most powerful findings from monitoring efforts was that almost one third of people seen in DISSC were suicidal. This reflects the urgency of peoples’ needs, and the power of DISSC to meet those needs very quickly: DISSC may actually be saving lives.

Pauline: “Suicidal was another thing – we were really shocked by that. That was really overwhelming. 32 percent are suicidal when they come to us.”

DISSC effectively diminishes many barriers to service, including finances, location, and the ability to plan appointments, for example. TFC and partners also discovered that DISSC enables them to serve almost twice as many men than traditional counselling:

Pauline: “So [DISSC diminishes] the barriers that people have in terms of finances, location, capacity, their ability to plan appointments, bring kids downtown. Men in particular are very averse to longer term planning, we know, and so we’ve been able to serve far more men. About 48 percent [compared to the general population in traditional therapy, which] is about 25 percent…So, we’ve been able to reduce a whole bunch of different barriers.”

Reduced revenue = more innovation and improved access

“It was amazing. [The Family Centre] lost so much money, but still increased services.”
Jean Dalton [Manager, Community Strategies, United Way of the Alberta Capital Region]

And then in 2018, TFC experienced a significant reduction in funding. They expected this, given economic conditions and reduced philanthropy and knowing that smaller organizations were struggling more than TFC. In discussion with their funder – the United Way of the Alberta Capital Region – TFC chose to stop receiving money for its interpreter and translation services. These became part of TFC’s revenue-generating social enterprise work.

While this shift reduced some of the funding pressure, the TFC took the situation as an opportunity to critically rethink existing practices. They gathered, as is customary in this organization, to think together.

Pauline: “When we started to write our proposal, that was when we sat in a room. There were people in there at the management level, director level. We had our communication people in there. We had our marketing people in there. We had our education people. We had our quality improvement. We really took it as an opportunity to think. So, before we started writing, we just started thinking.”

Through this collective exercise, another epiphany surfaced. DISSC was working well, so why were other TFC clients still having to book appointments, especially when 20 to 30 percent never show up? Wondering why they hadn’t thought of this sooner, they agreed to eliminate appointments for counselling altogether, and to call this new approach, “continuous intake”. Now, people can drop in to TFC six days and four evenings a week. Their first session is free. If more sessions are needed, a fee assessment is completed, and client and counsellor arrange to meet again.

Shifting to the continuous intake model meant revisiting the role of TFC’s Intake and Referral Unit that was responsible for receiving calls, setting up appointments (no longer necessary), and referring people to other services. As a member of the Community Mental Health Action Plan System Integration Leadership Team, Pauline had been involved in discussions about strengthening 211 services in the province. One day, it dawned on her: “Why are we doing information and referral when 211 is doing information and referral?” That insight led to conversations with 211 folks, and ultimately, closure of the TFC’s Intake and Referral Unit. Closure of the unit saved money and the continuous intake model increased access.

Pauline: “How we saved money was to close down our intake unit. Our Intake and Referral Unit would receive calls, set up appointments. [Then] 20-30% of the people wouldn’t come. Then they’d re-set up the appointment and 20-30 percent of those people wouldn’t come. And they’d give referrals and they would tell people to contact whoever or try this or try that – maybe try an education group…

So, I started to look at our intake room and I started to think, what are we really doing in there? What’s being helpful? And I was attending these [Community] Mental Health Action Plan committee meetings and I was part of the Systems group and at some point, it just sort of dawned on me, ‘Why are we doing information and referral when 211 is doing information and referral?’”

It was, again, one of those moments – ‘Duh’. What are we doing?’ So, we send people to them, then they send people to us. And 20 to 30 percent of people don’t show up. So, you start doing the math and it just didn’t make sense anymore. So, we stopped doing intake and referral.”

The TFC website was changed to indicate that people should contact 211 for information. Since then, the results of continuous intake and relying upon 211 for information and referral services are remarkable!

Pauline: “So we’ve saved probably $100,000 because that’s what we lost. And we gained access for people and we’ve increased our numbers. We’ve increased our continuous intake hours from the traditional to that model by 9 percent and we’ve increased our drop-in numbers by 28 percent over the last year…And the no-shows, of course, are zero. Because you’re either here or you’re not.”

By offering complementary services, rather than duplicating them, TFC and 211 are more effectively using resources and optimizing their unique expertise. 211 Alberta Manager, Stephanie Wright speaks highly of TFC’s decision to stop doing intake and referral because it means that TFC and 211 are now each doing what they do well:

Stephanie Wright: “Information and referral takes time away from staff doing other things. But also, it can be done better when you have the time and capacity to focus on really doing that well. So, 211 can be the first piece for information and referral but when more specific information and advocacy supports are needed, that’s where TFC’s role is. So now, TFC and 211 are each doing what we do well.”

The power of ongoing monitoring to learn and inform efforts

Underlying all of the efforts described above is TFC’s commitment to continually monitoring their efforts– measuring, counting, and comparing – in order to understand how things are going and what might need to be improved. In the case of DISSC and eliminating the Intake and Referral Unit, here are some of the things TFC tracked:

  • The number of “no-shows” for appointments
  • The number of sessions provided each day
  • Number of phone calls each day for people who don’t know where to go for service
  • Number of website hits and all hits related to marketing (all of the ways people are finding services)
  • Client age, gender, presenting issues, nationality; numbers of Indigenous clients
  • How many times clients have been seen
  • Whether the client is an individual, couple or family
  • Pre and post-counselling session distress tests
  • ACE questionnaires for each client
  • Whether the client is suicidal

Initially, TFC compared many of these numbers weekly, and then monthly, with data collected the previous year. Pauline described numbers after the decision to close the Intake and Referral Unit as “mind-blowing”:

Pauline: “Once you start getting evidence and information you can’t deny it. That was mind-blowing. The no show drop…I don’t know what we thought would happen when you close an intake room or let people come in when they need to come in, but when you go from 30 percent to zero, it’s amazing. Then people kept coming. That was the other thing. So, what if people don’t come? Then does it matter if you have no no shows if nobody comes through the front door? Are we serving enough people? That’s one of the things we did. We measure, measure, measure. I was measuring daily, weekly, then monthly, then bi-annually. And now we’re looking at it annually. But literally weekly. Are we ahead of last July? First week of July? Are we behind the first week of July last year?”

Advice to others wishing to innovate and improve services

Pauline kindly offered some advice to others who similarly want to be innovative and to improve the services they offer:

  • Just be open to changing. Don’t be afraid. Have courage to try.
  • When making a change, it is important to read the literature and reflect on what you do well. It’s always a jump when you do something new and changing is hard, but you can gain confidence to move forward by drawing upon the research and your own experience. Building on things you do well gives you faith to move forward.
  • Ensure sufficient supports for implementation. Pauline noted how important it is to have managers and staff to immerse themselves in, and oversee “all the moving parts” of the innovation Pauline: “You have to have managers and I don’t mean management positions; you have to have managers… I could have the manager list all the moving parts better than I could list them. There’s a lot of moving parts and so what are the pieces you don’t want to lose and what are the pieces you need in place? And it’s like everything. You start off heavy. My manager sat in the waiting room every day so that she could get a feel for what was going on.”
  • Train staff in order to build their skills and comfort. DISSC brought with it some new challenges, and it was soon recognized that people, especially receptionists needed additional training: “Pauline: So, we trained our receptionists. They have suicide intervention training…We’ve always trained everybody on trauma informed care for anything that we do. But they were getting scared that somebody would be suicidal, and not that they were going to do an assessment, but just so they could feel comfortable that they had a better understanding of what people were going through that.”
  • Be prepared for tons of surprises, learn on the fly and count stuff. Pauline advised that even though you will have a plan going in, there will always be “tons of surprises”. This makes it important to be able to learn on the fly. Measurement and data are critical, otherwise how do we know if we’re having an impact? Counting stuff helps to do that: “Pauline: “You just don’t know what’s going to go sideways. And you can’t write it all ahead of time. You honestly can never think of it… You have to learn on the fly and count stuff. People don’t like counting. People hate to count. But if you don’t count you miss it. You have to count it.”

Reflections on The Family Centre’s successes

While we can’t say definitively what made all of the TFC’s efforts so successful, a few things stand out:

A strong culture of innovation, ongoing learning and improvement. First, Pauline aptly described TFC as a learning organization. There is strong leadership for this. TFC makes a concerted effort to “think together” – including people from all parts of the organization – and to be open to new ideas, realizing there is always a better way to do things:

Pauline: “We are innovators…Because there’s always a better way to do things. There’s always a better way to do things. We just don’t know, and we’re always handicapped by our limitations of our information, education. We’re always trying to keep the windows open. We’re a learning organization.”

TFC intentionally creates space and time for people to think together. Bringing a diverse group of people with different experiences and mindsets together in a safe space fosters creativity and innovation. We heard this several times during our conversation with Pauline. Here’s one example:

Pauline: “We do a lot of meetings where we just sit around and think. We have marketing, we have programming, we have IT, we have everybody in the room, sometimes too many people in the room. I’m always like, ‘Is this the right use of everybody’s time?’ But, that’s where innovation does happen. Because everybody’s brains are different and actually, often [the ideas] don’t come from the program people. It’s very strange because it comes from other people who don’t have a lot of clinical background but have different experiences.”

Drawing from multiple kinds of evidence to inform practice and decision-making. TFC draws upon research-based evidence, but also wisdom gained from practical experience and an understanding of the local context, feedback from service users and evidence generated through monitoring and evaluation activities.

Commitment to, and well-established mechanisms for, monitoring, learning and adapting. As noted previously, TFC is highly invested in ongoing monitoring and measuring to understand and improve service delivery: “We measure, measure, measure”.

Commitment to employee well-being. Although not discussed in this story, our conversation with Pauline revealed a high level of attention to supporting the well-being of TFC’s people. This includes a wellness policy that, among other things, provides each staff person $500 annually to support their own wellbeing; positive psychology and strengths-based training and supervision; encouragement of reflective practice and mindfulness; concerted efforts to foster trust and humility and emotional intelligence; and more.

A long history of successful collaboration. And last but not least, this almost octogenarian agency appears to have mastered the art of collaboration in multiple initiatives and partnerships. This rare capacity has enabled DISSC to be delivered effectively at five other agencies across Edmonton. The agency’s ability to partner effectively is also demonstrated by its collegial relationship with funders such as the United Way.

Inspired? Intrigued? Encouraged? Want to implement something new in your organization? For a smorgasbord of ideas for how you can make it happen, search for the Resources section of Shared Wisdom for Supporting Mental Health.

2021-09-28T17:08:42+00:00Shared Wisdom|

Scuba buddies at work: Building a community of caring at Distress Centre Calgary

The rewards of supporting people in crisis or mental health challenges can be unparalleled. To know we’ve helped someone and made a difference in their lives can impart a deep sense of meaning and purpose to our lives.

But this work can also be intense and stressful. We see and hear so much each day that can wear us down and make our hearts heavy. There is a high potential for us to soak up the traumatic experiences of those we support, or to burn out from compassion fatigue. Pressure to serve more and more people without more and more resources adds further burden. Under these conditions, a work environment that holds and supports us is especially important. We can only give our best to others if we have the personal and organizational supports we need to maintain our own wellbeing.

In this story we describe the Distress Centre Calgary’s (DCC) journey to protect and promote the mental wellbeing of its staff and volunteers in the face of skyrocketing demands for service. Because the DCC is engaging staff in identifying and addressing work-related stresses that are impacting their wellbeing,

the Distress Centre is an exemplar of workplace mental health promotion. A big ‘aha’ has been the importance of building a community of care, including peer support (“scuba buddies”) within the organization. Executive Director Jerilyn Dressler generously invited us in to share their journey.

The impetus for change: Escalating demands for service

The Distress Centre Calgary (DCC) is a not-for-profit social services organization that provides 24/7 crisis support for Calgary and southern Alberta. Historically, the DCC maintained a “small agency feel”. It has been a place where people know and support one another, and where they want to stay and keep engaged. But, in response to demand, the DCC has grown; it now enjoys a culturally diverse workforce of about 100 staff and 250 active volunteers. While this is a good thing, the sheer number of people makes it more challenging to nurture and sustain the rich social fabric of the agency.

Distress Centre Calgary in a nutshell

Mission: “To provide compassionate, accessible crisis support that enhances the health, well-being and resiliency of individuals in distress”.

Vision: “Everyone is heard”.

“We do not define crisis. We do not judge. Anyone can call us day or night.” All services are free.

everyone is heard

DISTRESS CENTRE CALGARY SERVICES INCLUDE:

  • 24/7 crisis supports by telephone, e-mail, daily chat and specifically for youth, daily text
  • Professional counseling for people with issues that cannot be resolved over the phone.
  • 211 by phone or chat and now text for people seeking social, community or government services.
  • The Coordinated Access and Assessment (CAA) program supports Calgarians who are experiencing homelessness of out the Safe Communities Opportunity and Resource Centre (SORCe).

In the past few years, demands on the DCC have skyrocketed. Between 2015 and 2018, crisis contact volumes increased by 32 percent. In 2018, the Distress Centre responded to 140,000 contacts. At first, DCC volunteers and staff worked valiantly to keep up with escalating contact volumes, but like the proverbial frog in a pot of increasingly hot water, they eventually began to struggle. Interestingly, the Distress Centre’s vision: “Everyone is heard” added to their stress. Strongly invested in that vision, they worked tirelessly to ensure that every caller was indeed heard.

Eventually, DCC leaders noticed that staff were withdrawing, “putting their heads down”, and closing their office doors, trying to just “power through” busy periods; many had stopped taking breaks. And, leaders realized they were setting the tone for this – that they were continually saying, “I’m so busy” and isolating themselves. They began to wonder how the organization could manage if these patterns of behaviour – this “culture of busy” – continued. So, how could staff become empowered to set boundaries in order to care for themselves and each other? Something needed to change.

Jerilyn: “The volumes are going up and up and up and up. Demand is going up and up and up… People were in crisis as they were serving people in crisis because they didn’t feel empowered to set boundaries. They didn’t even feel empowered to take care of themselves and it wasn’t ending. We put our head down to power through busy periods but that busy period wasn’t ending. We had to say, ‘Okay, we need to take a step back, empower people to take care of themselves and each other and get out of that culture of busy’, because the work is always going to be there.”

In June 2018, the leadership team held a half-day, all-staff meeting to discuss these issues and possible solutions. Convening and participating in this meeting took courage for leaders and staff alike.

Jerilyn: “We were all very brave. I think everyone was really brave, not just me and the leadership team, but everyone was very brave and bringing the issues to that meeting and talking about them.”

Provided with a safe environment to speak freely about things that were impacting their wellbeing, staff did just that. They unloaded a lot and it was a difficult meeting. But, as upsetting as it was, getting everything out on the table was crucially important. Otherwise, the leadership team would never have known what staff were experiencing and thinking, and what specifically was upsetting for them. Armed with a better understanding of the real issues, they were then able to look for solutions.

Jerilyn: “Getting everything out on the table was really important…Had we just averted our eyes from what is happening in the Contact Centre – don’t look; it’s scary – we wouldn’t have known… and then we were able to move to solutions.”

No matter how valuable this meeting was, for Jerilyn as the leader ultimately responsible for the wellbeing of the organization and its people, this meeting felt like a “knife to the heart”:

Jerilyn: “[I took it personally.] It’s hard not to. It was knife to the heart stuff. Things are not good. People are burnt out. The turnover rate is rising. It was like a knife to the heart. I was nearly devastated by that meeting… I didn’t know if I could continue. I was like, ‘I’m going to take some time off in the summer to think about what this means for me. I don’t know that I’m the right person… But then I’m so dedicated to this place. I started here as a volunteer, so the Distress Centre is a part of who I am. I was like, ‘I can’t leave it worse off than when I found it. I’m going to fight through this’.”

The leadership team realized that to avoid this level of intensity again, they would need to institute some clear and formalized avenues for staff to communicate with them – to share concerns and be heard in an ongoing manner.

Jerilyn: “It never should have been a staff meeting that we waited for that… My hope is that will never happen again …because we are creating things to prevent that from happening. We are creating feedback loops and communication channels that didn’t exist previously.”

Early responses: Addressing work pressures and promoting self-care

This emotional jolt kickstarted the Distress Centre’s journey to reinvigorate and sustain its longstanding culture of high engagement and wellbeing, but now in the “new world” of overwhelming demands for service.

The leadership team responded immediately, first tackling some of the identified work-related pressures. An initiative that had been generating significant strain was dropped, and other initiatives were modified. Crisis call volumes were stabilized through new policy and technological measures. Staff and volunteers were reminded that the vision, “Everyone is heard” is an aspirational statement, not a mandatory daily requirement. New communication channels have been created through more surveys and more face time with leadership. Jerilyn and Robyn Romano, Director of Operations, strive to attend all of the different staff group meetings. And there was another half-day all staff meeting this year. All of these actions demonstrated to staff that they had been heard and that concrete things were being done to make things better. This in turn helped to build staff trust in the leadership team.

And yet, that growing demand for service wasn’t going to go away, and the likelihood of additional funding was low. Leaders decided to focus on what they could control, and that was supporting staff to take care of themselves. They started to talk about how, in this high stress environment, staff could be empowered to feel more in control of their situation, to feel they could set boundaries with callers and take a break when needed.

Jerilyn: “What we really can control is how we take care of ourselves… because if they burn themselves out, which is, ‘I’ll get to that next call and make sure that all calls are answered’, and ‘Everyone is heard’ is our vision statement. It’s a vision, not a mission. That’s in the perfect reality if we had all the funding we needed. That doesn’t mean we want people to respond to the demand at the expense of their own wellbeing. That’s when we really started focusing on, ‘Okay, this is a high stress environment. How can we empower people to set boundaries so they can feel like they’re in control of what’s happening for them?’ That’s the number one determinant for job satisfaction, is the internal locus of control, right? How can we help them feel empowered to set boundaries with the callers and to take a break when they need it?”

Reception area of Distress Centre Calgary

Reception area of Distress Centre Calgary (DCC). Photo courtesy of DCC.

Embedding self-care into the organization’s strategic plan

To ensure all of this would get the sustained and focused attention it needed, the leadership team embedded self-care into the organization’s strategic plan. This was approved by the DCC Board in January 2019.

Jerilyn: “So, we had the great idea of embedding self-care into the strategic plan. Okay, we need to make sure that this is a pillar of the work that we’re doing, because we can’t do anything without people who are well and healthy. So, we did embed it into our strategic plan, and it was very high level, you know, ‘We’re going to talk about what self-care means to us as individuals, as a group’.”

And yet there were some “nigglies” about this focus on self-care. Was it right to put all of the on us on employees?

Jerilyn: “We were putting all of the onus on our employees, and one of our newest managers, Mike Velthuis Kroeze, the Crisis Program Manager, questioned, ‘But, what are we doing as a leadership team? What policies do we need to put in place to make sure staff can care for themselves?’”

Epiphany: Self-care isn’t enough

And then, the March 2019 terrorist attack on two Christchurch, New Zealand mosques happened. In a Facebook post, Muslim activist Nakita Valerio commented on the tragedy and peoples’ response to it: “Shouting ‘self-care’ at people who need community care is how we fail people”.

That comment really struck Jerilyn – it was a “a big light bulb” helping her to realize that self-care for Distress Centre staff wasn’t enough either and rather, that a collective approach – a community of care where people support each other – was essential:

Jerilyn: “We have to create a community of care that supports other people; that encourages people to access support; that is also shared collectively and there is shared ownership of it. I can expect support from my colleagues but also, I expect that I will give support and provide that support and feedback and everything that goes with having a healthy, diverse, open culture at the Distress Centre.”

Jerilyn explained that a community of care is all about human connection and mutual support. She described this as being like “scuba buddies” – a community of like-minded people driven by the same mission, who believe in and truly understand the work and what you’re going through. You don’t go scuba diving with someone who doesn’t understand scuba diving – you go with someone who knows all about it and who can support you when needed:

Jerilyn: “They say you never go scuba diving alone. You always have a scuba buddy. You have someone who knows you don’t go scuba diving with a snorkeler or someone who’s going to sit on the beach. You go scuba diving with someone who knows how to scuba dive…having like-minded people who are driven by the mission and believe in the work and understand that there’s tough days and there’s good days and that’s very rewarding. But you need to have someone who understands what you’re going through. That often means within this environment, somebody sitting next to you, doing the same job as you. Peer support – it’s all about peers – scuba buddies.”

Not one to just sit on an idea for long, Jerilyn decided to take her idea out to her colleagues and see what they thought of it.

Another all-staff meeting…

In June 2019 Distress Centre staff and leaders came together for another all-staff meeting. The leadership team began by describing how they’d responded to staff feedback from that difficult 2018 all-staff meeting.

Jerilyn: “What we said to them this year, ‘We’ve changed things a lot since last year, based on your feedback… look what we did with your feedback’.”

Then they focused on the notion of a community of care and generating co-owned ideas for creating and sustaining that: “What ideas do you have for creating a community of care?”. Interestingly, most of the suggestions put forward were no- or low-cost – simple things that anyone could do at any time.

Here’s some examples of what came up:

  • Checking in with each other (raised by many).
  • Time and space for checking in with each other.
  • “Create space: my door is open if you need to talk”.
  • Ask people what they need.
  • Words of gratitude.
  • “You deserve a break; take a break”.
  • Smiles and laughter; creating a fun, happy work environment where we tell lots of stories and have lots of fun.
  • Wellness days to focus on different aspects of wellbeing.
  • More activities by the Wellness Committee.
  • Information sessions (e.g., lunch and learns).

Ideas about work practices and policies were also put forward:

  • Creating clear expectations – What do you expect of me? What should I be working on?
  • Setting an example (e.g., managers not sending work emails at night).
  • Change “sick” days to “personal wellness” days so that people don’t have to feel guilty calling in “sick” when they actually just need a mental health break.

As with any stakeholder engagement process, DCC leaders made it clear they would consider all ideas and try to implement as many as possible. However, with limited resources, not all could be addressed, and priorities would need to be determined. Following the meeting, staff were asked to complete a priority-ranking survey. By the end of 2019, DCC leaders expect to have some action plans for self-care and a community of care, based on staff’s prioritizations, in place.

The Distress Centre is also integrating the notions of self-care and community of care into the physical design of its workplace. In early 2020, the Centre is moving to a new building. The new offices are intentionally being designed to include ample space for people to debrief and a quiet room where people can meditate, pray or just generally relax.

Some of the staff at the Distress Centre Calgary. Photo courtesy of Distress Centre Calgary

Some of the staff at the Distress Centre Calgary. Photo courtesy of Distress Centre Calgary

Essential pieces of the puzzle, and moving forward

Stepping back and looking at their work to date, Jerilyn noted that this combination of things – self-care, a community of care and peer support, the ability to set boundaries and take a break when needed, and a physical space to enable this – are all essential pieces of the puzzle of creating a mentally healthy space:

Jerilyn: “There’s some actual physical space that we’re creating in hope that people will mentally create that space for themselves. All of these different things, not one of them is enough. They all have to work together.”

To assess progress, the Distress Centre will add some new questions to an annual employee satisfaction survey. The survey will be conducted this year to capture baseline data, and it will be repeated next year, once some initiatives have been rolled out. And so, through continued listening and a participatory approach, this work to support the mental wellbeing of DCC staff and volunteers will continue.

We’re certainly looking forward to seeing how it all unfolds!

Why the Distress Centre’s approach is so exciting

We think the Distress Centre’s approach to supporting mental health in the workplace is exciting and exemplary in many ways. First, the leadership team has fully invested in employee mental wellbeing and has ensured it will remain a priority by embedding it into the organization’s structure and policies (strategic plan; communication channels/feedback loops; physical design of the workplace). These new structures complement existing programs to support wellbeing, including a Wellness Committee and an employee assistance program that was expanded as a result of the participatory process with staff.

The second thing that’s so great about this work is recognition by organizational leaders that it’s the work that is largely problematic, not simply the inability of its people to “manage stress”. Even within fiscal constraints, they found ways to make the work less stressful, and in so doing have helped to protect employee mental wellbeing.

Third, in true health promotion fashion, the DCC is authentically engaging staff in identifying issues that are impacting their wellbeing, and in finding solutions; they are working with staff, rather than “doing to” or “doing for”. This is a process that fosters empowerment where people realize their own “power from within” to take control of factors that impact their wellbeing – the overarching goal of health promotion. Also congruent with mental health promotion are efforts to address factors that may contribute to ill-health, and the DCC’s intent to sustain its supportive environment for mental wellbeing.

But taking this open-ended approach took courage. As Jerilyn experienced, this is not for the faint of heart! For leaders, it can be extremely difficult to open oneself up for whatever comes out – and to hear that things aren’t perfect under one’s command. And for staff, there must be a high level of psychological safety in the organization such that they feel safe to express “what’s really going on”. We suspect the DCC’s longstanding culture of engagement and the value placed on reflective practice and ongoing learning have been instrumental in the DCC’s ability to engage staff and get to the heart of the matter.

Jerilyn concurs:

Jerilyn: “This challenge and the way we approached it was not only my doing, but our 48/49 years of history as a social work agency and emphasis on human connection, supervision and reflection… we have always been a teaching and learning agency. We work with volunteers. This is heart work, and we have to be kind to each other. All of this contributed to us taking this course of direction.”

And finally, recognition that “self-care is not enough” and that what is really important is a community

of care is exciting because it recognizes the power of relationships to support mental wellbeing in organizations. This is highly resonant with the research of William Kahn, an organizational psychologist who has studied holding environments in organizations. Holding environments are created when work colleagues make time and space to “hold” or support coworkers who are upset and together, work through that “upset” in caring and supportive ways.

Kahn has more recently written about resilient caregiving organizations – those that have the capacity

to absorb stress and continue to function effectively. Becoming a resilient organization is not easily achieved; however, it appears that the Distress Centre Calgary is well on its way.

“Resilient organizations, like individuals, have the capacity to absorb stress and difficult emotions without being so harmed that they cannot function effectively. They may sway and bend under the weight of what they absorb but they do not break; they maintain the capacity to right themselves… In resilient cultures, members have figured out how to learn and grow in the midst of difficult, sometimes painful environments; they have learned to remain connected rather than disconnected from one another and careseekers. This is not a simple proposition, and many caregiving organizations struggle to make it true.”

Want to support mental wellbeing in your workplace? Some thoughts…

When asked for advice about supporting mental wellbeing in the workplace, Jerilyn’s key piece of advice was to “don’t look away” and to “work as a team”:

Jerilyn: “It is important to not look away. The old adage, “Courage is not the absence of fear, but action in the face of fear” is certainly appropriate here. We were all feeling so overwhelmed in 2017-2018 – I was a brand-new ED working with a leadership team in new roles. It was hard to lift our heads up and look at what was happening elsewhere in the agency. But we carved out the time and approached it as a team.
I have big shoulders, but I couldn’t have possibly taken that on myself. The leadership team helped facilitate smaller groups to make sure everyone had the opportunity to express themselves and be heard. We took it on together and proceeded together…I remember debriefing with Robyn and David from my team late in the afternoon/into the evening after the June 2018 meeting. The “knife in the heart” was so much easier to take because they (and the other members of the leadership team) were right beside me.”

Another important learning is that this process doesn’t need to be expensive. Staff’s expressed needs were predominantly about shifting a mindset or being more mindful of mental wellbeing in the workplace, rather than expensive new programs or supports. This is good food for thought!

In closing, if you want to better support mental wellbeing in your own workplace, here are some questions you might ask yourself to get started…

  • How are we really doing in terms of mental wellbeing at work? Are we really seeing what is going on? Are there signs of distress? Are we afraid to “really see”? If yes, why?
  • What supports do we already have in place for supporting mental wellbeing in our workplace? For individuals? For all of us as a community?
  • What things in our work or work environment might be impacting our mental wellbeing?
  • How “safe” is our workplace for talking about difficult things? How can we make it safer for people to say what is really going on and to raise any concerns they might have?
  • What example am I/are we setting in regard to mental wellbeing at work?
  • How can we work together to better support our individual and collective mental wellbeing?
  • How will we know if what we’re doing is making things better?

End notes

i See for example, Canadian Mental Health Association. Mental health promotion: A framework for action.

ii See, for example, Bishop, A. (2015). Becoming an ally. Breaking the cycle of oppression in people. 3rd Ed. Black Point,

Nova Scotia: Fernwood Publishing, for a discussion of “power over” and “power with”.

iii Kahn, W. (2001). Holding environments at work. Journal of Applied Behavioral Science, 37(3); 260-279.

iv Kahn, W. (2005). Holding fast. The struggle to create resilient caregiving organizations. New York: Brunner-Routledge; pg. xi.

2021-09-28T17:10:50+00:00Shared Wisdom|

Sustaining a culture of continuous learning at the Aventa Centre of Excellence for Women with Addictions

 

“One of the reasons I enjoy working at Aventa is we are always ahead of the curve.”

“We’re constantly looking at best practices.”

The complexity and dynamism of the people and communities we serve, the issues they face, and the systems we work in makes optimizing the results of our efforts – making a difference in the lives of people we serve – a daunting challenge. To achieve the best possible outcomes in this environment, organizations need to continually learn, adapt and improve. Building and sustaining these abilities or capacities requires dedication and effort and we can learn from the experiences and wisdom of those who have succeeded in this regard.

For decades, the Aventa Centre of Excellence for Women with Addictions has fostered and sustained a culture devoted to ongoing learning and quality improvement. In this story, we map out how this award-winning organization has managed to make it work.

This story began with another about how Aventa integrates gender responsive trauma informed care (GR-TIC) into everything it does.

As Capri Rasmussen, Clinical Administrative Manager, kindly described Aventa’s efforts in that regard, the organization’s commitment to ongoing learning and quality improvement shone through. We heard about the strength of leadership around not only GR-TIC, but also around learning and improving. The terms, “continuous quality improvement” and “PDSA cycles” surfaced innumerable times. So did the importance of training and ongoing professional development; of reflective practice through clinical supervision; of monitoring and evaluating efforts; of continually seeking new ideas, evidence, and understanding what other organizations are doing – all in the interest of improving the care and services provided to women living with trauma and addiction.

Capri: “I think it’s an underlying philosophy, continuous quality improvement. People who are not afraid to try new things. We’re not afraid to go, ‘Okay, it didn’t work, we’ll try something else’…We have that freedom as a team – people come up with suggestions like, ‘Oh well, why did we do it this way?’ Well, let’s look at that, and understand.

And I think staff bring up those suggestions a lot, too. We get suggestions from clients that we respond to and try to incorporate wherever possible…. It’s just continuous quality improvement. Looking at, ‘What’s the evidence?’, ‘What are our partners doing? What are they expecting? What’s Accreditation Canada expecting? What are new developments from Stephanie Covington and things like that. We always make sure, for instance, that if there’s any curriculum changes, we buy the latest materials. We’re not using old materials.”

We returned to Capri and asked if she would tell us more about how Aventa sustains its culture of ongoing learning and improvement. She described numerous practices and structures that we have organized into two sets of “key ingredients” that seem to make it work. The first is organizational abilities or capacities that enable learning and quality improvement to occur. The second set of key ingredients is the processes through which learning and ongoing improvement occur.

Organizational supports for ongoing learning and quality improvement

At Aventa, a number of organizational supports or capacities provide the foundation for learning and improvement. These include the commitment of leaders and champions to ongoing learning and quality improvement; supportive values; a continuous learning environment; dedicated resources and formalized roles.

Leaders, champions and commitment

Aventa has numerous formal and informal leaders who are committed to ongoing learning and quality improvement for the purposes of optimizing care, services and outcomes for clients. There is an obvious passion for being on the forefront, for always seeking ways to improve.

Here are some things these leaders do to encourage and sustain a culture of learning and improving:

  • Continually reinforce the importance on ongoing learning and quality improvement – the desire for excellence, for the benefit of women with trauma and addiction.
  • Place strong emphasis on training and professional development.
  • Sustain an environment conducive to learning (see continuous learning environment below).
  • Enact the commitment to learning and improving by providing tangible resources including, for example, dedicated time for learning and reflection; purchase of the most up-to-date treatment curricula; resources for training; and dedicated roles to support learning.
  • Place a strong emphasis on clinical supervision/reflective practice (for clinical staff).
  • Monitor and evaluate efforts and use the findings to improve care and services.
  • Seek external validation of quality by maintaining accreditation with Accreditation Canada.
  • Share learnings and knowledge with partners and other organizations.

Values and a continuous learning environment

Continuous quality improvement and a commitment to lifelong learning as individuals, as an organization, and even for the entire sector are part of the culture of Aventa. There is constant discussion about new ideas and what changes could be made. A core value is, “Excellence: incorporating safety and best practices in the delivery of client-centred programs and services.”

Another consideration is that as a non-profit organization, Aventa has less “red tape” to navigate, making it more nimble and able to adjust practices more quickly and fluidly. This may help to positively reinforce improvement efforts as results can be seen and evaluated more quickly.

Capri: “I guess maybe it’s a culture thing – we talk about continuous quality improvement. We have a quality improvement committee – so we’re always talking about what’s a new idea, how do we make change and whether that’s in our training or policies and procedures. So, I just think we’re just open to that and we’re nimble as a non-profit; we can move quickly. We don’t have a lot of red tape. Maybe big organizations might not? So, we can respond to that and if it doesn’t work, we can go, ‘Okay, that didn’t work, so let’s try something different’.

It’s about that continuous quality improvement. So, as we respond to both the issues, the feedback, the staff, clients and families and what’s available, too – just that continuous. It’s kind of an evolution, right? Lifelong learning, individually and collectively as an agency and a sector.”

One of the foundational requirements for organizational learning is psychological safety – “a climate in which people feel free to express relevant thoughts and feelings”. While that might sound simple, it’s not! In fact, being able to seek help and tolerate mistakes while colleagues watch can be very difficult. Aventa recognizes this and aims for psychological safety through a continuous learning environment:

Capri: “We even talk about that as part of trying to have a no-fault environment. So, obviously not malicious type things, but basically having people be willing to say, like, “Oh, this happened, and this is a near miss, and this is what we can learn from it.” … it’s all of that; this just seems normal to me.”

Alongside this is ongoing attention to staff wellbeing and sustaining a sense of “team” where people know and respect one another. This probably helps create a space where people feel safe enough to speak frankly about things that might not be working so well and that need to be improved without fear of being sanctioned for speaking out.

Formal roles and dedicated resources

Capri: “I do think you have to have some dedicated resources, you have to have someone who’s responsible for components of that to make sure it happens and it is spread around the agency.”

Embedded in Aventa’s organizational structure are formal roles dedicated to ongoing learning and quality improvement. These include, for example:

  • Executive Director, Kim Turgeon, who champions and sets the tone for learning and improvement and provides concrete supports to enable it to happen. “We are firmly rooted in a framework of evidence-informed practice and accountability. As a centre of excellence, we strive to provide excellent care that is responsive to our clients’ ongoing and emerging needs.”
  • Program managers who work with staff, including clinical supervision, to improve practice.
  • A PhD prepared clinical supervisor [Dr. Beverly Frizzell, PhD, R. Psych] who facilitates weekly group clinical supervision with counselors to work through practice-related issues.
  • A Clinical Administrative Manager (Capri Rasmussen) who looks at training, and drafts policies and procedures to reinforce that training. This person also identifies and organizes new training, and coordinates accreditation processes, which includes training requirements.

Aventa has several internal committees with membership of staff from across the agency. The purpose of these committees is to provide feedback to the Senior Management Team and Aventa Board of Directors as it relates to agency policies and procedures. Some of the Committees include:

  • A Quality Improvement Committee: This committee discusses quality Improvement themes, makes recommendations, and implements quality improvement initiatives.
  • Ethics Committee: This committee encourages reflection and increases the level of consciousness about ethical issues among staff with the Aventa Ethical Framework, discussing ethical themes and making recommendations, and arranging staff education activities.
  • Joint Health, Safety & Risk Management Committee: This Committee consists of staff and management representatives working cooperatively to improve health and safety performance.

The commitment of the organization to ongoing quality improvement includes allocation of dedicated resources to make it happen. This includes providing time, resourcing and dedicated roles for professional development and clinical supervision, and for monitoring, evaluation, quality improvement and accreditation processes.

Aventa Centre building

The Aventa Centre of Excellence for Women with Addictions. Photo by Fraser GermAnn, Community Mental Health Action Plan

Learning and quality improvement processes

Undergirded by the foundational supports described above, learning and quality improvement occurs through numerous processes at Aventa. These include training and professional development; clinical supervision; “intelligence gathering”; and monitoring, evaluation, and accreditation.

Training and professional development

Great attention is paid to competencies, ongoing learning and professional development. There are formalized positions to support training/professional development, clinical supervision, and evaluation.

Clinical staff at Aventa typically have a bachelor’s or master’s degree in helping services and thus fall under the Health Professions Act which requires professionals to undertake several hours professional development each year. Aventa makes sure that staff are responsible for doing this and provides opportunities for them fulfill this requirement. Nevertheless, this means that while the organization has a focus on learning, so must its staff:

Capri: “We make sure that staff are responsible to keep their licenses, but we give them opportunities for that, so professionalization and the regulation of the Health Professions Act does spur [learning]… so, it’s not just the agency then; you individually have to have an attitude of continuous learning.”

For clinical staff, Aventa has determined that four critical areas of understanding are gender-responsive trauma informed care, addiction, mental health, and process group counseling. Once hired, clinical staff receive extensive training, including experiential learning around facilitating group processes. Beyond induction training, Aventa provides numerous professional development opportunities, including foundational topics but also topics relevant to current issues or challenges (e.g., most recently, opioid use).

See the story, “Trauma-Informed Care is Our Foundation” for more information about training and professional development at Aventa”

In reflecting upon all of the attention given to training at Aventa, Capri observed that it is all important because it builds a culture of continuous quality improvement, it reduces mistakes, improves staff morale and skills and development, and it probably also saves time:

“It’s all important because it builds a culture of continuous quality improvement. And, that’s just the way it is… I think it also reduces mistakes. And I think having a responsive approach to training improves staff morale and skills and their own development whether they intend to be a practitioner at Aventa long term or even their career development when they leave here one day. It just adds to a more competent sector in workforce…. And I don’t think it has to necessarily cost a lot of money, per se because there is going to be induction training, there’s going to be costs and time associated with that. But there’s also going to be costs and time associated with [not having training and] people being slower to be able to uptake and get ready to go, too.”

Staff meeting room. Photo by Fraser Germann, Community Mental Health Action Plan

Staff meeting room. Photo by Fraser Germann, Community Mental Health Action Plan

Clinical supervision

Clinical staff also participate in various clinical supervision activities, including a weekly group session to discuss challenges in practice. This is a critical aspect of learning and improving. [See the story, “Trauma-Informed Care is Our Foundation” for more information about clinical supervision at Aventa [insert link].

Intelligence gathering

Capri: “Our evidence is fed from many directions.”

“We’re not afraid to respond to what other people identify as being a good practice.”

The people at Aventa are continually gathering intelligence – scanning the broader environment for new ideas, new practices, new research, and so on. They often look to see whether good practices underway in other organizations might be a good fit for Aventa.

Monitoring, evaluation, quality improvement and accreditation, and reporting

Capri: “And then… we do our own evaluations about the outcomes that we want to see change and improve for the women.”

Alongside training and professional development processes, monitoring, evaluation, accreditation and reporting play a central role in ongoing learning and quality improvement at Aventa.

Capri spoke about PDSAs (plan-do-study-act) being a fundamental way of learning how things are working and adapting them in order to improve. PDSAs are ongoing cycles of planning, acting and reflecting on how things went, then adapting and trying again. The key parts are the simple questions: Well, how did that go? What can we do differently? These two simple but rich questions are a foundation for continuous learning and quality improvement. At Aventa, this process is applied both to small and to large change efforts. What likely makes it work, however, is Aventa’s strong culture of, and investment in, learning and continually improving.

Evaluations are completed for areas of our practice that we want to trial and improve. This includes, for example, new training. When Aventa started some new online training related to its curriculum, staff were asked to reflect on the pilot. Feedback was used to make adjustments, and then the program was fully instituted.

In terms of client experiences and outcomes, Aventa develops a client outcome report each year. This report includes benchmarks and quality improvement indicators for the next year. The larger internal document is shared with staff. A synopsis of this report is released to the public on the website. [Click here for the 2017-2018 report.]

In 2011, Aventa became an accredited organization through Accreditation Canada. The organization has “Exemplary Status” from Accreditation Canada. The decision to become accredited was not a requirement, but rather, a desire on the part of Aventa to seek an external validation of the quality of its services. It is evidence of Aventa’s commitment to evidence and quality improvement:

Capri: “Our commitment to the evidence and quality improvement and that kind of evolution is why we became voluntarily accredited with Accreditation Canada…we have an external validation of quality.”

Accreditation Canada’s standards and requirements direct data collection and staff training in some regards. In this way, the accreditation process has a become another foundational support for ongoing learning and improvement. [Click here to read the 2018 Accreditation Report for Aventa.]

Inspired? Intrigued? Encouraged? Want to make similar changes in your practice or organization? See Shared Wisdom for a smorgasbord of ideas for how you can make it happen.

Trauma-Informed Care Resources

Alberta Health Services. Trauma informed care modules. https://www.albertahealthservices.ca/info/page15526.aspx

Alberta Health Services. Why Welcoming is Important handout: https://www.albertahealthservices.ca/assets/info/amh/if-amh-ecc-why-welcoming-is-important-qrs.pdf

Arthur, E., Seymour, A., Dartnall, M., Beltgens, P., Poole, N., Smylie, D., … Schmidt, R. (2013). Trauma-informed practice guide. Vancouver, B.C: BC Provincial Mental Health and Substance Use Planning Council.

Barnett Brown, V. 2018. Through a trauma lens. Transforming health and behavioral health systems. New York: Routledge.

Bloom, S. & Farragher, B. 2013 Restoring sanctuary. A new operating system for trauma-informed systems of care. New York: Oxford University Press.

Canadian Centre on Substance Abuse Trauma Informed Care. http://www.ccsa.ca/Resource%20Library/CCSA-Trauma-informed-Care-Toolkit-2014-en.pdf

Harris, M., & Fallot, R. D. (2001). Envisioning a trauma-informed service-system: A vital paradigm shift. New Directions in Mental Health Services, 89, 3-22.

Manitoba Trauma Information and Education Centre (MTIEC). 2013. Trauma-informed: The trauma toolkit (2nd ed.). Winnipeg, MB: Author.

Manitoba Trauma Information and Education Centre: http://trauma-informed.ca

Poole, N., & Greaves, L. (Eds.). 2012. Becoming trauma informed. Toronto, ON: CAMH.

SAMHSA. 2013. TIP 57 Trauma-informed care in behavioral health systems. Author.

2021-09-28T17:11:31+00:00Shared Wisdom|

How the Distress Centre Calgary implemented Canada’s first peer chat and text service for youth in distress: ConnecTeen

Sometimes when supporting mental health in the community, we run into situations where a particular practice or program isn’t getting the results we’d hoped for, and where there aren’t any other tested or suitable alternatives. In these cases, we need to innovate – to try something new and different. In this story, we describe how the Distress Centre Calgary (DCC) did exactly that. Realizing their telephone-based teen distress line was underutilized, DCC decided to try something new, and became the first organization in Canada to offer an online peer chat and texting service for youth in distress, now known as ConnecTeen.

“We were the first in Canada. It was exciting!”

[Jerilyn Dressler, Executive Director, DCC]

The impetus for change: Low call volumes in a telephone-based teen distress line

The DCC introduced its telephone-based distress line for teens, called Teen Line in 1983. In 2009/10, the DCC reviewed its data regarding the nature and number of calls received by the program. They learned Teen Line was averaging less than 1000 calls a year – a fraction of the DCC’s total annual volume of 75-80,000 distress calls.

In reflecting upon the low call volumes for Teen Line, DCC leaders briefly contemplated shutting the program down. However, they agreed that supporting teens was critical and in fact, supports should somehow be broadened. Recognizing the growing preference of youth for online interactions, they decided to explore the notion of online chatting and texting.

Finding a workable solution and “just starting”

To inform this effort, the DCC scanned the literature to see what people in other jurisdictions were doing to support youth in crisis – and found very little of relevance. They did, however, discover a texting program in Reno, Nevada and contacted the program to learn how it worked. Deciding to implement something similar in Calgary, the DCC worked with their IT vendor to select a chat and texting interface. And that’s where the real learning – and the sharing of lessons learned with others – began.

Jerilyn: “There was nothing out there… There was very little of it happening across North America. So… we kind of just went into it and started learning for ourselves and started sharing what we were learning.”

“A whole new ball of wax”: Revisiting assumptions and changing course

The DCC started out small with online chats, and subsequently added texting. An initial assumption was that chat and text interactions could be managed in the same way as phone calls. But almost immediately, this assumption was shattered. Online chatting and texting with youth turned out to be a “whole new ball of wax” and it was clear that assumptions about how things would work, and implementation plans needed to be re-crafted. Here are four examples of how things needed to be changed.

  • Expecting teens in high risk situations to phone the distress line was not realistic. It was originally planned that if teens were in a high-risk situation, they would be asked to phone the distress line. But it was soon learned that youth would not talk by phone – that’s why they were chatting or texting in the first place! And so, volunteers needed to learn how to support youth in high risk situations via the online environment rather than by telephone.

    Jerilyn: “We thought we were just going to re-create what we do on the crisis lines on chat and text. Well, it was very, very different. It was so different. We were like, ‘If it’s a high-risk situation, we tell them to call the phone.’ We say, ‘No, you’re going to have to call the line.’…[Teens] wouldn’t do it. They would not do it. They don’t want to call; that’s why they’re chatting or texting… because they don’t want to pick up the phone and call. And that’s why we created the program. Why would we force them to phone? If there’s a high-risk situation, it just doesn’t make sense.”

  • Building rapport in an online environment is different from telephone and appropriate language is important. Initially, DCC volunteers found it difficult to build rapport with teens in the online environment. This was largely because they were communicating too formally, using the professional language they’d been trained to use when documenting telephone distress calls.

    Jerilyn: “Because we’re training people for professional documentation, they were not building rapport. Rapport was next to impossible to build online because they were very formulaic and using very perfect grammar – not reflecting peoples’ language back to them. We were taking the good things about peer support out of it by training them on professional documentation.”

    Once this challenge was recognized, the DCC developed new communication tools and strategies (e.g., “tips and tricks”, a list of acronyms) and trained volunteers how to connect with people online. Volunteers were encouraged, for example, to reflect teens’ language back to them and to write in a conversational tone that would build rapport. Once this happened, they realized it was actually easier to build rapport with teens online.

    Jerilyn: “It’s very, very different. Very different. Like, the use of short quick terms… the acronyms. We have a whole cheat sheet on the acronyms. It’s reflecting their language back to them, you have to somehow build rapport. And it’s actually easier when you know the tips and tricks, it’s easier to build rapport online.”

  • Online chat and text conversations are more likely to be of a high-risk nature. Another early insight was that chat and text conversations were also much more likely to be of a high-risk nature. In fact, when the DCC analyzed data about ConnecTeen contacts, they found that chat and text conversations are over ten times more likely than phone conversations to be related to self-harm, and more than twice as likely to be related to suicide. This is related to what is known as the “online disinhibition effect”:

    Jerilyn: “About 10 percent of our phone calls and about as high as 24 or 25 percent of our chats and texts are related to suicide. And it’s the online disinhibition effect.”

    Jerilyn pointed out that in part, these results are related to the fact that youth are more likely to talk about self-harm and suicide, but even when age is accounted for, the percentage of contacts related to suicide and self-harm is still significantly higher in chat and text contacts than in phone contacts. What this has taught the DCC is that online chat and text are valuable toolsfor getting at risks that people often aren’t willing to talk about in person or by phone. The Centre suspects that youth who text and chat are not more likely to be suicidal, but rather that they’re just more comfortable talking about these matters online.

Jerilyn: “People are more likely to share more openly [online] because it’s less scary.”

  • Chat and text conversations can be super-long. Another unanticipated consequence was that chat and text conversations can go on for hours. Having to stick with one conversation that could have prolonged periods of silence left volunteers bored and disengaged. They asked to be able to engage in more than one conversation at a time, but this didn’t jive with an established principle of “no juggling of text conversations” – one conversation at a time. But, in consideration of the volunteers’ request, the “no juggling” principle was revised to allow them to conduct two chats at a time. This has worked well to keep volunteers engaged and satisfied.

Jerilyn: “We said, ‘No juggling of text conversations’. Well, the volunteers were like, ‘Ugh’. They were so bored. If you have ever been to an empty restaurant, you get the worst service because the server is not engaged in what they’re doing. They’re chatting with the bartender, whatever. So, it was the same thing for our volunteers. They weren’t engaged… So, okay, you can do two chats at a time. And that actually really helped them get engaged.”

ConnecTeen today

As the DCC continued to collect data about the number and nature of ConnecTeen contacts, and spoke with volunteers and staff about their experiences, a great deal of learning and troubleshooting occurred. Things that weren’t working well were identified and rectified, and today, the program runs smoothly.

  • Today, peer support by phone, chat and text is available from 5 to10 PM, Monday to Friday, and from 12 PM to 10 PM Saturday to Sunday. Youth can contact the DCC during these hours to talk with highly trained youth volunteers.
  • ConnecTeen volunteers offer a confidential and non-judgmental space for teens to talk about what is going on in their lives. They don’t tell teens what to do but rather, encourage them to make safe decisions; they often suggest connecting with a trusted adult. Volunteers will also connect teens to relevant resources if they want additional supports.
  • Teens can also text or chat from 3 to 5 PM on weekdays, but during those times, adult volunteers or staff will respond.
  • The telephone distress line is available 24/7 for teens but outside of peer support hours, adult volunteers answer the calls.

It’s working! Evidence from ongoing monitoring

  • In 2017, demand for ConnecTeen services grew by 82% and demand for texting increased by 148% over the prior year.
  • By 2018, demand had tripled from 2584 contacts to 7699. However, this massive increase appears to be an anomaly as the number of contacts in 2019 stabilized at 5528 total contacts.
  • Nevertheless, in 2019, the number of ConnecTeen contacts was more than twice the number
    of contacts in 2016.

Some other interesting statistics include:

  • In 2019, 43% of all contacts came through text messaging and another 21% were through
    the online chat feature.
  • Text and chat conversations are 4 to 5 times longer than phone calls. More resources
    (volunteers, computers, physical spaces) are required to manage this volume of contacts.
  • Self-harm is a presenting issue on approximately 20% of all contacts. Anecdotally, many
    youth use ConnecTeen as a coping method in place of self-harm.
  • Approximately 3% of contacts in 2019 required emergency intervention to ensure the safety
    of a service user.

Foundations of successful innovation and implementation

By “just starting” – just trying something new and collecting information about how things were going along the way, the DCC successfully innovated and implemented Canada’s first peer chat and text service for youth in distress. Here are some reflections on factors that seemed to promote the DCC’s success (and there are likely many others!).

  • A culture of ongoing learning and improvement. Jerilyn notes that as a social work agency, the DCC has, “always been a teaching and learning agency that emphasizes human connection, supervision and reflection”. This culture seems to include some of the following key characteristics of psychologically safe organizations for learning: leadership that encourages and makes space for reflection and learning; openness to (and actively seeking out) new ideas; comfort with challenging assumptions; willingness to take risks, to experiment and to fail; and the ability to learn by doing.
  • Consideration of the unique needs, concerns and preferences of teens. By recognizing teen preferences for communicating, the DCC was able to develop something that teens would actually use. And when they learned more about teen preferences for interactions (i.e., little or no interest
    in using the telephone for high risk situations), they adapted their practices accordingly.
  • Courage, patience and persistence. It took significant courage to try something almost entirely new and untested. Implementing chat and text was a difficult journey but the DCC found ways to address emerging challenges and better prepare volunteers for the nature of texts and chats, including their higher risk nature. Now, they are well-trained to manage these dynamics.

    Jerilyn: “We knew we had to do this; this was a trend in communication, we should probably jump on that and be an early adopter. It was hard. I hope we did more good than harm in those early days. It was, at the time, very hard to build rapport because we hadn’t equipped people …we didn’t know the differences. We didn’t know how different it would be… Now we train people for that and prepare them for the higher risk nature of chats and texts…
    We didn’t know any of this before we started. It’s like we went in totally blind. Went in like, ‘This is good to do because youth don’t like calling anymore and they want to text and chat so let’s go’, and it’s a totally different ball of wax.”

  • Collection and use of data about services provided. Finally, the DCC is dedicated to collecting data about their services, and this data has been instrumental in guiding implementation and improvement efforts. Jerilyn explained that while personal information isn’t collected from ConnecTeen users, DCC volunteers and staff do record a “guesstimation” of age and the general nature of each conversation. This focus on data collection and analysis is part of the DCC’s culture of ongoing learning and improvement.
2021-09-28T17:12:46+00:00Shared Wisdom|

Brick Learning Centre Story

The power of love at the BRICK Learning Centre: Transforming students’ lives through caring relationships

  • Jason* was raised by his grandmother. But last month his nanna passed away and he went to live with his aunt. Yesterday, she kicked him out of her house. He has no other place to live.
  • Amanda saw her father die by suicide. She is doing well but does a suicide check-in several times a day with the BRICK’s full-time social worker: “I’m a “3” right now”.
  • Daniel was outside all night. At midnight, he jumped out his bedroom window to escape his drunken uncles. Now he’s sleeping on the couch in the school hallway.
  • Ashley didn’t sleep either. She was having flashbacks to the car crash that killed her mother and little brother.
*Names and details have been changed to protect the identity of students.

These are examples of the traumatic experiences that many students at the BRICK Learning Centre – an outreach school in Ponoka – are living with. Staff at the BRICK hear story after story like these ones. While the intensity and frequency of trauma experienced by some of the BRICK’s students is high, these kinds of things are happening to kids every day in every school and community in Alberta. The BRICK’s principal Ian Tisdale says, “If you don’t see it, you need to look deeper”. And when you do see it, the question becomes, “How can we better support these kids?”

This story is about just that – how to better support kids who are experiencing trauma or chronic stress. It’s about how the power of love and caring relationships can transform students’ lives and set them on the path to hope, self-confidence, mastery and high school graduation. We think the evidence and principles applied at the BRICK could be fruitfully extended to any individual, group or organization that works with children and youth.

Have you ever walked into a building and instantly felt a peaceful warmth and “good vibrations” – a positive energy? That’s the way it is at the BRICK Learning Centre – an outreach school in Ponoka that serves about 240 Grade 10 to 12 students each year. The place enfolds you the moment you set foot in the building – it’s not anything you see, but you feel it. It invites you in.

“BRICK” stands for Building Relationships Independence Community and Knowledge. It’s not what you might typically imagine an outreach school to look like. It’s not a street front space nor is it in a mall; rather, it is located in an elegant two-story brick building that used to be an elementary school. There are regular classrooms and a five-block schedule of classes, and yes, a principal’s office, too. There’s also a room where Elders and students can talk and smudge, a photography studio, a workout room, a classroom that doubles as a yoga studio, and a kitchen where staff and students share breakfast and announcements every morning.

We spent a day there, talking with Principal Ian Tisdale, Assistant Principal Erin Freadrich and other BRICK staff, and were blown away by what we saw: the power of love and positive relationships to transform the lives of students. The entire day was a lesson in this: “When relationships are the core foundation of what we do, we change kids and we change their futures”.

This shift in mindset – to privileging relationships as the foundation for all other work – is generating impressive results. There is a sense of family – a warm and safe environment that embraces each kid and adult just as they are. Students with eccentric behaviours are accepted as, “just doing their thing”. There is an active GSA and kids feel safe expressing their gender identity; they are thriving rather than hiding their “secret” and being shunned. As teacher Sheila Strychalski observes:

“We aim to ensure that all diversity is embraced and celebrated as a strength in students’ interpersonal and academic lives.”

There is minimal bullying or harassment. In the past 14 years, there has been only one fight, and that ended with the two boys apologizing to their peers for interrupting their learning, and then riding home together with a new understanding of each other’s realities.

“I have heard parents say how their child has been bullied or harassed in previous schools. I happily tell them they need to come and see how we are different.” [Valerie Jones, Administrative. Assistant]

Kids who might have dropped out, or who might have been expelled from other schools are attending the BRICK on their own terms. They are completing courses and graduating. And, graduation rates are going up – from 17 in 2017, to 27 in 2018 and in 2019, 36. The BRICK is now a school of choice for students. Rather than having to try regular school first, they can opt to come directly to the BRICK – and they do.

And, so are teachers. New teacher Al Wong told us:

“As a new member of the teaching staff at the BRICK Learning Centre this year, I was amazed by how many students who came in eager to register for school despite various challenges they may have faced. Furthermore, anyone coming into the school could see how welcoming and warm-hearted allthe staff are here at the school. Having taught at alternate school environments for the past 14 years, I’ll have to say that I am very excited to work with the students and staff here at the BLC this year!”

Foundations of the BRICK’s success

So, how do people at the BRICK Learning Centre make it all happen? Ian says, “It starts with being part of a strong school division that values alternative education. Strong schools exist as part of a strong division, not apart from one. Within the building, we have a group of adults who believe deeply and authentically in relationship and have this art for looking past everything to see what we can do to help.”

And then, BRICK staff draw upon numerous sources of evidence to inform their practice. This evidence includes professional wisdom gained through experience of “what works” with students who have experienced trauma; and similarly, the wisdom of students, family and Elders. It also includes academic research and theory (see below) and ongoing evaluation and critical reflection about how things are going. This evidence is interpreted through the lens of context – the environment in which the school is operating, including an understanding of the unique nature and capacities of the school (e.g., budget, resources, skillsets) and of Wolf Creek School Public Schools; the broader educational system; and, the local community including history, culture, resources/capacity, demographics, economics and political dynamics.

To learn more about evidence-informed practice, and applying evidence in your practice, see: Shared Wisdom for Supporting Mental Health in the Community

In terms of research-based evidence, BRICK staff draw upon research focusing on children and youth who have experienced or are experiencing chronic stress or trauma. Foundational is work on adverse childhood experiences (ACES), trauma and resilience. Children and youth who have experienced or are experiencing trauma are at risk for serious lifelong mental and physical health problems. The good news is that adverse childhood experiences (ACEs) aren’t a life sentence. A substantial and growing body of evidence demonstrates the powerful impacts of protective and promotive factors that buffer against adversity including, for example: stable, caring and supportive relationships with adults; personal skills to build a sense of mastery over life circumstances and to manage stress (e.g., coping, decision making, self-regulation); learning and school engagement; and, nurturing environments that support faith or cultural traditions and that support children and youth to do well.

At the BRICK, all of these protective factors are abundant, especially caring relationships – they are foundational to everything done in the school. The results are heartwarming and inspiring. We met and heard about many students who have experienced significant trauma in their lives. The BRICK embraces each one – gets to know them, respects them, supports them. And they are blossoming under this care.

BRICK staff also draw upon numerous other bodies of research in their practice. We have listed several of their sources in Appendix A, along with some “teaser” descriptions of the research that might entice you to read further – it’s all very interesting and informative! Unpacking all of this research is beyond the scope of this story. Instead, we focus on the common thread running through it all and that applies to anyone working with children and youth: the foundational importance of connection and caring relationships.

Caring relationships and “family” before everything else

At the BRICK, caring relationships come before everything else including course content. Relationships are embedded in the BRICK’s mission, vision, practices, and policies and every conversation. Each decision and action is based on the question: “What does this mean for the relationship part?”

The principle is that if you believe in kids and they believe in you, then they will, “go to the moon for you and do amazing work”:

“Some educators put course content in front of relationship. And the sad part to me is if you just put relationship first, you’re going to get all the course content because if kids believe in you and you’re believing in them, they’ll go to the moon for you and do amazing work”. [Ian Tisdale, Principal]

Here, it is recognized that when teachers focus on content first, they may miss all of the things going on in kids’ lives that are generating attendance and social or behavioural issues. When kids come to the BRICK, it’s relationship first, and students begin to flourish:

“[When kids] come here, all of a sudden, it’s relationship first. And out of that relationship, once we have that relationship established, then we can worry about Math or Social Studies or English. And then these kids come, and they flourish here.” [Ian Tisdale, Principal]

“One of the truly beautiful things about our school is that we get to actualize the entirety of Maslow’s hierarchy of needs. We know that kids can’t just leave their deficiency needs at the door before class. We tend to these needs before we tackle growth needs.” [Shawn Halbert, Teacher]

And this extends beyond one-on-one relationships to building a sense of family amongst all who work and study at the BRICK. Great emphasis is placed on building a family dynamic.

“Our focus here… really, really, we are a family. And we say that as part of our intake process. By coming here, you’re signing on, and we’re going to wrap around you. And we’re going to love on you. We’re not letting go of you.” [Erin Freadrich, Assistant Principal]

In the morning all students and staff eat breakfast together, like any family might, and then they go upstairs to the classrooms together. Mrs. Wilkinson, an educational assistant, comes in early to set out breakfast. Ian and Erin referred to her as a “Norman Rockwellian mom”:

“Every day, she’s there with an apron on and there’s a pot of oatmeal out, plus yogurt and continental breakfast things. For every kid that comes in that door, there’s Mrs. Wilkinson and, ‘Hey, good morning. Get yourself a bowl of porridge’.”

Having achieved a sense of family means that for kids, the BRICK is a safe place. When they need help in their personal lives, many come to the school for support. While we were visiting the school, a student came to the office asking for help. She came because of the relationship the school had built with her:

“That girl is here today because of the relationship piece. Her whole world is crumbling around her, but this is the place to come to. And even if we can’t fix her world, we can at least give her a safe haven for a little bit. And give her some hope of, ‘This is how we can help you right now’. And story after story of our kids – it is because of the relationship that they come to school.” [Ian Tisdale, Principal]

Being a “family” means going the extra mile – going beyond one’s “professional responsibilities”- to support the kids. Upon discovering a student had never had a birthday party, and hadn’t ever been invited to one, BRICK staff made her a cake and celebrated her birthday with her. When they knew another student was on her own and couldn’t afford clothes, they all chipped in some money and someone took her shopping at a goodwill store. When a student phoned the school and made some concerning messages, the school’s resource officer contacted the family and did a safety check.

All of this requires a deep and personal investment in the students, and when things go wrong, it can be heartbreaking:

“You have to be so invested in these kids. You have to love on them and so when we find out they’ve gone to jail, or we find out [they’ve died by suicide], or we found out that they quit school, it breaks our hearts. Because these are our babies…We weep with kids and we laugh, and we celebrate with kids and we’re human.” [Erin Freadrich, Assistant Principal]

And that is why Ian demands that BRICK staff build authentic caring relationships every single day:

“I demand from my staff to build authentic relationships every single day, knowing you’re working with at risk youth… relationship has to be the core of everything you do with students especially with at-risk kids. If students don’t have those relationships, it won’t matter what you do with them.”

The importance of family and caring relationships is also reflected in hiring practices that are geared toward relational competencies. Here’s how Ian describes it:

“If it comes to hiring staff, your A+ in Sciences in university means nothing to me. What means everything to me is your ability to connect with kids and build relationships and see the heart of kids….if you hardly made it through science, great… now you can identify with these kids here who are having trouble with math or science … but if you have a heart for kids and if you’re ready to take this on, day after day after day after day after day, it’s so rewarding.”

The payoff is a staff that understands and privileges the fundamental power of connection and relationship. Teacher Jim Wilkinson said relationship building begins with being a servant leader:

“For me, relationship building in my classroom starts with taking on the role of servant-leader. I make it abundantly clear that I am here to serve the kids – everything from picking up a pencil they dropped to being willing to help them no matter what else might be happening. As the classroom leader, my role is to ensure a safe, calm learning environment. It requires a balance of humility and confidence. Like most of teaching in an outreach setting, it’s a tightrope walk. Exhausting but exhilarating”.

The flexible and individually customized approach to instruction at the BRICK also enables a “relationships first” approach:

“The structure and process of how our school operates gives us the freedom to put relationships first. Students are easily able to pick up where they are at or where they left off and that pressure of not needing to have everyone in the same place at the same time alleviates the pressure on the relationship that we have worked so hard to build.” [Teri Lynn Amundson, Teacher]

Below we describe some other ways that caring relationships and a safe environment are sustained at the BRICK.

Messages of hope and encouragement only

All messaging to students is always positive. While this shows respect and care to students and helps build a sense of belonging, it also gives peace of mind to staff. When students leave the school or get into trouble or perhaps even die by suicide, staff can rest assured that all their interactions have been supportive and positive and that they have given their very best to each student.

An example is the gentle way in which students who are absent are contacted by the school’s administrative assistant, Carolyn Jarrett. The approach builds family by showing students that the school loves them and cares for them:

“Any time a student is supposed to be here on their schedule and they’re not, [Carolyn] phones. The phone message is very clear, that it’s, ‘Just that we want to make sure you’re safe. We miss you. When will you be back in school?’ They’ll say to her all the time, ‘I’ll be there tomorrow’. ‘All right, see you tomorrow.’ And tomorrow she calls them again ‘Oh, no, I’ll be there tomorrow’. It’s been very specific that her language is just a very kind, supportive, non-judgmental – just missing you, hope you’re safe and when can we expect you back again? We’ve seen over the two years where we’ve been doing this that our attendance has gone up substantially.” [Ian Tisdale, Principal]

And, students often express their appreciation to Carolyn:

“I have received cards from students telling me that they are in school because I phoned them on a regular basis, just checking in with them. Here is an example of what one student wrote to me: ‘Thank you for touching base with me when I’ m not here and calling and asking when’s the next time I’ll be back. I’m here today because of that, knowing that someone I don’t know much is wanting me to make it to school and be better. Have a good day’.”

The approach is the same for students who drift away from the school:

“We’ll see students who will just kind of drift away from us. They’ve got a hundred other things that are happening in their lives. So, we want to know that the last messages that we have are ones of hope.” [Ian Tisdale, Principal]

And when students come back, “they just get loved on”:

“When students come back after missing significant time, they just get loved on. They get hugged. They get, ‘Oh! We’re so happy to have you back!’… It’s just opening the door for kids to learn.” [Erin Freadrich, Assistant Principal]

After a student died by suicide, Ian looked at the student’s progress report to see what kind of interactions had occurred:

“One of the first things I did was look at the progress report. So, we can look back and say, ‘Okay, here’s all the times we called him and gave him a love message. Here’s what we’ve done to support him’. Even on the last progress report we had for him…there were four different messages like, ‘It was so good to see you last week. We hope to see you back again. Excited to see you back. We’re hoping that…’. It was just messages of hope and encouragement.”

wall of positive messages and cards

The power of love at the BRICK Learning
Centre: Transforming students’ lives
through caring relationships

Understanding the “why” behind disruptive behaviours

Traditionally, school approaches to disruptive behaviours have included punishment of some sort, or complete removal from the school through suspension or expulsion. But, at the BRICK, the opposite happens – connection and striving to understand the “why” behind the behaviour and then, “Let’s get you into school because this is what’s going to change your future.”

For kids who are used to being kicked out of school, this can be a surprise. Ian and Erin said it “really turns their world” when they do something they expect to be suspended for, and yet that doesn’t happen. For example, those who turn up at school drunk or high are not suspended. Instead, they are given a firm message that, “You can’t be at school in this shape. We need you to be in a safe space right now. Who can we call? We’re sad that you’re missing out on this learning opportunity. Come back tomorrow when you’re able to learn”. And, guess what? They do come back to learn. And they also come to realize that they are respected and cared for, even when they “screw up”.

Ian told us that early in his career, suspensions seemed an appropriate response. But once he started hearing the stories behind the behaviour, everything changed for him. Today, this is his advice for administrators and teachers (and we would argue, anyone who works with children and youth):

“If I could just say this to other administrators and teachers in the province: ‘Do this: understand the why behind the what.’ If a kid comes to school drunk, why do they feel that’s acceptable behaviour? Why do they feel that it’s something normal that they go get drunk or high at lunch?

Then once you start exploring their stories, it breaks your heart and you don’t want to suspend them. You don’t want to kick them out. What you want to do is just love them and give them a place to be that’s safe. It just changes, and for me that’s what so changed my perspective.”

Here’s an example. We heard about a boy who was inebriated and creating a ruckus on the school grounds at the end of the school day – in front of hundreds of people. Staff calmly removed him from the situation and brought him back into the school. While waiting for his kookum to pick him up, he talked with Ian. When Ian happened to call him “son”, the boy said, “You know what? No one has ever called me, son”:

“It broke my heart to think that his whole life, he’d never been identified as somebody’s son…. Here’s this boy who’s drunk and you know what? It doesn’t make me mad and want to suspend him for five days because how embarrassing he’s been in front of our school. I just want to hold him and hug him and love him.” [Ian Tisdale, Principal]

Ian made it clear that the BRICK is not a “free-for-all place”, however. To the contrary, BRICK staff have high expectations for their students:

“Academic progress and attendance are monitored consistently. We meet to talk about our students twice per week. When a student has been identified as being a “Student of Concern”, we ensure measures are put in place to help them be successful, and then we hold them accountable.”

Cultural humility

Mural in the Elder’s room

Mural in the Elder’s room. Photo by Kathy GermAnn, Community Mental Health Action Plan.

The BRICK Learning Centre is located close to the Maskwacis community, and many students identify as Indigenous. To ensure these kids feel safe and that their culture is respected and embraced by the school, staff practice cultural humility – a process of understanding personal and systemic biases, maintaining respectful relationships based on mutual trust, and self-reflection – humbly acknowledging oneself as a perpetual learner in understanding another’s experience.

“There are many times when, from our colonial lens, we’ll do something that makes sense to us, but it’s offensive… so there’s a lot of just asking… When we’re at the Wisdom Guidance Committee, we can ask questions. For example, we’ve ordered new gowns for our grads and so we’re going to have our logo there, but we want to have the four colours of the Cree Medicine Wheel but what’s the appropriate order of colours?… I think the culture that we have here in our building, of family, is that ‘You know what? Sometimes we’re going to do something and step on someone’s toes because we don’t know …If we’re doing something incorrectly, let us know because we’d love to do it right.” [Ian Tisdale, Principal]

medicine wheel

Staff also ensure that Indigenous culture is reflected in the school. This is achieved in numerous ways including, for example:

  • The school logo encompasses the colours of the Cree Medicine Wheel.
  • Elders are present in the school three mornings a week. There is a room where students can speak with them and smudge.
  • A Wisdom and Guidance Committee made up of parents, elders, community members, principals from Ponoka area schools, lead teachers, the FNMI student success coordinator and the superintendent. They meet monthly over a meal. School-related matters are discussed in a talking circle.
  • A First Nations, Metis and Inuit Student Success Coordinator – Shelagh Hagemann, helps ensure students are supported through an Indigenous lens.
  • A First Nations, Metis and Inuit Learning Supports Coach – Josephine Small – helps infuse culturally responsive content into courses.

Together, the Student Success Coordinator and Learning Supports Coach roles are intended to develop a holistic understanding of First Nations, Metis and Inuit cultures, worldviews, histories and current realities. These supports help to ensure that all students belong and can learn effectively. The approach fosters relationships that nurture and honour individual student’s stories and cultures and encourage the blending of both culture and curriculum to strengthen learning.

There are frequent communal activities and ceremonies. (e.g., teachers and students sharing breakfast and announcements every morning, feasts, smudging, and a round dance at graduation).

Indigenous history, art and other artifacts are liberally displayed throughout the school. A few years ago, staff walked through the school, trying to imagine how their Indigenous students might experience the place. They realized more could be done to reflect the culture and so added more Indigenous art and artifacts to their classrooms.

Staff often go to Maskwacis to meet with parents, recognizing that travel can be a barrier to parent participation in their child’s education.

A culture of equality and a focus on staff wellbeing

And finally, we come to the working environment for BRICK Learning Centre staff. Again, the focus is on relationships and equality. While Ian and Erin are ultimately accountable for the school, all staff are viewed as equals and all are included in discussions about what’s going on, and should go on, at the school.

Yoga studio in a classroom at the BRICK

Yoga studio in a classroom at the BRICK. Photo by David Rust,
Community Mental Health Action Plan

“There is no hierarchy here. In all of our discussions about what we’re doing with the school, we have admin assistants, social works, EAs and teachers… I look at everybody here as being equal. We just have different roles that we do.” [Ian Tisdale, Principal]

And, everyone is viewed as a teacher, recognizing that while some staff are in professional teacher roles, everyone else – educational assistants, administrative assistants, the social worker, custodians – also has a critical role in the school:

“When I say ‘teachers’, I mean everybody because everybody has a teaching role in this school. The admin assistants teach people, the educational assistants teach people, the custodian, social worker – everyone teaches people in this building in different ways.” [Ian Tisdale, Principal]

Focused attention on staff wellbeing

Given that so many of the BRICK’s students are at risk, there are expectations on staff to be extremely mindful in their interactions with students. Just one small word could trigger a student or cause them to leave the school.

“We have to be perfect with these kids or they won’t come back, so we have to be at our best everyday…If this doesn’t fit and suit where you’re at, then you can’t be here, because when you work with the most vulnerable kids, you have to be your best all the time. Because one slight little comment can have a deep impact.” [Ian Tisdale, Principal]

But the work is hard – it hurts and listening to kids’ stories requires opening yourself up and making yourself vulnerable. Vicarious trauma and compassion fatigue are real concerns for staff.

“There’s hurt. 100 per cent, there’s hurt… the hard part isn’t marking essays and marking modules as much as sometimes that stacks up. The real hard part is being vulnerable to learn stories of kids because that means you’re going to hear some awful things.” [Erin Freadrich, Assistant Principal]

So, there needs to be significant support for staff wellbeing. And indeed, many strategies are in place for this, including the following:

  • A lot of talking and “checking in” to see how people are doing : “We meet all the time and talk about our kids and our school. I meet with staff and just say, ‘How are you doing?” [Ian Tisdale, Principal]
  • Staff are strongly encouraged to monitor their own mental health. If needed, they are encouraged to take a day to do something that will support their mental wellbeing – seeing a counselor, for example. They can access Homewood Health for supports through Wolf Creek Public Schools.
  • Staff also support each other in taking “mental health minutes” during the school day. If someone needs an extra-long break, their coworkers will cover for them.

The parking lot is empty at 4:00 because it is recognized that the work is difficult, and people need to go home to their personal lives:

“If you look at our parking lot at 4 pm, it’s empty because I want [staff] to go home… I tell people to go home because they’ve worked harder than most people have worked and the stories they’ve heard. The seven or eight hours that you’re here are so overwhelming that you need just to go away and enjoy… get into whatever your evening routine’s going to look like.” [Ian Tisdale, Principal]

  • Teachers are encouraged to share their own interests and passions with kids. A few years ago, each teacher was invited to develop programs for kids that were based on their own personal passions. So, there are now yoga classes, photography classes, and a workout room.
  • Staff spend time together in “wellness” events. They often attend educational and fun events together, further strengthening relationships and mutual support.
  • Staff are encouraged to ask, “what’s your why?” – a way of reconnecting to a sense of purpose in the work which is a deep source of wellbeing.

The work adds to wellbeing

While working at the BRICK can be emotionally demanding and it can be difficult to hear the stories of students’ lives, it appears that the rewards far outweigh the challenges. Erin told us that the many stories of student success add to staff wellbeing:

“There’s story after story – there’s no end to the stories of our kids of coming from brokenness that find success. And I think that’s what also helps with the staff wellness piece.”

Ian similarly told us that this has been by far the most challenging job of his career, but also by far the most rewarding. And it appears to be the same for all staff at the BRICK because there is virtually no turnover of staff. In fact, staff who retire often stay on as substitutes:

“People are here and staying and they love it. And even for people who retired from here, they’re our key substitutes and they come back in bulk to be here.” [Erin Freadrich, Assistant Principal]

Custodian Jacquie Burton told us:

“I just love how the kids are so respectful and kind. I love coming to work every day.”

Our guess is that this work affords a deep sense of meaning and purpose – of doing important work that makes a difference. And, it also fosters a sense of belonging as part of the school family that consists of all students, family, community members, Elders and staff.

Ongoing learning and adaptation

As a school the BRICK has a philosophy of continual growth and development. This means a continual openness to change, and to discussing what’s working, what’s not, what could be adapted and what should be dropped:

“So we need to explore everything we do all the time and realize that we can change. Always we should. We can and we should change and adapt. Because when we change and adapt, we meet kids’ needs.
We always say to staff, ‘Everything is always on the table all the time. ..If there’s any practice that’s not working, let’s ask questions about why it’s not working and adapt it or get rid of it.” [Ian Tisdale, Principal]

BRICK staff are guided by the ultimate goal of increasing graduation rates, with the logic that this can be achieved by meeting the social, emotional, behavioural and academic learning needs of students.

As a team, staff have developed their own mural of where they want to go as a school, and they reflect upon (and adjust) it regularly. The mural highlights areas of excellence – things they are already doing well and that could be showcased to others, as well as areas of growth – things that still need to be addressed. One area of focus for 2019-2020 continues to be increasing graduation rates. The school had anticipated that 50 students would graduate in June 2019, but for various and multi-faceted reasons, only 36 did. So, staff will spend time this year trying to understand more about why that happened, and how things could be improved.

Applying “what works” at the BRICK in other settings

The BRICK Learning Centre is an exemplar of the power of connection and caring relationships between students and school staff. It is also an exemplar of how adopting a different lens and approach can serve students who don’t fit the mold of traditional schools in a way that enables them to succeed personally and academically. And that shift in mindset costs very little. It doesn’t take a lot of time or resources; in fact, the effort invested in getting to know kids pays off in spades – greater student achievements, growth, and in the case of the BRICK Learning Centre, graduation.

“It’s about taking those moments to find out about the kids – it doesn’t take a whole lot of time.” [Erin Freadrich, Assistant Principal]

We noted at the outset that while the intensity and frequency of trauma experienced by some of the BRICK’s students is high, this is happening with students in every school and community in Alberta.

Imagine the potential if, in every child-and youth-serving group or organization, caring and trauma-informed relationships came first and “programming” second? What if every child and youth felt welcomed, nurtured, respected and accepted wherever they went?

Brendtro and colleagues believe this is very possible – that anyone can make a difference in the lives of children and youth who have been exposed to trauma:

“Building restorative relationships is not limited to those with formal training in counseling. An adult who is involved in ongoing daily events has many opportunities to show small acts of kindness and respect. While trained therapists make important contributions, everyday supportive relationships are the most potent way to heal trauma. Clinical psychologist Ricky Greenwald writes:

‘You do not have to be a therapist to create a therapeutic or healing relationship with a child. Parents, counselors, teachers, coaches, direct care workers, case managers and others are all in a position to help a child heal. The quality of your relationships is the vehicle for learning’.”

 Research-based evidence applied at the BRICK

Ian and Erin cited the work of several researchers that guide work with students at the BRICK. When we looked at this research, we realized that although much of it is focused toward teachers, it can apply to anyone working with children and youth.  Here is a brief description of the research and some “teasers” that might intrigue you to check these resources out.

Researcher(s) Some key ideas from the research that can apply to anyone working with children and youth
Brendtro, L., Brokenleg, M., & Van Bockern. 2018.  Reclaiming youth at risk. Futures of promise. 3rd Ed. Bloomington, IN:  Solution Tree Press. A model of resilience and positive youth development to help people connect with and “reclaim” traumatized youth.  How four Circle of Courage values – Belonging, Mastery, Independence, Generosity – enable youth to thrive. Strengths-based approach.
Carrington, J. 2019.  Kids these days. A game plan for (re)connecting with those we teach, lead & love. Alberta:  Jody Carrington. Relationships and connection with kids matter. It is only through relationships that we can teach kids to regulate their emotions. If they don’t have control of their emotions, they can’t connect or learn. “Kids aren’t seeking attention; they are seeking connection.”
Dweck, C. 2016.  Mindset. The new psychology of success. New York: Ballantine Books. In contrast to a “fixed” mindset where people believe their basic abilities, talents and intelligence are fixed for life, a growth mindset is the opposite – it’s the belief that one’s talents can be developed through effort, persistence and good teaching: “everyone can get smarter if they work at it”. People with a growth mindset are more likely to continue working hard despite setbacks.
Greene, R. 2014.  Lost at school.  Why our kids with behavioral challenges are falling through the cracks and how we can help them. New York: Scribner. A framework for understanding challenging child/youth behaviours. Put simply, Greene argues that every kid wants to do well, but some don’t know how to do that, and so it is up to professionals to help them figure it out.
Souers, K. & Hall, P. 2016.  Fostering resilient learners: Strategies for creating a trauma sensitive classroom. Alexandria VA:  ASCD. How ACES affect student readiness to learn.  We should view every student as though they have experienced trauma.  The importance of understanding the “why” behind behaviours and of fostering a safe and secure environment where it is okay to be “not okay”.  By nurturing and holding high expectations you will build relationships that enable students to grow, thrive, and learn at high levels. They outline ways trauma sensitive learning environments.
Tileston, D., & Darling, K. 2008.  Why culture counts. Teaching children of poverty.  Bloomington IN:  Solution Tree Press. Key considerations about, and a model for teaching children/youth living in poverty.  “We cannot build resilience for children of poverty without addressing the impact of their culture on achievement.” While it might not be possible for teachers to fix poverty, it is possible to teach so that students can learn and succeed despite obstacles.
2021-09-28T17:13:30+00:00Shared Wisdom|

Trauma Informed Care Aventa Story

A chilly gray April day. Standing outside the locked, barred door, pressing the bell. Waiting. What is this place like? What are the people like? Another door. Another set of uncertainties, the unknown.

But what a relief upon stepping inside! Warmth. Comfort. Safety. Pretty things – a giant turquoise glass vessel on a coffee table; wall-sized abstract prints of navy and white, reminiscent of the sea. Cushy soft leather chairs. Fluffy cushions. No hint of “institution” or “facility” here. This could be someone’s living room or a boutique hotel. And then there’s Lisa, who smiles warmly and says, “Hello!”.

How many women, struggling with addiction and the trauma it buffers, have stepped across this threshold and felt the safe, warm embrace of Aventa? How many have left feeling strong and full of hope? Thousands.

Nestled amongst the towering spruce trees of Calgary’s Mission community, the Aventa Centre of Excellence for Women with Addictions has been serving women with addictions for almost 50 years. From its humble roots as a volunteer-run home for women struggling with alcoholism, Aventa has grown and evolved over the years, earning a longstanding and excellent reputation for providing gender-responsive, trauma informed addiction treatment services exclusively to women.

Aventa Centre building

The Aventa Centre of Excellence for Women with Addictions. Photo by Fraser GermAnn, Community Mental Health Action Plan

Today, Aventa has 65 community-based beds and offers three phases of live-in treatment; another live-in program for young adults aged 18-24; an FASD Transitions Program; and a program for pregnant or parenting women with addiction concerns. In addition, Aventa offers a wide array of on-site supports for wellness, and after-care groups to support women in their recovery. [Click here to see a full listing of programs and services.]

Aventa’s mission is: “To improve the lives of women and their families affected by addiction, mental health and trauma through treatment, advocacy and education, in a safe and supportive environment.” Aventa materials often include the statement, “When women are healthy, families are healthy and communities are healthy.”

Two staff from Aventa Centre outside of the building with a banner that highlights the organization's vision, mission, and values.

Capri Rasmussen, Clinical Administrative Manager and Kim Turgeon, Executive Director, Aventa Centre of Excellence for Women with Addictions. Photo courtesy of Aventa.

In 2007, Aventa adopted a gender responsive, trauma informed care (GR-TIC) approach, based on the work of TIC pioneer, Stephanie Covington. Twelve years later, the people at Aventa say that, “trauma informed care is our foundation – it is the core of what we do”.

This story is about what gender responsive TIC (GR-TIC) looks like at Aventa and how the approach has become embedded throughout the organization.

Aventa’s journey to gender-responsive TIC

By the early 2000s, staff at Aventa had long recognized that most of the women they served had experienced trauma at some point in their lives. Trauma was addressed wherever and whenever possible, but many felt there was a need to do more, to make more room for the women’s’ stories of trauma to flow and be heard. There was a receptivity to something better; a readiness for change.

In 2007, a convergence of events and insights further opened the door for that “something better”. There were changes in personnel, Aventa had recently moved into a new facility, a needs assessment determined that Aventa clients would benefit from a trauma-informed curriculum, and Aventa staff heard Stephanie Covington, a leader in TIC, speak at a conference.

Multiple sources of evidence – staff insights and experiences, client experiences, a needs assessment, a consideration of contextual factors, and exploration of research evidence – pointed the way forward. Covington’s holistic and gender-responsive approach seemed a perfect fit. Funding was secured to bring her to Calgary and train Aventa staff, launching Aventa’s journey to gender-responsive TIC, numerous awards, and positive outcomes for the women served by its staff and programs.

What is gender-responsive TIC?

A gender-responsive or gender-specific approach means that TIC is tailored specifically for the gender of people receiving services. This is in recognition that gender-related social roles, relationships, opportunities and identity shape peoples’ experiences and that people of different genders may have different realities and experiences[i]. Specifically, they may experience different forms of trauma and respond to and recover from trauma differently[ii]. It has been demonstrated that addictions in women typically exist for different reasons and manifest differently than for men with addictions. This underlines the need for gender-specific care[iii].

Covington[iv] describes gender-responsive TIC for women this way:

Being gender responsive means creating an environment through site selection, staff selection, program development, content, and material that reflects an understanding of the realities of the lives of women and girls and that addresses and responds to their strengths and challenges.”

Aventa exclusively serves women, so programs and approaches are tailored to meet their needs. Capri Rasmussen, Clinical Administrative Manager at Aventa says, it’s about, “What’s your experience and how can we better respond to it?”:

“There’s a need to be gender-responsive, culturally responsive – all of those types of things. It doesn’t mean, ‘Not for you’, but it means, ‘What’s your experience and how can we better respond to it?’ It doesn’t mean that men don’t have these types of trauma – we know that they do. But, we’re saying that the women we work with do, so we’re responding to that. We’re serving women… so the programs and approach are customized toward the experiences of women with trauma and addiction…it’s about understanding the lives of women and girls.”

Additional programming to meet the needs of women at Aventa include parenting, female-oriented birth control, sexual abuse counseling and even financial literacy. There is also a strong focus on relationships and helping women to build healthy connections with others.

Three workbooks. The workbook in the middle is called

Some of the materials used in Aventa’s programs. Photo by Fraser GermAnn, Community Mental Health Action Plan.

So, what does GR-TIC look like in practice?

Aventa is an exemplar of how GR-TIC can become integrated into the very fibre of an organization.[v] GR-TIC is not only manifested in the care and services provided; it is also expressed and perpetuated through a web of mutually reinforcing organizational practices and processes – leadership, values and a philosophy of care, roles and responsibilities, hiring practices, training and professional development, policies and procedures, staff wellbeing, monitoring and evaluation, and the physical environment. Below are some examples of these practices and processes.

Interactions and relationships with clients – enacting TIC principles.

TIC principles are enacted in numerous ways. Some examples are listed below.

  • Trauma awareness. With TIC as the foundation of all its work, Aventa addresses trauma awareness in numerous ways, particularly education for staff (and other agencies as well) that emphasizes how common trauma is, how it impacts people and how they may adapt their behaviours in order to cope and survive.
  • Emphasis on safety and trustworthiness. Physical safety is ensured in numerous ways, including compliance with established safety guidelines and accreditation criteria. As a residential addiction treatment facility, physical safety is also assured through security features such as locked doors and security cameras.

Psychological safety and trustworthiness are addressed in many ways. A central focus is on building trusting and respectful relationships. While skills and interventions are important, the connection made between two people helps in the change process, as does demonstrating compassion and an understanding that there is a “why” underlying every sort of behaviour.

Transparency is also important. Clients are told what will happen and what to expect in advance. For example, each step of the intake and admission process, and what the treatment program will entail is explained in advance. This helps them to feel safe:

“We’re really good at trying to explain things in advance, what’s going to happen, and that’s part of that safety thing for the clients as well. They’re telling us they want to be here in a safe, sober environment to do their recovery work. They want to make sure we’re providing that to the best of our ability.” [Capri Rasmussen]

The safety of Aventa staff is also important and is addressed through a culture of caring and staff wellbeing (see below).

  • Opportunities for choice, collaboration and connection to build a sense of self efficacy, self-determination, dignity and personal control, Aventa emphasizes relational practices that help women build safe and healthy relationships with staff, peers in their program, and with their own families. This is an important part of programming that is offered.

Choices and preferences are accommodated wherever possible and safe. This includes, for example, the ability to practice one’s own religious and cultural traditions:

“We operate from that really neutral space where people are encouraged to bring their experiences or culture, whatever is helpful for them – such as accommodating Ramadan, things like that. That’s part of the consistency and compassion.” [Capri Rasmussen]

Through surveys and evaluations, clients are also asked to suggest improvements to the services that Aventa provides.

  • Strengths-based, skill building and empowerment – A central aspect of Aventa’s programming is helping women realize that addiction is often a means of coping with trauma – a way of surviving. This helps to build a more positive sense of self which then supports development of new and healthier coping and grounding skills, greater competence, and more broadly, a sense of hope that they can change, and life can look different.
Poster that reads

The walls in Aventa’s residential building are covered with inspirational quotes like these. Photos by Fraser GermAnn, Community Mental Health Action Plan.

Poster that reads,

The walls in Aventa’s residential building are covered with inspirational quotes like these. Photos by Fraser GermAnn, Community Mental Health Action Plan.

Organizational conditions and processes

Committed leadership, organizational values and a philosophy of care. Leaders at Aventa are firm believers in, and strong champions of GR-TIC. They are also strong advocates for ongoing learning and quality improvement. A philosophy of care document outlines Aventa’s views on trauma informed care and harm reduction. It talks about the “why”, not just the “what” and includes tips for practice. This leadership and philosophy of care grounds organizational decision making and resource allocations, making GR-TIC a consideration in everything that is done.

Hiring practices. Hiring decisions at Aventa are based on the philosophy: “It’s not about a specific degree; it’s about the best fit”. This is based on research showing that the ability to build a therapeutic alliance is central to success with clients. As such, Aventa looks for people who have a positive attitude, the ability to be welcoming and engaging, who have genuine compassion and unconditional regard for others, and the belief that people (and the sector) can change. These qualities or competencies are then matched with other requirements of the job (e.g., clinical skills, professional designation).

Training and ongoing professional development. Strong emphasis is placed on education for staff. Numerous training and professional development processes are in place, including the following:

  • Induction training for new clinical staff.
    • Completion of components of AHS trauma-informed care modules.
    • Completion of online modules developed by Stephanie Covington re: gender-responsive trauma informed care, and clinical care.
    • Several weeks of observation and co-facilitation of process groups based on Covington’s material, and then engaging in ongoing clinical supervision with reflective practice on how they’re moving through and integrating the materials into their process groups.
  • Regular training is offered in three core areas: gender-responsive trauma informed care, addiction, and group counseling. Dr. Covington or her associates have visited Aventa several times to provide training grounded in her GR-TIC research and practice.

Other foundational topics such as ethics, safety, Indigenous awareness and working with diverse communities are addressed annually. Requirements of funders and Accreditation Canada (in order to maintain accredited status) also provide a framework for training content. For example, one funder required that staff to take gender-based analysis training.

Topics of current interest or sector and community issues are also addressed. These topics are identified through conversations with staff as a collective, and individually, and through observation of current issues relating to women with trauma and addiction. Most recently, for example, staff received training related to opioid use.

A half day each month (excluding December and summer) is devoted to training. Staff also take online training. In summer 2019, Aventa staff are trying out some of the online training available through the Crisis and Trauma Resources Institute. They will evaluate these in the fall and decide whether or not to continue with these.

  • Another component of Aventa’s strong education plan is documentation and manuals. A philosophy of care document guides actions and practices. And, there are manuals that set out organizational practices for specific topics such as ethics, managing information, client confidentiality and so on.
  • Training for non-clinical staff. Non-clinical staff also receive a general orientation to the women that Aventa serves and why, boundaries and how to support clients. Clinical staff support non-clinical staff in applying this knowledge.
  • Information about “global topics” as well as community resources and educational opportunities is shared with all staff. For example, for “National Indigenous History Month” and “Indigenous Day”, all staff received an educational email about the Treaty area in which Aventa is situated, community resources and educational opportunities.

Reflective supervision. A core of ongoing practice improvement for clinical staff is clinical supervision – a form of critical reflection. Aventa and has a framework for this that includes three components:

  • Each clinical staff person reports to a clinically trained program manager who does supervision with them.
  • A PhD-prepared clinical supervisor provides weekly clinical supervision in a group format. Staff can bring in scenarios or case consults, or there might be discussions about interventions – and what went well, what didn’t go so well. Staff are vulnerable in this kind of process, but it is a safe space and it works, people learn from one another. As Capri Rasmussen notes,

“For every person who has a question, there’s probably three in the audience that didn’t want to ask it that can learn from it. So, we find that group is very helpful because you’re learning in the supervision whether or not you’re the person with the presenting issue. And we’re a team here. So not individuals in private practice; we want to build that team format.”

  • There is also open supervision time where staff can make one-to-one appointments with the clinical supervisor.
A comfortable meeting space for staff and for clients.

A comfortable meeting space for staff and for clients. Photo by Fraser GermAnn, Community Mental Health Action Plan.

Organizational policies and procedures. Organizational policies and procedures are regularly reviewed to ensure congruence with GR-TIC. Policies, practices and programs that promote healthy connection to children, family members, significant others and the community are an important part of this. This is resonant with the relational base of GR-TIC for women.

Culture of caring and staff wellbeing. Aventa has a staff wellness strategy, and it is recognized that the principles of TIC are also important for staff. The impact of vicarious traumatization for staff is well understood, so supports for prevention and for post-incident are available. Strong emphasis is placed on self-care and “doing your own work” around one’s own traumatic experiences. Alongside that is building a strong and cohesive team. At the core is a culture of respect, caring about the work, caring about each other, having time for training, and having fun together. There are several “Wellness Wednesdays” each year. One of the most recent Wednesday activities was at the luge track at Calgary Olympic Park – a good bonding experience! Others have included meditation workshops and movies. These activities allow staff to get to know each other on a deeper level, strengthening the sense of team. Staff wellbeing surveys are also conducted as part of Aventa’s accreditation with Accreditation Canada.

Ongoing learning and quality improvement. Aventa has strong leadership commitment toward sustaining a culture of ongoing learning and quality improvement. Extensive work around monitoring and evaluation is done. Aventa voluntarily sought and received accreditation from Accreditation Canada in 2011. The organization has “Exemplary Status” from Accreditation Canada. This provides an external validation of the quality of the organization and the care it provides.

[See the story, “Sustaining a culture of continuous learning at the Aventa Centre of Excellence for Women with Addictions” for more information about this [insert link].

A welcoming and safe physical environment. Aventa has taken great care to design physical spaces that are safe, warm and welcoming and feel more like a home than a facility. The buildings are safe, clean, bright and pretty. There are “proper beds” covered with quilts. The walls are covered with art and inspirational quotes. The floors are easy to clean, but they are not “institutional” – they look like a floor you might have in your home. There are nooks and crannies where clients can be alone; and there are communal spaces where they can be together.

Clients have expressed their appreciation of this:

“I hear from a lot of women that talk about when you walk into this place, you feel the care, you feel the welcoming environment… and I hear all the time that Lisa, our receptionist, makes people feel safe and comfortable.” [Capri Rasmussen]

Surveys are done with staff and clients in order to identify what people like about the current environment and what else they would like: “If we could do something different, what would that look like?”. The feedback received has been used to make changes.

Gender-responsive, trauma-specific clinical care

While GR-TIC forms the ground in which all care and services are provided at Aventa, trauma-specific care is also provided by clinical therapists. While anyone can “do” trauma-informed care, trauma specific care requires training and clinical expertise.

For this clinical work, Aventa uses Covington’s model known as “Women’s Integrated Treatment” (WIT). WIT is grounded in theories of addiction, trauma and women’s psychological development. WIT has been shown to result in reduced substance use, less depression and fewer trauma symptoms, including anxiety, sleep disturbances and dissociation[vi].

Specifically, two of Covington’s curricula are used: “Helping Women Recover” and, “Beyond Trauma: A Healing Journey for Women”. These are group process-based and the content is holistic. For example, the content of “Helping Women Recover” focuses on self, relationships, sexuality, and spirituality.

Outcomes

An extensive array of monitoring and evaluation strategies are employed to assess the success of programs and services. The organization produces an annual report of its findings and shares the highlights publicly on its website. From the 2017-2018 report, a sampling of reported outcomes includes:

  • 488 admissions within the reporting period
  • 94% reported having a better understanding of their addiction
  • 97% reported that the treatment program had provided them with skills that are useful for their recovery
  • 93% reported they are better able to manage their emotions
  • 88% reported they are better able to manage their trauma
  • 93% reported feeling better about themselves
  • 97% reported having an increased sense of hope for their future

Clearly, Aventa’s programs and services are generating many beneficial outcomes for the women they serve. Thousands of women have crossed that threshold into Aventa’s embrace, worked with other women and Aventa’s staff, and have found light, love, hope, and strength. This is evidenced not only in the statistics noted above, but in testimonials shared by former clients:

“I came here broken and you helped me pick up the pieces of my life. My future looked bleak and you helped clear the fog in my head. My heart was full of sorrow, but as I leave this place, I am full of light and love. You’ve given me back my life with hope for the future.” [Cathy B., Aventa website]

“The last four and a half months have saved my life. I came to this centre broken and full of self-loathing. I truly believe this program was one of the biggest tools in not only picking up the pieces of myself and my life, but putting them back together in a way that was stronger than I could have ever imagined.” [Ashley F. Aventa website]

When I came to Aventa I was lost, broken and alone… I was greeted with acceptance and understanding. The program helped me open up, let go and grow in a safe environment. I am leaving Aventa a strong woman, ready to take on the challenges and the future.” [Rachel F. Aventa website]

Aventa is an awesome program for women suffering from addictions and trauma. I felt like it got more to the root of my problems and why I was drinking so I didn’t have to deal with my feelings. That was what I hadn’t dealt with in other co-ed treatment facilities.”

[“Linda” in, Aventa Outcomes and Community Impact Summary, 2017-2018 fiscal year, online.]

Aventa leaders’ advice for others who want to integrate TIC and GR-TIC into their organizations

When asked what advice they would offer to other organizations wishing to implement trauma informed care, Aventa leaders offered the following:

  • TIC is an organization-wide effort – an integrative approach; it must become embedded into everything that is done: “You can’t simply read a book and send staff off to training if you want to implement TIC”. Training is not enough.
  • Implementing TIC is like introducing any kind of change. This includes assessing what needs to be changed and why, and then looking at the resources that exist to help with the change.
  • It might be helpful to assess existing practices. For example, the BC Centre of Excellence for Women’s Health’s Trauma Informed Practice Guide (see its Appendix 2) includes an organizational assessment tool.
  • Start with training but don’t stop there.
    • Find a training/approach that works for your organization and provide that to staff.
    • Ensure there is a way to sustain this training as new staff come onboard.
    • Evaluate and adapt or refine your training approach and bring in other aspects as needed.
    • Support training with other organizational supports such as clinical supervision and supportive policies to reinforce and sustain good practices.
  • Look at your policies and make them more trauma informed; monitor this over time.
  • Dedicate resources (people, time, money) and supervision to ensure successful implementation of TIC.
    • Capitalize on whatever information and resources are available and free. There are several good Canadian-based toolkits, some of which are listed at the end of this story. Capitalizing on these would be helpful, as would talking with other agencies about what they’re doing. This might be as simple as having staff complete some or all six of AHS trauma modules, and then building in training each month or quarter, then building in supervision.
    • Consider developing a community of practice around TIC or create some other way of working on TIC collectively.
  • Endorse and resource ongoing monitoring, learning and adaptation – Aventa has an underlying philosophy of continuous quality improvement. People here are not afraid to try new things and if something doesn’t work, try to understand why, then try again. This culture helps ensure that learning is occurring, and adaptations are made as needed to continue to improve the care and services that are provided. [See the story, “Sustaining a culture of continuous learning at the Aventa Centre of Excellence for Women with Addictions” [insert link].
Aventa Centre building photo

Photo by Fraser GermAnn, Community Mental Health Action Plan.

Intrigued? Encouraged? Want to make similar changes in your practice or organization? See Shared Wisdom for a smorgasbord of ideas for how you can make it happen.

Resources

The Aventa Centre of Excellence for Women with Addictions has an informative website that is well worth exploring.

Trauma-informed care

Alberta Health Services. Trauma informed care modules. https://www.albertahealthservices.ca/info/page15526.aspx

Alberta Health Services. Why Welcoming is Important handout: https://www.albertahealthservices.ca/assets/info/amh/if-amh-ecc-why-welcoming-is-important-qrs.pdf

Arthur, E., Seymour, A., Dartnall, M., Beltgens, P., Poole, N., Smylie, D., … Schmidt, R. (2013). Trauma-informed practice guide. Vancouver, B.C: BC Provincial Mental Health and Substance Use Planning Council.

Barnett Brown, V. 2018. Through a trauma lens. Transforming health and behavioral health systems. New York: Routledge.

Bloom, S. & Farragher, B. 2013 Restoring sanctuary. A new operating system for trauma-informed systems of care. New York: Oxford University Press.

Canadian Centre on Substance Abuse Trauma Informed Care

http://www.ccsa.ca/Resource%20Library/CCSA-Trauma-informed-Care-Toolkit-2014-en.pdf

Harris, M., & Fallot, R. D. (2001). Envisioning a trauma-informed service-system: A vital paradigm shift. New Directions in Mental Health Services, 89, 3-22.

Manitoba Trauma Information and Education Centre (MTIEC). 2013. Trauma-informed: The trauma toolkit (2nd ed.). Winnipeg, MB: Author.

Manitoba Trauma Information and Education Centre: http://trauma-informed.ca

Poole, N., & Greaves, L. (Eds.). 2012. Becoming trauma informed. Toronto, ON: CAMH.

SAMHSA. 2013. TIP 57 Trauma-informed care in behavioral health systems. Author.

Gender-responsive trauma informed care

BC Centre of Excellence for Women’s Health. Online. Trauma, Gender, Sex Informed Approaches to Substance Use videos: http://bccewh.bc.ca/featured-projects/traumagendersubstance-use-project-2/tgs-videos/

Canadian Women’s Foundation. Online. The facts about gender-based violence.

Covington, S. (2012). Curricula to support trauma-informed practice with women. In N. Poole & L. Greaves (Eds.) Moving the addiction and mental health system towards being more trauma-informed. Toronto: Centre for Addiction and Mental Health (CAMH).

Covington, S. (2008). Women and addiction: A trauma-informed approach. Journal of Psychoactive Drugs, SARC Supplement 5, 377-385.

Covington Curriculum: https://www.stephaniecovington.com/books-and-curricula.php

Schmidt, R., Poole, N., Greaves, L., & Hemsing, N. (2018). New Terrain. Tools to integrate trauma and gender informed responses to substance use practice and policy. Vancouver: BC Centre of Excellence for Women’s Health.

Endnotes

[i] Schmidt, R., Poole, N., Greaves, L., & Hemsing, N. (2018). New Terrain. Tools to integrate trauma and gender informed responses to substance use practice and policy. Vancouver: BC Centre of Excellence for Women’s Health.

[ii] Covington, S. (2012). Curricula to support trauma-informed practice with women. In N. Poole & L. Greaves (Eds.) Moving the addiction and mental health system towards being more trauma-informed. Toronto: Centre for Addiction and Mental Health (CAMH).

[iii] Aventa Centre of Excellence for Women with Addictions.(2018). Annual report 2017-2018. Author, pg. 11. Note also that Stephanie Covington also has a curriculum for men who have experienced trauma.

[iv] Covington, S. (2008). Women and addiction: A trauma-informed approach. Journal of Psychoactive Drugs, SARC Supplement 5, 377-385.

[v] It is also an exemplar of an organization that has embraced the power of ongoing learning and improvement to optimize services and outcomes. See the story, “Sustaining a culture of continuous learning at the Aventa Centre of Excellence for Women with Addictions” [insert link].

[vi] Covington, S., Burke, C., Keaton, S., & Norcott, C. (2008). Evaluation of a trauma-informed and gender-responsive intervention for women in drug treatment. Journal of Psychoactive Drugs, Suppl 5; 387-398.

2021-09-28T02:08:39+00:00Shared Wisdom|

From enforcement to coffee and compassion: Trauma informed care at Edmonton City Centre

Have you ever had the feeling that things “aren’t just quite right” – that you could be doing things differently and getting better results? Have you ever experienced a convergence of events that made you realize things needed to change? This is a story about these very experiences – and how critical reflection, courageous action, and linkages between a large business and community-based mental health and addictions agencies has generated ground breaking changes in downtown Edmonton.

Sometimes an epiphany shatters our vision of what is right and doable. At Edmonton City Centre, “security” means something entirely different today than it did a few short years ago. Arrests of “trespassers” are down. Inclusion, respect, a listening ear, kind words, linkages to services, and donations of coffee, food and clothing to those who could be considered “vulnerable” are up. What’s happening at Edmonton City Centre has the potential to transform hundreds, if not thousands of lives, yet the “technology” is simple and something anyone can provide: respect, compassion and an understanding of how trauma can impact our lives.

A moment of insight made Pam Brown, Safety and Security Manager for Oxford Properties at Edmonton City Centre, realize that people seeking shelter and safety in the mall shouldn’t be treated with scorn and disdain, nor should they be arrested and criminalized. Rather, they should be seen, heard and respected as valued customers of the mall and part of the social fabric of the downtown community. And, as part of that community, Edmonton City Centre should be a supportive environment for all its members, including those navigating the challenges of serious mental illness and/or addiction, homelessness, and poverty.

Pam Brown, Safety & Security Manager, and Sean Kirk, General Manager, Oxford Properties Group, Edmonton City Centre

Pam Brown, Safety & Security Manager, and Sean Kirk, General Manager, Oxford Properties Group, Edmonton City Centre

Following that insight, Oxford Properties shifted from a policing and enforcement model of mall security to a compassion- and trauma-informed approach. In the first year of doing so, arrests in the mall went from 800 in a year, to 30. Instead of landing in court or jail, vulnerable people are now being seen, heard, respected, included and connected to addiction, mental health and social services. They know that City Centre’s security agents are there to support them, not to make their lives more difficult. Brown’s spark of insight yielded an innovative approach that is compassionate and trauma informed and that has exponentially expanded the reach of traditional addiction and mental health services. This approach has created informal links to addiction, mental health and social services, and, in and of itself, promotes mental health and wellbeing. All of this is delivered in a shopping mall – a non-traditional setting – by informed lay persons using minimal resources within existing structures, and through business – agency partnerships.

Oxford Properties Group owns and operates Edmonton City Centre and some 50 million square feet of real estate in Canada, including numerous shopping malls in Alberta. More than 1.5 million people work in, shop at, live in or visit one of Oxford’s properties around the world, every day.

Brown’s advice? This is something anyone can do: “Just take the first step and see what happens. What’s the worst that could go wrong? And taking that step gives others permission to do it too.”

One million visitors pass through the doors of Edmonton City Centre every year. Many of those guest have experienced or are experiencing significant trauma in their lives. They may be living with the scars of adverse childhood events (ACES) or they may have fallen on hard times, unable to find work or housing; many are living with serious mental illness and its constant and debilitating companions – stigma and discrimination. And, many rely on substances to ease the pain of it all. For these people, the mall is not only a place to shop or get a coffee; it is a sanctuary.

Those who don’t understand, haven’t walked in their shoes, call them “zombies” or “weirdos” give them a wide berth, rush past, pretending not to see. But Brown, Oxford Properties and Paladin Security see them as human beings with a story, perhaps a harrowing life path that none would envy. The last thing they need is to be arrested. The first thing they need is to be seen as worthy and valuable human beings – and that might just be enough to save their lives.

Brown has worked at City Centre mall for 36 years. Over that time, there have been 20 deaths by suicide in the mall. In various roles over the years, she heard about these deaths and in some cases, wrote reports about them. But, she never allowed these tragedies to “sink in”:

I developed this shell and it’s like, ‘Okay, I didn’t make this choice’ and I’d offer up a prayer and move on.”

But, a convergence of events and insights, including three deaths by suicide at the mall within 18 months and another critical incident involving a vulnerable person made Pam realize something needed to change – that there is a better way of doing things – that there must be care and compassion and an understanding that there might be trauma somewhere. These are human beings who need someone, and that it might simply be a kind word that saves someone’s life:

Pam: “There’s got to be care and compassion. We’ve got to understand that there may be trauma somewhere … we don’t know their story and we have to try and manage this first with care, compassion, customer service, and if that doesn’t work, then you go into the policing model kind of thing…I realized we’re in the middle of a business centre – it’s a shopping centre, it’s not social services. But we should first think, ‘This is a human being who needs somebody, and it might be a kind word that saves their life’, and so that person may be very vulnerable.”

Pam also realized that at some point, any one of us might be vulnerable – herself, people on her security team, business owners in three-piece suits. In particular, she noted that some of Oxford’s security agents had attended all three of the recent deaths by suicide and might be vulnerable:

“But then, our security agent might be vulnerable as well…so we have to teach the security team and the whole property – we have to teach them that when you’re feeling vulnerable, you might not be the right person to approach this, or you may be the perfect person to approach this, but you have to know who you are.“

Around the same time, a successful enforcement effort to curb illegal activity in the mall was wrapping up. All things combined, Pam recognized it was time for her team to shift out of enforcement mode toward a support capacity – making the mall a safe and inclusive place for all of its patrons, including in particular its more vulnerable ones:

“Let’s be the good guys because we were the bad guys for years here. So, let’s be the good guys now. Let’s change that around; let’s start seeing what we can do. Let’s see if we can provide a little bit of support capacity in some way.”

But, how to do that? Not knowing exactly where or how to start, she began simply by calling various agencies for support:

“I had no idea how I was going to do it at the time, but you know, we had to figure it out somehow –even if it was to sit and talk with people for a few minutes and then phone somebody. And, we did a lot of phone calling in the beginning – the police Mental Health Unit, CMHA, social service agencies.”

And, she found Jenny Jones, Director of Crisis Support at The Support Centre, to talk with Oxford’s security staff about how to identify signs of suicidal intention – a very good first step. What “compassion-focused” mall security looks like: Safety, trusting relationships and linkages to formal services With a new vision for compassion-focused security in mind, a practice shift was needed. The existing security service provider had an excellent record of enforcement but struggled with the shift to a support role. When contract renewal time came, Oxford Properties set out new requirements aligned with a compassion-focused security model. Paladin Security rose to the top of candidates and was selected to take on the work. They understood the need for a compassionate approach from the beginning:

Pam: “Paladin walked in and they got it from the very beginning… They hired the right people to provide customer service and right off the bat, they started working with our teams on the floor and our Central Service people.”

From a compassion-based model, the approach is to understand that there may be trauma in peoples’ lives, to see people, to connect, to engage in conversation, listen, build rapport and trust, and whenever appropriate and possible, link to helpful supports. If these efforts fail to calm disruptive behaviours, then the person may be escorted by the security agent out of the building, oftentimes to appropriate and nearby services. Every effort is made to avoid arrests and criminalization except in the case of illegal activities.

Pam: “We’ve moved from arresting everybody who is trespassing to walking them out. For two reasons. One is for somebody who is having a bad day – who has mental health issues or trauma of some kind –they shouldn’t have a criminal record. We don’t want to give them a criminal record – we try to avoid criminalization; and the other thing is if people have a severe mental illness, how can you arrest them?”

Arrests are not only an insult to dignity and wellbeing; they are a double whammy for people who struggle to navigate the court system. Some have wound up in jail and experienced the associated downward spiral that often follows, simply because they lacked the means to appear in court for “trespassing” charges at the appointed time.

Edmonton City Centre mall

Edmonton City Centre. Photo courtesy of Oxford Properties Group.

With the new approach to security in place, security agents are developing trusting relationships with members of the mall’s more vulnerable population. The mall is viewed by many now as a safe space even safe enough to share thoughts of suicide. And the security team has become a connector – an informal linkage to formal addiction, mental health and social services that are in close proximity to the mall. Pam describes the kind of encounters that occur now:

“We have to talk to people and say, ‘Listen, you know, tell me what’s going on. People are really upset by the fact that you’re shouting… Can I help you?’ And so, for people that are displaying signs “of trauma, we try to approach them and let them know that we see them. And, what we’re finding is that when they know we see them, we know when they’re having a bad day… Most of the time they’ll nod, and they’ll say ‘Hi’, but on some days you know that life has just gotten out of hand and they’re not that happy. But they know they can trust us. So, we’ve got quite a few people who come for coffee and come for their meals and maybe a little bit of shopping and they feel safe enough to do that because they know that we’ll take care of them.

There’s a number of people who approach our security team to say, ‘I’m going to take my life today’, and we know they’re looking for help. They’re at their wit’s end, so we get them to WIN House or we get them to whatever agency we can, and if they’re not accepting that kind of help, we usually call the police because it’s probably more than we can handle… So there’s quite a few of those conversations.I think this is because the community knows that that conversation can be had here… while we aren’t a social services agency, I think people feel like we’re less judgmental than other locations, so they feel safe coming here.”

Paladin’s security team, alongside Oxford’s front line workers, also provides more tangible forms of support. They gather donations such as winter coats and shoes and second hand items in good form and offer these to mall patrons in need of such things. They also offer coffee and meals and have the discretion, under Oxford Properties’ policy, to spend up to $500 to meet customer needs.

Pam: If somebody comes in without a pair of shoes, we go through our box first to see if there’s some that will fit them – coats, mitts, hats, gloves – because people steal other peoples’ shoes downtown, so they come here thinking maybe they can warm up. They don’t ask for a pair of shoes, but we see them without shoes and we’ll see if we’ve got a pair that works for them. One of our agents saw a guy without shoes, realized he had big feet and probably wasn’t going to find anything, so [our agent] took his expensive shoes off, gave them to this guy and bought another pair for himself.

These are frontline people coming up with this…. It was one of the Paladin people that said, “When ‘Roll up the Rim’ comes, we should just save all the free doughnuts, the muffins, the coffees and hand them out if somebody needs coffee and a muffin’…. We’ll buy coffee or a meal and we reimburse people who do that. Very compassionate people… all that was at a grassroots level.”

This generosity has had some very welcome yet unanticipated consequences for the Edmonton City Centre security team – it has allowed them to express their compassion, generosity and humanity. It is a better feeling to be the “good guys”, to get to know people and to be able to express their humanity and generosity on the job, rather than being “enforcers”

Pam: “It was like they were waiting for permission to be good people, they are innately good people, but they just wanted to show that.” And while it can be frustrating at times to walk people out of the building, it is much easier than arresting and criminalizing them. By helping people rather than making their lives more difficult, the security agents feel better about themselves.”

Pam: “It’s easier on our agents – maybe a lot more frustrating – but it’s easier on their psyche when they’re able to walk somebody out …rather than arrest them and criminalize them, and make their day worse than it already is… You develop a stronger team when they see the individuals they’re dealing with are human beings and they make choices that are based on those individuals being human beings – and not just some kind of policy. It’s like when you go to the doctor and he sees you as a symptom rather than a human being. Well, the behaviour is a symptom of something that’s happened … that person needs to be treated like a person… it’s easier on the agents. It makes their life better. They feel better about themselves when they get home.”

Paladin Security also recognizes that initiatives like this help grow careers. Since most young security agents have their sights on a career in policing, having this in their resumé enhances their advancement prospects for two reasons. This is because they know how to take care of their own mental health; and second, they also recognize there is a better way of approaching situations involving vulnerable and marginalized people. They can support individuals in ways that don’t involve “policing” by referring individuals to the agency that can serve them best.

Of course, this is not to say that Edmonton City Centre is now a place where “any behaviour goes”. To the contrary, security agents strive to be good citizens, good representatives of the property, and good members of and partners with the downtown community. As such, they continually balance compassion with enforcement as needed to ensure illegal behaviours are squelched, and that the mall is a pleasant and safe space for everyone. In this way, they serve mall customers, tenants and vendors, but also the broader community of which the mall is a part:

Pam: “As long as we keep behaviour within the expected social norms, then we’re serving our tenants and our vendors and we’re serving our community, so that’s what we try to do.”

Paladin Security also sees this as a far-reaching initiative. Having numerous contracts in the downtown core, they often see many of the same people who frequent Edmonton City Centre, thereby extending their compassion-based approach beyond the mall.

Formalizing the approach: Compassion to Action training

Early educational efforts to help security staff recognize suicidal intentions were a helpful and important starting point, but more was needed – particularly that people need to also be able to take care of their own mental health while responding and afterward. Oxford Properties and Paladin Security see the need for a proactive approach that will help prevent development of mental health problems for their own staff who attend traumatic events:

Pam: “I’m still not satisfied that we’re doing enough for the young security team because they are young and right now they all think they’re invulnerable – they’re going to see this stuff and it’s never going to bother them – but as you grow older you kind of realize that maybe it does bother you because you never examined it and never came to terms with it and one day it pops up.”

Given the deaths by suicide at the mall, Edmonton Police Services invited Pam to sit as a business person on the Edmonton Suicide Prevention Strategy Implementation Planning Committee. Here, she became an ambassador for business, and she connected with numerous mental health, addiction and social service agencies. And it’s where she met David Rust, Project Lead for the Community Mental Health Action Plan.

Through discussion with David and others on the Committee, the idea of developing a training program for security staff and, ultimately business owners in the mall, began to grow. Now, a more formalized training plan has been developed and tested. Oxford Properties collaborated with experts in trauma, addiction, mental health literacy, treatment and training and the Community

Mental Health Action group to design and deliver a mix of online and classroom training called “Compassion to Action”. Training content was developed collaboratively by Line Perron, Training Consultant with the Community Mental Health Action Plan, with Oxford Properties and Paladin Security. This one-day training focuses on moving from “protection to connection” and trauma informed care (TIC), which encourages understanding people through the lens of “What happened to you?”, rather than“What’s wrong with you?”. TIC also emphasizes understanding how what has happened to people shapes who they are today and how they behave. This includes learning about adverse childhood experiences (ACEs), what to look for, how to create an environment of engagement, and how to connect with people who have experienced trauma in their lives. Practical advice about connecting with local agencies is also included. Finally, the training helps participants learn how to keep one’s mind “solid” when responding to traumatic events such as deaths by suicide; how to protect and maintain one’s own mental health; and, how to ask for help when needed.The immediate target audience is the security team at Edmonton City Centre, but the ultimate aim is to provide training and information to all tenants of the mall with the intention of making the mall a welcoming, safe, inclusive, trauma informed environment.

Pam: “All of our tenants need to know what our security agents know because there’s a barrier for them too – they see homeless people, people with addictions, people with mental illness amongst all the regular people in their stores – having the information available online and in class for them as well [will help them] understand that this is what our society is comprised of – and that you can’t ignore these people; they don’t go away.”

David Rust believes this training will help shift the culture around mental health and addiction to one of greater compassion, inclusion and connection in Edmonton. It will change how people are welcomed, engaged and supported at Edmonton City Centre. Rust anticipates vulnerable persons will be treated better and be less victimized, and that in fact, this appears to be happening already:

David Rust: “People in the mall will now be treated better or even less victimized – you can see that already… I’d love to see the same kind of engagement from someone that works in a watch shop in the mall – that they can begin to engage the mall’s vulnerable persons differently, too.”

Ripple effects…

Edmonton City Centre mall interior.

Edmonton City Centre. Photo courtesy of Oxford Properties Group.

Edmonton’s Downtown Business Association recently asked Pam Brown to speak about the changes the mall has made. What she shared with them was that Oxford Properties is changing the community. And Oxford is continuing its commitment to the community, most recently through partnership with the City of Edmonton on its’ RECOVER: Urban Wellness Plan.

Pam: “As an offshoot of this project we have also entered into a project with the City of Edmonton. We are seeking alternate methods of engaging the community, involving all the Oxford staff and not just the security providers, so that the vulnerable have more to do in their day giving them something more to look forward to than just the same routine each day. This collaboration with the City of Edmonton truly underscores our commitment to the community and we are excited to see what we can accomplish.”

Oxford is also finding that other corporations are now wanting to employ their security agents:

“What we’re seeing right now is that a lot of other corporations not only want security agents wearing our uniform – and it’s an Oxford uniform – they want the people because there’s presence, there’s compassion, there’s empathy and care.”

Given the millions of people who pass through the mall each year, and even more powerfully, the vast number of major retail and office spaces owned by Oxford Properties Group in Alberta and around the world, the potential influence of this initiative is staggering in its potential.

Trauma-Informed Care Resources

Alberta Health Services. Trauma informed care modules. https://www.albertahealthservices.ca/info/page15526.aspx

Alberta Health Services. Why Welcoming is Important handout: https://www.albertahealthservices.ca/assets/info/amh/if-amhecc-why-welcoming-is-important-qrs.pdf

Arthur, E., Seymour, A., Dartnall, M., Beltgens, P., Poole, N., Smylie, D., … Schmidt, R. (2013). Trauma-informed practice guide. Vancouver, B.C: BC Provincial Mental Health and Substance Use Planning Council.

Barnett Brown, V. 2018. Through a trauma lens. Transforming health and behavioral health systems. New York: Routledge.

Bloom, S. & Farragher, B. 2013 Restoring sanctuary. A new operating system for trauma-informed systems of care.New York: Oxford University Press.

Canadian Centre on Substance Abuse Trauma Informed Care http://www.ccsa.ca/Resource%20Library/CCSA-Trauma-informed-Care-Toolkit-2014-en.pdf

Harris, M., & Fallot, R. D. (2001). Envisioning a trauma-informed service-system: A vital paradigm shift. New Directions in Mental Health Services, 89, 3-22.

Manitoba Trauma Information and Education Centre (MTIEC). 2013. Trauma-informed: The trauma toolkit (2nd ed.). Winnipeg, MB: Author.

Manitoba Trauma Information and Education Centre: http://trauma-informed.ca

Poole, N., & Greaves, L. (Eds.). 2012. Becoming trauma informed. Toronto, ON: CAMH. SAMHSA. 2013. TIP 57 Trauma-informed care in behavioral health systems. Author.

2021-09-27T22:58:23+00:00Shared Wisdom|

On the Agenda

This series of videos, presentation slides and supporting materials can help trainers, team leaders, manager or others to pave the way for discussions and action aimed at developing a psychologically healthy and safe workplace. The 13 psychological workplace factors have been identified, through a large body of research, as the main areas of concern related to psychological health and safety in the workplace, offered through WSMH. (1-2 hours per module)

Competency: Knowledge, Behavioural

Audience: Management and Staff

Cost: Free

Being a Mindful Employee: An Orientation to Psychological Health and Safety in the Workplace

This free online training program offered by CCOHS is about psychological health and safety in the workplace. The goal is to help an employer understand the 13 psychosocial workplace factors from the National Standard of Psychological Health and Safety in the Workplace and what you can do to help yourself and others in the workplace. (75 minutes)

Competency: Knowledge

Audience:  Staff

Cost: Free

Canadian Centre for Occupational Health and Safety

This website offers a Mental Health E-course package. This package of E-courses is intended to help employers understand mental health issues in the workplace. Modules include: Mental Health Awareness; Health and Wellness; Signs, Symptoms and Solutions; Psychologically Healthy Workplaces; Communication

Competency: Knowledge

Audience: Management and Staff

Cost: $169

Gender Based Analysis Plus. GBA+

SWC has an analytical process used to assess how diverse groups of women, men and non-binary people may experience policies, programs and initiatives. It acknowledges the need to go beyond biological (sex) and socio-cultural (gender) differences and considers many other identity factors,like race, ethnicity, religion, age, and mental or physical disability. (2 hrs.)

Competency: Knowledge, Behavioural

Audience: Management and Staff

Cost: Free

Working Through It

This can be used in workplaces: 1) As a private resource for individuals who may be struggling with health, personal, financial or workplace issues, and are looking for practical strategies and inspirational stories to help them cope. In this section you can learn how to share this opportunity with those who may benefit. 2) To provide awareness education for supervisors, managers, union stewards or other leaders whose responsibilities include supporting or managing employees who may have mental health issues. From WSMH (duration not specified)

Competency: Knowledge

Audience: Management and Staff

Cost: Free

Certified Psychological Health and Safety Advisor

This ground-breaking certification training program is for individuals and consultants who want to help organizations improve psychological health and safety in their workplaces or implement the National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard). (2 day)

Competency: Knowledge, Behavioural, Activating

Audience: Management (large organizations)

Cost: $1500

Mental Health Works

Mental Health Works provides capacity building workshops on workplace mental health to both employers and employees. Their approach is person centred, evidence based, and solutions focused. They meet the needs of workplaces for mental health training in three essential areas. Core Workshop (1 day)- provides participants an in depth understanding of mental health and mental illness. It is made up of four modules: Mental Health at Work, Mood and Depression, Stress and Anxiety, and Psychological Health and Safety. Focus (1/2 day); Essentials (1 hour)

Competency: Knowledge, Behavioural, Activating

Audience: Management and Staff

Cost: Not indicated

Developmental Pathways of Addiction and Mental Health

This AHS Mental Health and Addictions Learning Series offers a web-based interactive e-Learning curriculum designed to support healthcare providers to enhance their practice working with children, youth and their families experiencing addiction and mental health issues. The focus of these modules is to help health providers recognize and reduce significant stressors for vulnerable children and their parents, enhance their resilience, and increase their coping skills. In providing mental health support to children and youth the focus needs to shift toward health promotion and disease prevention, rather than just treating the impact of mental health disorders. (11 modules, 1.5-2 hours each)

Competency: Knowledge, Behavioural

Audience: Children / Youth

Cost: Free

CRI Trauma Informed Certification

Offered locally through ECDSS Community Resilience Initiative (CRI) course highlights CRI’s capacity-building framework for building resilience, that describes community’s learning and movement from theory to practice and how to implement evidence-based strategies into action. The training includes three groups of topics: the NEAR sciences, a cluster of emerging scientific findings in the fields of Neuroscience, Epigenetics, ACE Study, and Resilience; Brain States, the critical transition from Knowledge to Insight; and ROLES, CRI’s signature training on Recognize, Observe, Label, Elect and Solve, core strategies thattake us below the tip of the proverbial iceberg. (1 day)

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: TBA

Trauma Informed Care: Translating Trauma Informed Principles into Practice

This introductory training acknowledges the prevalence and significant impact of trauma in an individual’s life and aims to inform service providers how to apply a trauma-informed lens to their current practice. This workshop will define and describe the six main trauma-informed principles outlined in the literature and will focus on how to translate these principles into practice. (2 day)

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: $220

Question, Persuade, Refer Suicide Prevention Training (QPR)

Offered through the Question, Persuade, Refer Institute, this course teaches participants: How to Question, Persuade and Refer someone who may be suicidal; How to get help for yourself or learn more about preventing suicide; The common causes of suicidal behavior: The warning signs of suicide; How to get help for someone in crisis (1 hour)

Competency: Knowledge

Audience: All

Cost: $29 USD

Suicide Prevention, Risk Assessment and Management (SPRAM)

AHS Learning Series course introduces four (4) distinct character profiles, each depicting a pathway of care within a unique practice setting (i.e., mental health inpatient, corrections etc). Upon completion of the selected pathway, the learner will be provided with a Certificate of Participation (6 CME /CEU study credits). (7 modules)

Competency: Knowledge

Audience: All

Cost: Free

Suicide Intervention Training (Lethbridge Family Services)

The core of the training is the three-step RAP Model for intervention, which involves rapport building, assessing the individual, and planning for intervention. Focus on skills in active listening, conducting a standardized risk assessment, and developing safety plans with individuals at risk. Additional content on specific populations and community resources. (2-day)

Competency: Knowledge, Behavioural, Activating

Audience: ALL

Cost: Confirm cost with organization

Strategies for Living (Grande Prairie)

This is an interactive workshop offered by the Suicide Prevention Resource Centre in Grande Prairie, for people working with youth. This one-day workshop discusses biological risk factors, vulnerabilities, and understanding suicidal thoughts and behaviour in the adolescent population. (1-day)

Competency: Knowledge, Behavioural, Activating

Audience: Youth

Cost: $100

Walk With Me

Offered by the Centre for Suicide Prevention, this is intended for Indigenous caregivers working in Indigenous communities. This workshop draws heavily on Indigenous culture and tradition as it seeks to take participants through the cycle of suicide grief. Walk with Me takes the participants on a journey from the past, to the present and looks to the future; it creates a context for people to examine where they are in the grief cycle and how they can move forward to hope. (1-day)

Competency: Knowledge, Behavioural, Activating

Audience: Indigenous

Cost: $150

 

Little Cub

This Centre for Suicide Prevention workshop is a discussion-based workshop examining suicide prevention in Indigenous children and communities. The workshop draws heavily on storytelling and oral tradition. It begins by recognizing the unique precipitating factors of suicide in Indigenous communities and moves through to identifying risk and protective factors in children 12 years of age and younger. The workshop finishes by empowering participants with knowledge and tools to transfer the care of a child at risk of suicide to a community based resource person. ( 1 day)

It is recommended that participants of this workshop also attend the 2-day ASIST workshop for skills-based training.

Competency: Knowledge, Behavioural, Activating

Audience: Indigenous / Children

Cost: $150

 

Tattered Teddies

An interactive knowledge-based workshop which examines warning signs in a child and explores intervention strategies through stories and case studies. Intervention approaches build on the skills taught in the Applied Suicide Intervention Skills Training (ASIST) as they apply to children. (half day)

Competency: Knowledge, Behavioural, Activating

Audience: Children / Youth

Cost: $100

 

Suicide to Hope

This workshop is designed for clinicians and caregivers working with those recently at risk of and currently safe from suicide. It provides tools to help these caregivers and persons with experiences of suicide work together to develop achievable and significant recovery and growth goals. The focus of this workshop is recovery and growth for persons recently at risk of and currently safe from suicide, including people who experience recurring thoughts and feelings of suicide. This workshop is owned by LivingWorks Education and is delivered in Alberta by Centre for Suicide Prevention. (1 day)

Competency: Knowledge, Activating, Behavioural

Audience: All

Cost: $195

 

safeTALK

This workshop emphasizes the importance of recognizing the signs, communicating with the person at risk and getting help or resources for the person at risk. It uses the Tell Ask Listen and KeepSafe model. This workshop is owned by LivingWorks Education and is delivered in Alberta by Centre for Suicide Prevention. (half day)

Competency: Knowledge, Activating, Behavioural

Audience: All

Cost: $95

 

Question, Persuade, Refer Suicide Prevention Training (QPR)

Delivered provincially through Imagine Institute for Learning, this Gatekeeper course is a half-day course aimed at building confidence in how to question, persuade and refer someone who may be suicidal. Participants will learn the warning signs for suicide and increase their knowledge around suicide. They will also increase their confidence in engaging in active listening, asking clarifying questions and making appropriate referrals.

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: $45

 

ASIST Tune-Up Recertification

This refresher workshop is for people who hold a valid ASIST certificate. This workshop extends a person’s ASIST certification for a further two years and offers participants an opportunity to review the Pathway for Assisting Life Model, discuss successes and challenges in using the model, and clarify concepts covered within the model. This workshop is owned by LivingWorks Education and is delivered in Alberta by Centre for Suicide Prevention. (3.5 hours)

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: $100

 

Applied Suicide Intervention Skills Training (ASIST)

Offered through the Centre for Suicide Prevention two-day interactive workshop in suicide first aid. ASIST teaches participants to recognize when someone may have thoughts of suicide and work with them to create a plan that will support their immediate safety. Although ASIST is widely used by healthcare providers, participants don’t need any formal training to attend the workshop—anyone 18 or older can learn and use the ASIST model. (2 days)

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: $210

 

Healthy Minds Healthy Children

This AHS website contains current online and archived courses. Current issues in child and adolescent mental health intended for professionals in Alberta working with children and adolescents in the area of addiction and mental health.

Competency: Knowledge, Behavioural

Audience: Children, Youth

Cost: Free- Must register online

 

Developmental Pathways of Addiction and Mental Health

AHS Addiction and Mental Health Learning Series offers a web-based interactive e-Learning curriculum designed to support healthcare providers to enhance their practice working with children, youth and their families experiencing addiction and mental health issues. The focus of these modules is to help health providers recognize and reduce significant stressors for vulnerable children and their parents, enhance their resilience, and increase their coping skills. In providing mental health support to children and youth the focus needs to shift toward health promotion and disease prevention, rather than just  treating the impact of mental health disorders. (11 modules, 1.5-2 hours each)

Competency: Knowledge, Behavioural

Audience: General

Cost: Free

 

Gender Based Analysis Plus (GBA+)

A Status of Women Canada course to assess how diverse groups of women, men and non-binary people may experience policies, programs and initiatives. It acknowledges the need to go  beyond biological (sex) and socio-cultural (gender) differences and considers many other identity factors, like race, ethnicity, religion, age, and mental or physical ability. (2 hours)

Competency: Knowledge

Audience: All

Cost: Free

 

Circle of Courage

Starr Commonwealth offers this course which is a model of positive youth development based on the universal principle that to be emotionally healthy all youth need a sense of belonging, mastery, independence and generosity. This unique model integrates the cultural wisdom of tribal peoples, the practice wisdom of professional pioneers with troubled youth, and findings of modern youth development research. (6 hours)

Competency: Knowledge

Audience: Indigenous, Youth

Cost: Not specified

 

Make the Connection

This course offered by the Psychology Foundation of Canada is effective in promoting positive parent-to-infant attachment and is a strong candidate for public health initiatives targeting parenting skills. 3 courses target different age groups: 0-1, 1-2, 2-3. (Duration not specified)

Competency: Knowledge, Behavioural, Activating

Audience: Children

Cost: Not indicated

 

Kids Have Stress Too!

Offered provincially through Imagine Institute for Learning, this Psychology Foundation of Canada program is designed to help the important people in children’s’ lives learn to promote resiliency by buffering the impact of stress, and building positive coping strategies to deal with life’s stressors. Two programs span from pre-school to grade 3. (1 day)

Competency: Knowledge, Behavioural, Activating

Audience: Children

Cost: $110

Mental Health First Aid First Nations

The MHCC offers this course through CMHA and is intended for First Nations however, is also recommended for anyone that works with First Nations. It is designed to provide an opportunity for First Nations participants and others who work with First Nations to learn and have serious conversations about mental health and wellness. Participants will reflect on their life experiences, acknowledge the historical context of the colonization of Canada and move forward to address and explore ways to restore balance on a journey to mental health and wellness. (20 hours)

Competency: Knowledge, Behavioural, Activating

Audience: Indigenous

Cost: Not indicated

 

Mental Health First Aid

The MHCC offers this course through CMHA which focuses on the four most common mental health disorders including substance related, mood related, anxiety and trauma related, and psychotic disorders. Participants who take this course are well prepared to interact confidently about mental health with their family, friends, communities, and workplaces. (2 day)

Competency: Knowledge, Behavioural, Activating

Audience: General

Cost: Not indicated

 

Principles of Prevention Training

The Centre for Disease Control (CDC) introduces users to the fundamental aspects of violence and violence prevention. This valuable training explains the key concepts of primary prevention, the CDC’s role and public health approach, and the use of the social ecological model for violence prevention. (5 modules, 90 minutes total)

Competency: Knowledge

Audience: All

Cost: Free

 

Developmental Pathways of Addiction and Mental Health

This AHS Mental Health and Addictions Learning Series offers a web- based interactive e-Learning curriculum designed to support healthcare providers to enhance their practice working with children, youth and their families experiencing addiction and mental health issues. The focus of these modules is to help health providers recognize and reduce significant stressors for vulnerable children and their parents, enhance their resilience, and increase their coping skills. In providing mental health support to children and youth the focus needs to shift toward health promotion and disease prevention, rather than just treating the impact of mental health disorders. (11 modules, 1.5-2 hours each)

Competency: Knowledge, Behavioural

Audience: General

Cost: Free

 

Brain Story Certification

The Alberta Family Wellness Initiative’s new course has been streamlined and is more concise, but continues to provide a deeper understanding of brain development and its connection to addiction and mental health. The course now includes a new bibliography, a new glossary, an improved navigation system, updated videos and reflective questions in each module. (20 hours in total)

Competency: Knowledge, Behavioural

Audience: All

Cost: Free

 

Circle of Security-Core Sensitivities

Circle of Security International offers this seminar which focuses on the correlation between core sensitivities and insecurity as described within attachment research; the intergenerational nature of each core sensitivity and how sub-sets of insecurity can be transmitted between parent and child; issues of vigilance within each core sensitivity regarding: autonomy, vulnerability, and/or intrusion Implications for treatment of parent/child dyads, teens, and adults; and the implications for all interpersonal relationships. (3 days)

Competency: Knowledge, Behavioural, Activating

Audience: General

Cost: Not indicated

 

N.E.A.R Sciences: Understanding the relationship between Neuroscience, Epigenetics, Adverse Childhood Experiences and Resilience.

Imagine Institute for Learning offers a full-day learning immersion which will introduce participants to the neuroscience and epigenetics of brain development, the impacts of ACEs on brain architecture and human development as well as the hope of resilience. (1-day)

Competency: Knowledge, Behavioural, Activating

Audience: All

Cost: $110

 

Prescription Drug Training for Youth and Adults

The Spirit of Healing offers 2 courses. The course for youth focuses on safe and unsafe use of prescription and over-the-counter medication and encourages using traditional and alternative ways to stay safe, healthy and balanced in all areas – mentally, emotionally, physically and spiritually.

The adult course provides information on prescription drug use and misuse and includes traditional and complementary approaches for healing pain as well as ways to reduce harm to the individual, family and community. (15 hours each course)

Competency: Knowledge, Behavioural

Audience: Indigenous / Youth / Adult

Cost: Free after creating an account

 

PACES Provincial Addiction Curricula and Experiential Skills Training/Alberta Opioid Dependency Treatment Virtual Training

The focus of the Alberta ODT Virtual Training Program through AHS is to provide healthcare providers with the necessary knowledge, skills, and attitudes when providing care to patients with opioid use disorder (OUD). (7 modules, 25-35 minutes each)

Competency: Knowledge, Behavioural

Audience: General

Cost: Free

 

Harm Reduction Approach Overview

The State of New York Department of Health offers an introduction to basic philosophy and practices of HIV/STI/HCV harm reduction with regards to substance use and sexual risk behavior. The webinar provides an opportunity to reflect on your values and attitudes regarding harm reduction, as well as learn specific harm reduction strategies. (2 hours)

Competency: Knowledge

Audience: General

Cost: Not indicated

 

Developmental Pathways of Addiction and Mental Health

This AHS Mental Health and Addictions Learning Series offers a web- based interactive e-Learning curriculum designed to support healthcare providers to enhance their practice working with children, youth and their families experiencing addiction and mental health issues. The focus of these modules is to help health providers recognize and reduce significant stressors for vulnerable children and their parents, enhance their resilience, and increase their coping skills. In providing mental health support to children and youth the focus needs to shift toward health promotion and disease prevention, rather than just treating the impact of mental health disorders. (11 modules, 1.5-2 hours each)

Competency: Knowledge, Behavioural

Audience: General

Cost: Free

 

The Brain Story Certification

The Alberta Family Wellness Initiative’s new course has been streamlined and is more concise, but continues to provide a deeper understanding of brain development and its connection to addiction and mental health. The course now includes a new bibliography, a new glossary, an improved navigation system, updated videos and reflective questions in
each module. (20 hours in total)

Competency: Knowledge, Behavioural

Audience: General

Cost: Free

 

Elements and Priorities for Working Toward a Psychologically Safer Workplace

This report was prepared to support organizational readiness to embrace the National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard). It includes the 5 elements of a standard management approach, to creating and sustaining an organizational plan of mental health and wellness. Offered through WSMH.

 

Trauma-Informed: A Trauma Toolkit

This toolkit from Klinic Community Health Centre aims to  provide knowledge to service providers working with adults who have experienced or been affected by trauma. It will also help service providers and organizations to work from a trauma-informed perspective and develop trauma-informed relationships that cultivate safety, trust and compassion.

 

Safe Messaging about Suicide, Mental Illness and Mental Health

The Mental Health Commission of Canada offers this 1-hour webinar to help people learn how to safely talk about suicide and mental health. Information will be provided to help participants gain the confidence necessary to learn from people with lived experience and engage in safe and meaningful conversation about suicide and mental health. (1 hour)

 

Zero Suicide Toolkit

This toolkit is a comprehensive program of strategies, tools and readings to assist behavioral health providers in achieving safe suicide care. Addresses the following core components: Lead, Train Identify, Engage, Treat, Transition, Improve. This is offered by the Suicide Prevention Resource Centre and the National Alliance for Suicide Prevention.

 

Creating a Compassionate Classroom

The Alberta Teachers’ Association offers this booklet to help educate all of us about mental health, mental illness, and how we can help our students, our colleagues and ourselves. This booklet encourages the development of more compassionate classrooms, schools and communities by changing how we look at mental health and mental illness, school culture, education, policy and partnerships on the large scale, but also the small.

 

HEADSTRONG

HEADSTRONG is an evidence-based anti-stigma initiative created by the Mental Health Commission of Canada (MHCC). It inspires youth ages 12-18 to Be Brave, Reach Out and Speak Up about mental health. Now a national initiative, HEADSTRONG teaches students how to reduce stigma and become mental health champions in their schools. CMHA Edmonton has a partnership with MHCC and coordinates and delivers Headstrong Youth Summits across Alberta.

 

Alberta Addictions Service Providers

Website contains links to numerous in-person events, online courses and archived webinars on various mental health and addictions topics.

Visit Website

Need Help for Mental Health? Tool

The Need Help for Mental Health? Tool is a mental health navigation tool. There is a pre-made tool specific to Edmonton, but a customizable version of the Tool is also available for communities to edit based on the population they work with. This tool is a basic overview of the mental health services that are available. It can be used by anyone to help themselves or others connect to mental health and social services in their community by reading through the questions and seeing which services meet their needs.

The Need Help for Mental Health? Tool is available in several different languages:

2021-07-26T22:03:53+00:00Mental Health|

Trauma-Informed Care: Training that can Benefit Anyone

The Community Mental Health Action Plan partners with many organizations that play a significant role in improving addiction and mental health supports and services in Edmonton and surrounding areas. One of our valued partners is the Imagine Institute For Learning, a provincial organization dedicated to the advancement of best practices, research-based professional learning, and community engagement for everyone who works with children and families. Imagine offers a variety of training courses for mental health and suicide prevention, one of which is Trauma-Informed Care.

70% of people have experienced at least one traumatic event in their life.1

Trauma-Informed Care (TIC) training takes an in-depth look at what trauma is, the biological response to trauma, and behaviours that it may cause. It teaches people how to apply this knowledge to their work and personal life. Although this training is often taken by service providers in the social and mental health fields, it is a course that can be beneficial for anyone. There is a high likelihood that any person you interact with is coping with one or more traumas1. Most people do not develop a disorder from a traumatic event; however, it can lead to post-traumatic stress disorder (PTSD) in some cases. Research shows that creating awareness and recognition in the community can go a long way to preventing difficulties for those coping with trauma.

“It is not what’s wrong with them. It’s what happened to them.”

Through understanding trauma, we can approach others with more empathy, and perhaps too, be kinder to ourselves as we may also be coping with trauma. TIC training has already been expanding beyond the service provider sector to areas such as education. Imagine Institute recently held a training session for teachers in the Red Deer area that demonstrated the need for this training.

“I believe every person involved in a child’s development (from parents to bus drivers to school staff) should have some level of training in Trauma Informed Care. It has been very informative and provides tools that can be employed starting today.” – Testimonial from a teacher in the Red Deer Trauma-Informed Care Training session

You can find upcoming courses for Trauma-Informed Care or other free training sessions on the Imagine Institute For Learning website. AHS also has online Trauma-Informed Care modules available that are valuable for learning about trauma for those who are unable to make the in-person (currently virtual) TIC training. If you want to find more opportunities to learn about TIC and other mental health training, check out the Mental Health Training Framework.

Please note:  Course content has sensitive topics that may be triggering for some people.

References:

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603306/

2021-09-22T17:04:29+00:00Blog, Featured Content|

How 211 Alberta Can Help During a Pandemic

How 211 Alberta Can Help During a Pandemic

During a pandemic or disaster, things change quickly. Government supports and social services might be closed, have limited hours, or have significant phone wait times. New community resources might pop up as people try their best to respond to community needs.

Information and referral services such as 211 Alberta are essential in reducing the strain on emergency services, government departments and support service agencies during disaster situations by handling non-emergency calls.

211 is an essential service that helps Albertans find the right resource or service for whatever issue they need help with, at the right time.

How 211 Alberta can help you during the COVID-19 pandemic

As a government or social services agency

  • 211 acts as a communication hub. One phone call, text conversation or online chat is all that is needed to get people to the right place, limiting the number of instances of misinformation and misdirection for those seeking support. 211 also prevents a large number of confusing help lines from being developed.
  • 211 hosts a comprehensive database of resources and services. The need for this information during a disaster when available resources can change on a daily, or even hourly basis. New resources surface while others may become unavailable. 211 Information and Referral Specialist can also use this data to identify unmet needs and monitor the allocation of available resources. For the most up-to-date information 211 has, here’s 211’s COVID-19 Resource List.
  • 211 can expand the capacity of first responders by diverting calls from emergency responders during a disaster.
  • 211’s data has the potential to play a key role in identifying trends of previous disaster response to help in shaping the response of future disasters. To subscribe to 211’s Weekly Covid-19 Report, click here.
    211 can help build up sector capacity and build connections by linking community organizations together prior to disaster striking.

As someone who needs help:

  • 211’s infrastructure and network allows for the system to have extended capacity and reach during a disaster. Since the comprehensive database is online, it can be accessed from many regions, and makes resources accessible beyond the communities from which they originate.
  • 211 Information and Referral Specialists can provide support to callers post-disaster, connect them with services and meet new needs that may have surfaced because of the disaster.
  • 211 Information and Referral Specialists are highly skilled in crisis intervention.
  • To reach 211, dial 2-1-1, text INFO to 211 or visit www.ab.211.ca and click “live chat.”

As someone who wants to help:

One of the largest gaps that arises during a disaster is coordinating the influx of donation and volunteer offers of support that come in. In many cases, agencies do not have the capacity to respond, and helpers can feel discouraged when their offers are not taken up. 211 can coordinate these offers of help and support by directing people to available opportunities to be of service. In partnership with VolunteerConnector, 211 can refer people to available volunteer opportunities and coach them on how to use the VolunteerConnector website at https://www.volunteerconnector.org/.

To help keep 211 up-to-date, visit the 211 Alberta website to check information about your organization’s
programs and services. If you have any updates, email database@ab.211.ca

211 is here to help individuals looking for support and frontline staff looking for information about changing
resources during a pandemic. It is a part of our community of supports that can help direct you to the right
place.

Learn more: https://www.ab.211.ca/

2021-09-22T17:05:56+00:00Blog, Featured Content|

About the Action Plan in 6 Images

About the Action Plan in 6 Images

1. Easier Access to Services for Individuals and Families Struggling with Mental Health, Mental Illness, and Addiction

The purpose of the Community Mental Health Action Plan is to ensure that everyone involved in mental health and addiction in Alberta has the opportunity to maximize collective resources, leverage opportunities to respond to existing gaps, foster innovative approaches and identify a continuum of integrated supports and services. This will translate into easier access to services for individuals and families struggling with poor mental health, mental illness, and addiction.

2. A Focus on Prevention and Promotion

70% of adult Canadians living with a mental health problem or illness say their symptoms started in childhood.

Once mental illness is recognized, help makes a difference for 80% of the people who are affected

The Community Mental Health Action Plan works within this reality. We know there is much we can do at the community level to work together effectively and provide enhanced services for individuals and their families, focusing on:

  • The promotion of positive mental health
  • Prevention of mental illness through early identification and intervention

3. Strengthening the Capacity of Professionals and Non-traditional Supports

The Community Mental Health Action Plan builds the capacity of organizations and non-traditional allies to make practice shifts that can better support positive mental health of others. 

This capacity building work has brought together diverse government, community, and business stakeholders across sectors. As a result, organizations from different sectors can better integrate their work with each other.

An example of this is the Mental Health Training Framework. It is a guide that helps professionals identify training and resources to support the development of knowledge, behavioural, and activating competencies. The Training Framework leverages existing provincial investments made in training and professional development. 

4. Honouring and Learning from Lived / Living Experience

We regularly engage with individuals and families who have previous, current, or ongoing experience with the mental health system to ensure they are partners in creating practice shifts that will ultimately benefit them. We have done this through large group community meetings, focus groups, one-on-one consultations and outreach, and invitations to our Living Library Task Group. 

Their expertise and perspectives are highlighted in the Living Library, Shared Wisdom stories, and Navigation Findings

5. Supporting Albertans through COVID-19

The Community Mental Health Action Plan is collaborating with provincial organizations to develop a plan to ensure frontline supports are informed about, and have access to, psychosocial supports. 

Mental health is an issue that concerns all of us and it is not a concern specific to COVID-19.  However, during this time, mental health issues can be exacerbated by the stress of not working, conflicting information about how to navigate social distancing, parenting while working from home, and other situations. 

In order to help our community, we are highlighting COVID-19 resources for individuals, staff, and organizations on our home page. Each of the resources has been reviewed by our team to Our goal is not to have a comprehensive list of resources available (that would be overwhelming) but to provide a starting point for support. 

See 211 Alberta and our blog post for information about how 211 can help you during the pandemic. 211 is an essential service and can support government and social service agencies, along with people who need help or want to help. 

6. Many Ways to Use Our Website!

The website has six topic areas that you can find tools and resources under such as these:

  • A Mental Health Training Framework to create a training plan for your organization in the areas of trauma, mental health, suicide, workplace wellness, addictions, and brain development
  • The Need Help for Mental Health Tool, a mental health resource listing that comes in 8 languages. You can use the Edmonton version or customize your own! 
  • Compassion to Action, an innovative training for security guards about supporting vulnerable populations. 
  • Stories about extending mental health and addictions support in non-traditional settings and the Shared Wisdom Resource Guide on how to implement changes for the well-being of your staff and clients.  
  • 211 Alberta which is a 24/7 service available across the province, by phone, text, chat which conducts needs and risk assessments before connecting inquirers with the appropriate support. 
  • And more! 

Sign up to our newsletter to get updates on new content added to the website.  

2021-09-22T17:14:11+00:00Blog, Featured Content, Mental Health|

Mental Health Training Framework

The Mental Health Training Framework provides people with a starting point to find trainings about mental health to develop knowledge competencies in 6 different areas. There is a matrix that accompanies the framework that provides information on the format of the training, the level of impact on changing behaviours, and who the training is best taken by.

Organizations can customize it to their needs and create an internal training matrix for their teams or organizations. A knowledgeable workforce will help address the full spectrum of mental health and wellness for all Albertans.

2021-08-04T14:31:41+00:00Uncategorized|
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