Northeast Tennessee ACEs Connection

Program Description

The Northeast Tennessee ACEs Connection (NETNAC), a trauma-informed system of care in northeast Tennessee, was born as a response to community need in a region that is ground zero for the opioid crisis with an NAS rate 10 times the national average and skyrocketing domestic violence rate. In 2015 Community Crime Prevention Programs (CCPP) partnered with East Tennessee State University’s (ETSU) Psychology Department to begin a Trauma-Informed training initiative, with no funding from either organization, equipped with only a draft course from SAMHSA. In less than two years a movement has arisen. Since October 2015, in 42 events, 2,000 cross-sector professionals have been trained, through formal trainings, community talks, Paper Tiger screenings, and trainer courses in which 116 professionals have been trained to train. The resulting trauma-informed system of care has begun to draw national attention. System of care partners implement trauma-informed practices into services offered, increasing resilience to mitigate the effects of Adverse Childhood Experience (ACEs). Examples include School Resource Officer (SROs) partnering with public schools to notify of the presence of a child during police calls. Topper Academy (former alternative school) saw attendance improve from 50-88%, discipline referrals decrease, and over 200 credits earned in one semester.

Creativity

NETNAC learned that discipline-specific educational presentations on trauma-informed care were non-existent in many fields, so NETNAC created them. Content from SAMHSA Trauma-Informed Care training materials, TN ACE’s Initiatives “Building Strong Brains” curriculum, and other resources have been integrated into discipline-specific training’s, which share common language, thereby increasing cross-disciplinary communication and collaboration. NETNAC has now trained healthcare, mental health, education, corrections, homeless services, domestic violence, and law enforcement professionals in what many describe as “moving” presentations. Through NETNAC trainings, which provide practical applications and best practice resources, partners quickly move from being trauma-aware to embedding practices into their services where trauma-informed care becomes a norm. Once trained, organization representatives can participate in bi-monthly system of care meetings. In the first year, 22 agencies joined. The system of care offers the chance for networking, encouragement, and collaboration among organizations that unify around the common theme of trauma-informed care.

Leadership

NETNAC ‘s core leadership team consists of the CCPP Coordinator from the Johnson City Police Department and a tenured faculty member from the ETSU Psychology Department. The CCPP Coordinator had an established track record of civic engagement, coordinating a large number of community partners to enhance public safety, enabling the efforts of NETNAC to spread quickly. The faculty member brought years of experience in research including survey development, research design, and data analysis. Additional system of care leaders are developed in two ways. Each system partner is encouraged to have an in-house trauma-informed care trainer and to designate someone to attend the bi-monthly meetings to give progress updates. A subset of partners are trained to be NETNAC trainers. These individuals attend the train the trainer course, but also much provide evidence of training experience, and must be endorsed by NETNAC co-leaders.

Sustainability

Since inception NETNAC has had no operating budget, therefore sustainability is not dependent on funding. Motivation of the core leaders and value placed on this endeavor by the leaders’ employers enable the system of care to be sustained without dedicated funding. Hours spent training or in system of care meetings are incorporated in job descriptions for core leadership. Because partner agencies control their implementation of trauma-informed practices, the system of care can be maintained without either dedicated staff or funding. Additional funding has and can be used to facilitate trauma-informed care practices, however. Grant funding was received for a trauma-informed care demonstration project, but, although funding ended, that project, the system of care, and training’s have continued. We attribute this to the value placed on trauma-informed care by our partners and the fact that trauma-informed care concepts easily become an integrated part of practice in the organizations we train.

Replicability

Any community can easily follow the documented methodology of NETNAC for creating their own System of Care. NETNAC core leadership have already been in consultation with other communities who are starting their own systems of care. Once a community identifies leadership interested in creating a system, they begin with outreach within their existing networks of partners to raise awareness of the effects and prevalence of ACEs. As interest grows, the leadership team begins to schedule training events for these partners. After several agencies have received training, leadership can begin holding system of care meetings where partners are encouraged to review their policies and procedures and move beyond being trauma-aware to trauma-responsive and trauma-informed in practice. System partners provide encouragement to one another at these meetings and often brainstorming to remove challenges to change are identified and shared.

Results/Outcomes

At this point, we have trained over 2,000 individuals, 116 of whom were trained to conduct trainings. We have routinely surveyed training participants who have overwhelmingly reported that trauma-informed care training increases their understanding of ACEs, predicted outcomes of ACEs, and increases their knowledge of appropriate trauma-informed practices. We verified this self-report information through a study in one location confirming that the training actually does increase understanding and application of trauma-informed principles. We are currently conducting a study to learn what changes have been made within organizations to become more trauma-informed. A study to be initiated this winter will be conducted in area organizations to determine whether clients perceive the organization to be implementing trauma-informed principles. NETNAC with its 22 partner organizations has extended the dissemination of trauma-informed principles and allows for collaboration and communication that would not happen without such a system in place.