8. Quality assurance
In both of the organizations I have worked for in the past 10 years, Maine Children’s Home in Waterville and the Maine General Medical Center there has been recognition at the urging of the State of Maine to implement some measures of quality assurance with regard to trauma informed care. What I recall from my time as Clinical Director at MCH was all of our clinicians working with children were encouraged to take the Trauma Focused CBT courses offered nationally and become proficient with that method – this was my first exposure to using evidence based trauma specific interventions.
At the IOP where I’ve been for the past 6 or 7 years, the focus on trauma is incorporated into the primary modality used, DIALECTICAL BEHAVIORAL THERAPY, an evidenced based program for helping suicidal people, initially, but now widely recognized as being useful to sufferers of depression, certain personality disorders and other mood disorders.
In the interest of continuous improvement the IOP sought to have all of the clinicians trained in SEEKING SAFETY as mentioned elsewhere in this class as an evidence based program to deal specifically with trauma and substance abuse which often go hand in hand. So as of today, October 2021, this Seeking Safety modality is frequently used as an education class, one of the three daily scheduled sections of the IOP day, and is also offered as a weekly Friday afternoon group for those patients invited to attend after their completion of the 6 week morning classes in the IOP. This particular use of Seeking Safety has the wonderful added benefit of being facilitated by a Clinical Art Therapist who incorporates art directives into every group.
Other topics presented during Education often come directly from requests from the clients for more information on other topics, as well as Trauma.
Finally, about 4 years ago IOP instituted a continual client centered evaluation system called the Outcome Rating Scale which gives an individual picture of how a client is doing and progressing, or not, in the experience of IOP. These evaluations are then tracked, presented to the clinical team in a weekly visual presentation and used to assist in planning phases of the individual’s treatment: ie, is IOP right for them? would they rather simply go to individual therapy, is hospitalization recommended, etc.
11. Physical environment of the organization:
Located in downtown Augusta in a large brick building formerly used by Central Maine Power, Maine General IOP occupies one-half of the 2nd floor, shared by the needle-exchange program and other social service offices. Other floors are also occupied by Maine General divisions, including outpatient counseling, the ACT team, and medication assisted treatment. Although this can have its advantages in that clients can easily locate the next phase of their treatment with the help of clinical personnel, the physical location of the building across from the fire station with its frequent alarms, sirens and speeding vehicles can be very disruptive to group presentations. Imagine for example, leading a meditation exercise with the interruption of a fire alarm followed by 3 firetrucks leaving the station.
Next, the front lawn of the building because of its proximity to downtown attracts smokers – specifically not welcomed by the hospital but tolerated as a reality of having working offices near a population of sometimes homeless people. I believe our staff deals with this situation as well as they can – certainly there is plenty of help offered to quit smoking, recognized as another addiction. Information about finding nearby shelters is also available- although often those shelters are not open during the day. I do not offer a solution to this situation – I am merely describing it for purpose of a less than ideal environmental condition, both for clients, employees and those individuals smoking on the lawn.