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Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 1
Overview of the Fidelity Scale
Please note: Full, detailed instructions are available in the Fidelity Scale Instruction Guide. It is essential that the full guide be reviewed prior to
beginning this process.
1) The intent of this instrument is to gauge the extent to which a program or agency has developed a culture of trauma-informed care. By trauma-
informed, we mean a culture that incorporates knowledge about trauma—its prevalence, impact, and the complex paths to recovery and healing—into
every aspect of the program’s contacts, activities, relationships, and physical settings. Safety, trustworthiness, choice, collaboration, and
empowerment are the core values of that culture. (See Harris, M. & Fallot, R.D. Using Trauma Theory to Design Service Systems. San Francisco:
Jossey-Bass, 2001 for a fuller description of this concept.)
2) When scoring a program, we recommend being conservative in deciding whether or not a specific indicator is met. For instance, in #1.d., if some
of the signage is missing or unclear or unwelcoming, then the score should indicate that the standard has not been met (even if some of the signs are
welcoming and hospitable). This may mean that, especially the first time the fidelity scale is administered, the scores may be quite low. That is fine.
It simply means there is more room for growth in the program’s culture.
3) The Source of Evidence column should indicate the specific sources of information used to arrive at a decision about a score. More than one
source of evidence may be used to score a particular item. For example, item #2.b. may call for input not only from the staff (STINT), but from the
Executive Director or CEO (CEOINT), from clients (CLINT), via in-person observation (IPOBS), and possibly from consumer or staff surveys
(SURR).
4) In the row below the scoring, there is space for documenting findings, both strengths and challenges. Notes under “challenges” should be used to
guide your plans for changes and enhancements. These should also be noted in your Implementation Plans, to ensure action steps are taken to
remedy the issues.
5) Scoring should be done on a program-specific basis, acknowledging that there are many items that may apply to the larger, multi-program agency
or organization. Programs may then be combined to arrive at an organization-wide score. Simply put an “X” in the column indicating your score and
fill in the scoring summary on last page of this document.
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 2
Domain 1. Program Procedures and Settings: “To what extent are program activities and settings consistent with five core values of
trauma-informed cultures of care: safety, trustworthiness, choice, collaboration, and empowerment?”
Domain 1A. Safety for Consumers and Staff—Ensuring Physical and Emotional Safety: “To what extent do the program’s activities and
settings ensure the physical and emotional safety of female and male consumers and staff members?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One or two
indicators
are present.
3
Three
indicators
are present.
4
Four or five
indicators
are present.
5
Six or seven
indicators
are present.
Source of
Evidence
1. Physical Setting:
a) a) The area around the program (sidewalks and parking
lots, e.g.) is safe for women and men and the program is
accessible for both clients and staff.
b) The program’s entrance area and waiting room is safe
and hospitable, offering adequate personal space; exits
are clearly marked and accessible;
c) If there are security personnel present, they are trained
in customer service as well as in maintaining safety;
d) The program’s signage is clear and welcoming; it
directs people to the most frequently used areas (e.g., rest
rooms, intake and reception areas);
e) The program’s décor includes images and colors that
fit well with the recovery goals of the clients; ideally,
some of the art work, paint, and flooring should have
been created or selected by a team of consumers;
f) The program has designated “quiet spaces” for use by
clients and staff who need or want a place of respite;
g) Staff offices are safe and/or have appropriate safety
back-ups like “panic buttons.”
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 3
2. Interpersonal Contacts:
a) The program’s first contact (by phone or in person)
with prospective clients is welcoming and respectful.
b) The staff (including the reception staff) are attuned to
signs of distress among clients and respond in a gentle,
compassionate way.
c) In making contact with clients, staff take into account
whether clients may be involved in potentially dangerous
situations (e.g., domestic violence or living in a shelter);
d) Clients are given clear guidelines in advance about
what to expect of the program;
e) All staff are given clear guidelines in advance about
what to expect of the program; supervisors and managers
set the tone by offering clear and reassuring messages
about the program’s tasks and expectations;
f) All staff members (including senior administrators)
feel supported when they have challenges in their work;
“we are all in this together.”
g) Staff doing work that takes them into areas away from
the office feel safe and supported by the program.
1
None of the
possible
indicators
is present.
2
One or two
indicators
are present.
3
Three
indicators
are present.
4
Four or five
indicators
are present.
5
Six or
seven
indicators
are present.
Source of
Evidence
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 4
Domain 1B. Trustworthiness for Consumers and Staff—Maximizing Trustworthiness through Task Clarity, Consistency, Transparency,
and Interpersonal Boundaries: “To what extent do the program’s activities and settings maximize trustworthiness by making the tasks
involved in service delivery clear, by ensuring consistency and transparency in practice, and by maintaining boundaries that are appropriate to
the program?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five
indicators
are present.
Source of
Evidence
a) The program makes it clear who will do what, when
and with what goals in mind; it is clear which actions will
be taken and who is responsible for these actions—this is
true in all aspects of the program’s functioning, for both
clients and staff.
b) The program is transparent in the way it operates;
administration and managers share information openly
with staff and clients (without violating their own
responsibilities regarding confidentiality)
c) The program reviews its services with each prospective
consumer, based on clear statements of the goals, risks,
and benefits of program participation, and obtains
informed consent from each consumer; new staff go
through a parallel process in which expectations are
clarified and responsibilities made clear.
d) The program has a clear procedure for the review of
any allegations of boundary violations, including sexual
harassment and inappropriate social contacts.
e) Administrators and supervisors consistently validate
the importance of staff support.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 5
Domain 1C. Choice for Consumers and Staff —Maximizing Consumer and Staff Choice and Control. “To what extent do the
program’s activities and settings maximize consumer and staff experiences of choice and control?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicators
are present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five or six
indicators
are present.
Source of
Evidence
1. Routine Practice:
a) Staff review the program’s service options (e.g., types
of services offered, locations, housing possibilities,
choices regarding clinicians—including gender) with
each consumer prior to the development of an initial
recovery or service plan
b) The program routinely asks consumers about how and
when they would like to be contacted.
c) The program ensures that each service option is as
independent of others as possible, so that a consumer’s
choice about one service does not necessarily affect
another.
d) The consumer’s goals are given the greatest weight in
recovery planning.
e) Staff members are provided options, when possible,
regarding factors that affect their daily work (hours and
flex-time; timing of leave; décor of office; trainings
offered).
f) The program offers a balance between autonomy and
clear guidelines for staff members’ work responsibilities;
it is alert for ways to maximize staff choice regarding
how they meet their job requirements.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 6
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
3
One
indicator is
present.
4
5
Both
indicators
are present.
Source of
Evidence
Crisis Preferences:
a) The consumer collaborates in developing a plan (e.g.,
Wellness Recovery Action Plan and/or a crisis/safety
plan) that indicates the consumer’s preferred options,
including responses from staff, in crisis situations.
b) The program consistently takes into account these
preferences in responding to client crises, including
preferences regarding gender of supportive others.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 7
Domain 1D. Collaboration for Consumers and Staff —Maximizing Collaboration and Sharing Power: “To what extent do the
program’s activities and settings maximize collaboration and sharing of power between staff and consumers? Between staff and
supervisors and administrators?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two
indicators
are present.
4
Three
indicators
are present.
5
Four
indicators
are present.
Source of
Evidence
a) The program has a routine and effective way of
gathering consumer opinions about the program’s
direction and operations; weighs consumers’ opinions in
their decision-making; and communicates clearly with
consumers the process of decision-making. Alternatives
include a Consumer Advisory Board, regularly used
focus groups, suggestion boxes, etc.
b) The program has a routine and effective way of
gathering staff opinions about the program’s direction
and operations; weighs staff opinions in their decision-
making; and communicates clearly with staff the process
of decision-making. All staff are included in any change
process, including support staff.
c) The program cultivates a model of doing things “with”
rather than “to” or “for” consumers.
d) The program creates ways to engage consumers as
partners in plans for the recovery support services they
need and want.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 8
Domain 1E. Empowerment for Consumers and Staff—Prioritizing Empowerment and Skill-Building: “To what extent do the program’s
activities and settings prioritize consumer and staff empowerment and growth? For women and men?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five or six
indicators
are present.
Source of
Evidence
a) The program routine recognizes consumer strengths
and skills in the planning, implementation, and evaluation
of its services.
b) The program routine recognizes all staff members’
strengths and skills in the planning, implementation, and
evaluation of its services.
c) In each formal activity, the program helps to develop
or enhance consumer skills explicitly.
d) In each contact, the consumer feels validated and
affirmed.
e) The program offers training designed to strengthen or
develop specific skills needed by staff in order to perform
their jobs well.
f) The program emphasizes shared accountability and
responsibility throughout its hierarchy (in contrast to
blaming the person with the least power).
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 9
Domain 2. Formal Service Policies: “To what extent do the formal policies and procedures of the program reflect an understanding of
trauma and recovery?”
Criterion/Indicators
1
None of the
indicators
are present.
2
One or two
indicators
are present.
3
Three or four
indicators are
present.
4
Five or six
indicators
are present.
5
Seven or eight
indicators are
present.
Source of
Evidence
a) The program has developed written policies that seek to
eliminate involuntary or coercive practices (seclusion and
restraint, involuntary hospitalization or medication, outpatient
commitment). For those programs whose clients are “mandated”
to treatment, efforts are made to maximize the realistic choices
enrollees have. These efforts are part of the program’s written
policies.
b) The program has a written de-escalation policy that minimizes
possibility of re-traumatization; the policy includes reference to
a consumer’s statement of preference for crisis response,
including preferences regarding gender of those involved as
supports.
c) The program’s policies regarding confidentiality (incl. limits
and mandated reporting) and access to information are clearly
written, maximize legal protection of privacy, and are
communicated to each consumer.
e) The program has clearly written and easily accessible policies
outlining consumer and staff rights and responsibilities as well
as a grievance policy.
f) The program’s policies address issues related to staff safety,
e.g., community visits, being alone in an area of the building,
incident reviews reduce staff vulnerability
g) The program’s policies address the need for debriefing after
critical incidents, Both staff and clients involved in the incident
are also engaged in the debriefing, which has as its goal an
understanding and preventive approach (in contrast to a blaming
one)..
h) All services are based on trauma-informed values and the
curricula and materials used are trauma-informed.
CEO Interview
(CEOINT)
Client
Interview
(CLINT)
Staff Interview
(STINT)
Clinical
Record Review
(CRR)
Policy
Document
Review (PDR)
In-Person
Observation
(IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 10
Domain 3. Trauma Screening, Assessment, Service Planning and Trauma-Specific, Gender-Specific Services: “To what extent does the
program have a consistent way to identify individuals who have been exposed to trauma and to include trauma-related information in
planning services with the consumer? To what extent are trauma-specific services readily available”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five or six
indicators
are present.
Source of
Evidence
1. Screening, Assessment, and Service Planning:
a) Universal Trauma Screening. Within the first month
of service participation, every consumer has been asked
about exposure to trauma.
b) The trauma screening includes questions about lifetime
exposure to sexual, physical, and emotional abuse.
c) The trauma screening is implemented in ways that
minimize consumer stress; it reflects considerations given
to gender of interviewer, timing, setting, relationship to
interviewer, consumer choice about answering, and
unnecessary repetition.
d) Unless specifically contraindicated due to consumer
distress, the program conducts a more extensive
assessment of trauma history and needs and preferences
for trauma-specific services for those consumers who
report trauma exposure.
e) The program conducts gender-specific assessments for
women and men, and for girls and boys, if applicable.
These assessments are based on knowledge of gender
differences in socialization as well as biology.
f) Recovery planning is conducted in an individualized,
person-centered way that is based on trauma theory and
knowledge.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 11
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five
indicators
are present.
Source of
Evidence
2. Trauma-Specific Services:
a) The program ensures that those individuals who report
the need and/or desire for trauma-specific services are
either offered them on-site or referred for appropriately
matched services.
b) Trauma-specific services are effective; they have an
evidence base for the population being served.
c) Trauma-specific services are accessible. People can
get to them easily and they are offered at times that meet
the members’ needs.
d) Trauma-specific services are affordable for the
members.
e) Trauma-specific services, in style and content, are
responsive to the preferences of the program’s
consumers.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 12
Domain 4. Administrative Support for Program-Wide Trauma-Informed Services: “To what extent do agency administrators support the
integration of knowledge about trauma and recovery into all program practices?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five
indicators
are present.
Source of
Evidence
1. Overall Administrative Support:
a) The program has adopted a formal policy or mission
statement that refers to the importance of trauma and the
need to account for consumers’ experiences of trauma in
all aspects of program operation.
b) The program has a clear philosophy, reflected in its
day-to-day operations, that takes trauma into account.
The philosophy is reflected in written materials as well as
in informal practices.
c) The program has named a trauma specialist
(“champion”) and workgroup(s) to lead agency activities
in trauma-related areas and provides needed support for
these initiatives.
d) The group reflects the composition of the staff and
people in recovery in terms of gender, race, and cultural
background. All constituencies in the program are
represented on the workgroup.
e) Program administrators monitor and participate
actively in responding to the recommendations and
activities of the trauma leadership team or workgroup
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 13
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five
indicators
are present.
Source of
Evidence
2. Services Offered by the Program:
a) The program offers simultaneous, integrated services
for mental health, substance abuse, and trauma.
b) The program uses role models and mentors, who may
also be people in recovery.
c) The program makes available, on site or by referral,
primary care, spiritual, employment, and parenting
services.
d) The program offers specific services for pregnant
women or makes referrals to such programs.
e) The program offers child care or helps make
arrangements for such care for parents who need it
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 14
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
3
One
indicator is
present.
4
5
Both
indicators
are present.
Source of
Evidence
3. Trauma Survivor/Person in Recovery
Involvement:
a) Administrators actively solicit the opinions of people
in recovery who have had experiences of trauma. By
membership on a Consumer Advisory Board (CAB), by
focus groups, by individual interviews, and/or by
suggestion boxes, people in recovery can have their
voices heard. Both male and female survivors are
represented.
b) People in recovery who have had lived experiences of
trauma are actively involved in all aspects of program
planning and oversight. Both female and male survivors
are represented.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 15
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two
indicators
are present.
4
Three
indicators
are present.
5
Four
indicators
are present.
Source of
Evidence
4. Program Data-Gathering and Program Evaluation:
a) Program gathers data addressing the needs and
strengths of consumers who are trauma survivors and
evaluates the effectiveness of the program and trauma-
specific services. Gender, race, and age may be
important categories in understanding these data.
b) Administrators include at least five key values of
trauma-informed cultures in consumer satisfaction
surveys: safety, trustworthiness, choice, collaboration,
and empowerment. The respondent’s gender, race, and
age may be factors considered in understanding these
data.
c) Administrators include at least five key values of
trauma-informed cultures in staff satisfaction surveys:
safety, trustworthiness, choice, collaboration, and
empowerment. The respondent’s gender, race, and age
may be factor considered in understanding these data.
d) Results of both the consumer and staff surveys are
consistent with a trauma-informed culture. All ten of the
key values ratings are at the “agree” or higher level on
the rating scale.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 16
Domain 5. Staff Trauma Training, Education, and Support: “To what extent have all staff members received appropriate training in
trauma and its implications for their work?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two or
three
indicators
are present.
4
Four
indicators
are present.
5
Five
indicators
are present.
Source of
Evidence
a) All staff (including administrative and support
personnel) have participated in at least 2.5 hours of
“basic” trauma education that addresses at least the
following: 1) trauma prevalence, impact, and recovery; 2)
ensuring safety and avoiding re-traumatization; 3)
maximizing trustworthiness (clear tasks and boundaries);
4) enhancing consumer choice; 5) maximizing
collaboration; 6) emphasizing empowerment;.
b) All staff have participated in at least 2.5 hours of
education addressing the necessity of staff support and
care in a trauma-informed context.
c) All new staff receive at least one hour of trauma
education as part of orientation.
d) Direct service staff have received at least three hours
of education involving trauma-specific techniques (e.g.,
grounding, teaching trauma recovery skills).
e) All staff are provided adequate resources for self-care,
including supervision, consultation, and/or peer support
that addresses secondary traumatization.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo, Colette Anderson, and Kim Selvaggi in
developing and formatting this scale. 17
Domain 6. Human Resources Practices: “To what extent are trauma-related considerations part of the hiring and performance review
process?”
Criterion/Indicators
1
None of
the
possible
indicators
is present.
2
One
indicator is
present.
3
Two
indicators
are present.
4
Three
indicators
are present.
5
Four
indicators
are present.
Source of
Evidence
a) Prospective staff interviews include trauma-related
questions. (What do applicants know about trauma,
including sexual, physical, and emotional abuse? About
its impact? About recovery and healing? Is there a
“blaming the victim” bias? Is there potential to be a
trauma “champion?”)
b) Staff performance reviews include trauma-informed
skills and tasks, including the development of safe,
trustworthy, collaborative, and empowering relationships
with consumers that maximize consumer choice.
c) The program routinely assesses staff members’
knowledge of trauma relevant for the program’s goals
(see content in Domain 5). This may be done following
educational events or as part of performance reviews or
in ongoing supervision.
d) The program has a consistent way to recognize
outstanding performance among staff.
CEO Interview
(CEOINT)
Client Interview
(CLINT)
Staff Interview
(STINT)
Clinical Record
Review (CRR)
Policy Document
Review (PDR)
In-Person
Observation (IPOBS)
Survey Review
(SURR)
Findings
Strengths:
Challenges:
Creating Cultures of Trauma-Informed Care: Program Fidelity Scale Version 1.3 (1-14)
Community Connections, Washington, D.C. (Draft; not for distribution without the written permission of
the authors.)
(c)Roger D. Fallot & Maxine Harris. 2014. The authors gratefully acknowledge the assistance of Stephanie Covington, Eileen Russo,
Colette Anderson, and Kim Selvaggi in developing and formatting this scale.
18
Agency/Program ________________________________________ Date ___________
Person(s) Completing Scale:_______________________________________________
Domain 1. Program Procedures and Settings
1A.1. # of indicators_____ Rating. _____
1.A.2. # of indicators_____ Rating. _____
1B. # of indicators_____ Rating. _____
1C.1. # of indicators_____ Rating. _____
1C.2. # of indicators_____ Rating. _____
1D. # of indicators_____ Rating. _____
1E. # of indicators_____ Rating. _____
Domain 1 Subtotal # of indicators_____ Rating (average of the first seven ratings): _____
Domain 2. Formal Services Policies
Domain 2 Subtotal # of indicators_____ Rating: _____
Domain 3: Trauma Screening, Assessment, and Service Planning
1. # of indicators_____ Rating. _____
2. # of indicators_____ Rating. _____
Domain 3 Subtotal # of indicators_____ Rating (average of the two ratings): _____
Domain 4: Administrative Support for Program-Wide Trauma-Informed Services
1. # of indicators_____ Rating. _____
2. # of indicators_____ Rating. _____
3. # of indicators_____ Rating. _____
4. # of indicators_____ Rating. _____
Domain 4 Subtotal # of indicators_____ Rating (average of the four ratings): _____
Domain 5: Staff Trauma Training and Education
Domain 5 Subtotal # of indicators_____ Rating. _____
Domain 6: Human Resources Practices
Domain 6 Subtotal # of indicators_____ Rating. _____
Grand Total of Ratings_(from right column)_______________÷ 6 = Overall Mean of ___________
Interpretive ranges for overall mean: 1.00-2.00 = Beginning the trauma-informed process; 2.00-3.00 = Not
very trauma-informed; 3.00-4.00 = Somewhat trauma-informed; 4.00-5.00 = Very trauma-informed; 5.00 =
Fully trauma-informed.
Grand Total of Indicators _________________
