Methodology/Theoretical Framework

Trauma-Informed Care

Appleseed  is committed to the trauma-informed care model both in treating  its clients as well as promoting a trauma informed agency culture. 

Trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?” A trauma-informed approach to care acknowledges that health care organizations and care teams need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation. Adopting trauma-informed practices can potentially improve patient engagement, treatment adherence, and health outcomes, as well as provider and staff wellness. It can also help reduce avoidable care and excess costs for both the health care and social service sectors.

Trauma-informed care seeks to:
  • Realize the widespread impact of trauma and understand paths for recovery;
  • Recognize the signs and symptoms of trauma in patients, families, and staff;
  • Integrate knowledge about trauma into policies, procedures, and practices; and
  • Actively avoid re-traumatization.

There are a number of benefits to using a trauma-informed approach, not only for clients but also for providers and staff. Many clients  with trauma have difficulty maintaining healthy, open relationships with a health care provider. For clients, trauma-informed care offers the opportunity to engage more fully in their health care, develop a trusting relationship with their provider, and improve long-term health outcomes. Trauma-informed care can also help reduce burnout among health care providers, potentially reducing staff turnover.

Source: Trauma-Informed Care Implementation Resource Center

Motivational-Interviewing (MI)

Appleseed believes that the concepts in Motivational Interviewing of collaboration, evocation, autonomy align with overall mental health excellence.

“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.”  (Miller & Rollnick, 2013, p. 29)

The most current version of MI is described in detail in Miller and Rollnick (2013) Motivational Interviewing: Helping people to change (3rd edition). Key qualities include:

  • MI is a guiding style of communication, that sits between following (good listening) and directing (giving information and advice).
  • MI is designed to empower people to change by drawing out their own meaning, importance and capacity for change.
  • MI is based on a respectful and curious way of being with people that facilitates the natural process of change and honors client autonomy.

It is important to note that MI requires the clinician to engage with the client as an equal partner and refrain from unsolicited advice, confronting, instructing, directing, or warning. It is not a way to “get people to change” or a set of techniques to impose on the conversation. MI takes time, practice and requires self-awareness and discipline from the clinician. (Miller & Rollnick, 2009)

While the principles and skills of MI are useful in a wide range of conversations, MI is particularly useful to help people examine their situation and options when any of the following are present:

  • Ambivalence is high and people are stuck in mixed feelings about change
  • Confidence is low and people doubt their abilities to change
  • Desire is low and people are uncertain about whether they want to make a change
  • Importance is low and the benefits of change and disadvantages of the current situation are unclear.

Source: MINT Excellence in Motivational Interviewing

Systems Theory

Appleseed believes that viewing all persons through the lens of the systems that impact their day to day function is critical to fully implement excellent and holistic care.

Systems theory is an interdisciplinary study of systems as they relate to one another within a larger, more complex system. The key concept of systems theory, regardless of which discipline it’s being applied to, is that the whole is greater than the sum of its parts. What this means is that when holistically examining how smaller systems come together to affect the greater complex system, certain characteristics of the whole—the complex system—can not be easily explained or rationalized when looking singularly at any one of its systems—its parts.

A holistic approach to an individual’s personality, choices and hardships is important when it comes to successful social work. Like the other fields mentioned, a social worker must look at all factors that come together in a unique way to shape their experiences and who they are. Social workers may employ systems theory to understand problems like child abuse, family issues and community dysfunction as they relate to individuals’ personal issues, such as anxiety, low self-esteem, self-harm or relationship issues. Based on systems theory, multiple practices have been created that are specific to social work. 


Standards for Ohio Domestic Violence Programs

Safe Haven strives to adhere to the Standards for Ohio Domestic Violence Programs set forth by the Ohio Domestic Violence Network.

Since the early 1970’s, the domestic violence movement has been actively working in Ohio to develop greater
awareness about the violence directed at survivors and their children and to bring about social change. In
response, concerned citizens have opened crisis shelters, safe homes and non-residential programs to meet the needs of women and children in crisis. As services and programs develop, standards and guidance are needed to ensure that the services we provide are of the highest quality.

As external monitoring of domestic violence shelter programs increases, service providers need to develop
sophisticated levels of management and program excellence without compromising their ability to provide
empowering services to survivors. Furthermore, program standards need to take into account the unique
characteristics of programs that work with survivors and their children.

 Encourage the highest level of ethical practice and accountability to survivors
 Establish the minimum level of responsibility, service and competency expected from providers
 Provide a measure of program performance and efficiency
 Provide information regarding ideal intervention methods
 Articulate a philosophy that focuses on the physical, sexual and emotional safety of survivors and their
 Enhance public awareness of domestic violence and support a community that refuses to tolerate violence
 Provide uniform levels of performance, which increase both the safety of survivors and their children as
well as the credibility of the programs that serve them
These standards are meant to be used as a tool to enhance services and to make the operation and evaluation of domestic violence programs more effective. The goal is not so much to perfectly comply with these standards as to continuously strive to meet them by taking steps to ensure our intentions are to
practice in this manner. The Ohio Domestic Violence Network is available to serve as technical assistance advisors in the implementation of these standards and provide any additional support needed.

Source: Ohio Domestic Violence Network: Promising Practices Standards for Ohio Domestic Violence Programs


Ohio Core Rape Crisis Standards

Safe Haven strives to adhere to the Ohio Core Rape Crisis Standards set forth by the Ohio Alliance to End Sexual Violence.

The Core Standards for Rape Crisis Programs in Ohio, 2016 Revised Edition serves as the authoritative document on the delivery of rape crisis program services in Ohio. OAESV and the Standards Review Committee acknowledge that there are numerous types of programs in Ohio providing services to survivors of sexual violence, including (but not limited to) domestic violence shelters, dual domestic violence-rape crisis programs, prosecutor-based/victim-witness programs, social service organizations, and mental health agencies. While this document defines and outlines the core service standards for rape crisis programs specifically, it is the expectation that any organization that is providing any services to survivors of sexual violence will administer those services according to standardized best practices. The intent of developing and distributing standards for rape crisis programs is threefold:

1. To ensure that every survivor in the state of Ohio has access to consistent services regardless of personal or demographic characteristics, or location in the state;
2. To provide a formalized framework for identifying and describing specific services and characteristics that define a rape crisis program in Ohio; and
3. To serve as a resource for rape crisis programs in terms of training for staff and volunteers, continuing education, and best practices.

Source: Ohio Alliance to End Sexual Violence: Standards for Rape Crisis Programs in Ohio