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Leveraging collaboration and brain science to end cycles of poverty and trauma at CUPS-Calgary

Here's another post from my 3-week fellowship trip, visiting trauma-informed communities in the Pacific Northwest and Canada.  This one is about the Calgary Urban Project Society, or CUPS, and how they're leveraging brain science and collaboration to end cycles of poverty and trauma: 

The Calgary Urban Project Society, or CUPS, was founded in 1989 with a vision to help people overcome the challenges of poverty and attain brighter futures. Over the past couple of years, with their involvement in the "Change in Mind" initiative, CUPS has updated their approach to incorporate the brain science about trauma and resilience to focus more specifically on helping adults and families in Calgary living with the adversity of poverty and traumatic events to build resilience in 4 key areas:

  • Economic Resilience
  • Social-Emotional Resilience
  • Health Resilience
  • Developmental Resilience

"Many of our clients have huge trauma burdens - and for those who have children, we know the ACEs research shows this impacts their kids as well," Tanya Leavitt, Mental Health Program Manager, explains.  So CUPS has specifically incorporated a focus on trauma-informed care into their strategic plan and made it an organizational priority.

They have a Trauma-Informed Care (TIC) Team at CUPS with representatives from every department and every program and service in the agency. Their TIC Team also includes five clients who have been participants in various CUPS programs and services, and who represent diverse perspectives in terms of ethnicity, gender and age.

The TIC Team focuses on agency policies and procedures, and how to ensure that everything they do at CUPS is trauma-informed and utilizes the brain science around trauma and developing resilience.

TIC Team members serve a one-year term, then rotate off so other agency staff and clients can become part of the team. Tanya explains, "Our goal is that eventually every single employee here will have served on the TIC team at some point."

With 166 staff members and 480 volunteers, CUPS served 9,364 clients last year with services that include a primary care healthcare clinic; a women's health clinic; a dental clinic; mental health care services; substance abuse supports; parenting education; an early intervention child development centre with full day pre-school and kindergarten that includes on-site healthcare, psychological services, speech and language services, occupational therapy and physiotherapy; income and financial supports; education, skills &  training services; food and nutrition services; legal advocacy & justice services; and three housing programs for individuals and families experiencing homelessness (these programs include case management and graduated rent subsidies).

Through close collaboration with many partners, they serve as a "one-stop shop" to offer an integrated set of services that address many of the barriers and needs people living in poverty are facing.

Amanda Rae Storteboom, CUPS Operations Manager, explains that when a client first walks in the door, CUPS staff walk the client through an initial conversation to complete a "Resiliency Matrix" identifying the characteristics the individual possesses across four domains of resilience: economic, social-emotional, health and developmental. "This helps identify all of the different resources and services that may benefit that client," she adds. Historically, clients would come to CUPS for one particular service or program, but other challenges or barriers in their lives could end up de-railing the progress they might have made through that program or service. They used to have over ten different entry points into CUPS programs and services.  The Resiliency Matrix allows them to get a comprehensive look at all the major aspects of the client's life, at a single point of entry, so they can take a holistic approach to assisting the client across multiple life domains.

biopsychosocial+model.jpgThis holistic approach is mirrored in the mandatory full-day trauma and resilience training that all CUPS staff must complete."We've basically taken the biopsychosocial model of health, and pulled it apart for this training," Tanya explains. The training covers trauma, how it can play out in people's lives, the brain science about trauma and resilience, and scenarios and practical information about what is and is NOT helpful for people to be able to build resilience, overcome adversity and reach their potential. The staff training also covers vicarious and secondary trauma and self-care for staff.

Tanya developed their staff trauma training curriculum using resources from SAMHSA, the Alberta Family Wellness Initiative's free 30-hour "Brain Story certification" training (available to anyone around the world at no cost!),  Alberta Health Services (here's a link to an entire issue of their Apple magazine devoted to brain science, trauma and resilience) and the Government of British Columbia's guide to trauma-informed practice.

The results at CUPS have been impressive. In their housing programs alone, CUPS housed 703 adults and children last year. 95% of the households remained successfully and stably housed or graduated out of the program and no longer require subsidy. Participants have reported significant reductions in their use of public systems, including a 80% decrease in EMS use, 27% reduction in ER visits, and a 76% reduction in interactions with police and the justice system.

Measuring all of their results, specifically related to overcoming trauma and building resilience, has presented some challenges, though.They've had to work out information-sharing agreements and client consent/release forms across various programs and services. They've had to address issues with the databases and computerized systems they use to capture the right data. And they had to develop a common, comprehensive intake process for every client, regardless of what services or programs the client may have initially come to CUPS for (using the "Resiliency Matrix" mentioned earlier).  They are capturing the scores from that initial Resiliency Matrix assessment, then re-assessing clients every six months to look at gains in resiliency across economic, social-emotional, health and developmental domains.

Both Tanya and Amanda Rae describe what's happening at CUPS around trauma-informed care and building resiliency as a "work in progress." Ultimately, their vision is to help the people they serve to end the cycle of poverty and trauma for themselves and their families.

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