Program Domains of Trauma-Informed Practice Associated with Client Perception of Care and Staff Perceived Organizational Support: A Study of Women’s Substance Use Programs Utilizing Qualitative Comparative Analysis

Background: Trauma-informed practice (TIP) is a strength-based service delivery approach that acknowledges the widespread prevalence and impact of trauma in the lives of both the people seeking services as well as amongst its’ workforce (Harris Fallot, 2001; SAMHSA, 2014). As programs and organizations implement a TIP approach to service delivery, examining the degree to which an organization is able to integrate TIP principles into their practices and operations and how it relates to client and staff perception of care can be helpful for program evaluation. Purpose Objectives: Guided by a Knowledge Based View (KBV) of the firm (Grant, 1997; 2002; 1991) and Resource Based Theory (RBT) (Barney, 1991), this study sought to examine combinations of program domains and the degree to which they are trauma-informed that are associated with client perception of care and staff perceived organizational support. Methods: A case study design involving nine women’s substance use agencies across the province of Ontario, Canada was employed to study TIP organizational capability in six program domains. To facilitate the study of combinations of organizational capability domains that are associated with the outcomes, Qualitative Comparative Analysis (QCA) was used as the main analytic approach. Findings: QCA results indicate, that the degree to which program domains are trauma-informed may not be related to staff perceived organizational support and client perception of care outcomes as anticipated. It is possible that organizational capability in TIP has more distal and perhaps little connection to the outcomes as measured by the SPOS and OPOC. Conclusions: Although the CCTIC has utility to inform program planning and implementation for trauma-informed services, it may be challenged as a tool to evaluate the extent to which program domains are associated with client perception of care and staff perceived support. Future studies should look at replicating the CCTIC as a more refined and calibrated measure of TIP that can be readily used to evaluate TIP as it relates to provider and client experiences of care to inform policy and program evaluation.

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