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The Stress, Trauma And Resilience (STAR) Program at The Ohio State University Wexner Medical Center offers training, education, treatment and programming to build and maintain resilience in communities.
Founded in 2009 within the Department of Psychiatry and Behavioral Health at the Ohio State College of Medicine, STAR and its component programs — including the Trauma Recovery Center — work to enable a culture shift wherever teams are trained, such as a hospital, workplace or school. The STAR team also studies the trauma recovery needs of specific populations to find the best ways to provide successful, ongoing care.
STAR Program initiatives support:
- Trauma survivors
- Professionals and learners at Ohio State
- First responders (police/fire/emergency medical services) external to Ohio State
- Schools
- Corporations and nonprofits
Demand is growing for these services, as most people will experience some form of crisis, stress or adversity at some point.
“We’re teaching people how to recognize the signs of stress way upstream and create a culture of support where the message is, ‘We take care of each other here,’” says Arianna Galligher, LISW-S, director of the STAR Program.
Support and training for professionals at Ohio State
The STAR Program offers several programs and services for professionals and learners at the Ohio State Wexner Medical Center, including:
- Brief Emotional Support Team (BEST) training
- Peer support, grief support and debriefing
- Proactive rounding
- Schwartz Center Rounds (a monthly social/emotional grand rounds panel discussion)
The cornerstone of STAR is BEST, which teaches frontline staff to recognize and intervene when a peer is impacted by day-to-day stress. While many hospital-based well-being efforts have traditionally focused mainly on physicians, BEST is designed to include everyone, regardless of their discipline or role at the medical center, says Galligher. She also serves as director of the Gabbe Health and Well-Being Program, which coordinates and provides strategic oversight for all Ohio State Wexner Medical Center initiatives working to improve the well-being of faculty, staff and learners.
To date, more than 850 Ohio State Wexner Medical Center faculty and staff have completed BEST training. BEST began in 2014 and teaches how to:
- Build and maintain a trauma-informed care environment
- Navigate conversations around a tough day
- Recognize if a colleague needs the next stage of support
- Get someone to the right place for more care
“This is a different approach than standard mental health first-aid training,” Galligher says. “We want to create systems that are flexible and responsive and create a culture of support within a team. That means being able to offer support through the day-to-day stressors as well as through major events or crises.”
During COVID-19, STAR Program leadership remodeled their training mechanism to make it a more accessible opportunity that keeps people engaged. They added a monthly online check-in session to provide ongoing education and support to BEST-trained individuals as it became increasingly evident that peer supporters needed and deserved their own support as well.
STAR Program staff facilitate the sessions to address a different topic each month and have an open forum for discussion about situations occurring on each unit. The virtual format of the monthly check-ins allows people from different parts of Ohio State to gather more easily.
“It’s hard to step outside of your unit for an hour, but you can join a Teams meeting and be engaged, even if you have to go in and out during that hour,” Galligher says. “You can still stay connected and get information to deepen your own knowledge.”
A diverse, interdisciplinary group of employees and learners has received training. The goal is for everyone to feel comfortable approaching a co-worker and checking in with them, whether that’s an Environmental Services employee asking a nurse if they’re OK or a doctor making sure a patient care associate is coping well after a tough case.
Ongoing quality initiatives
Within Ohio State, there is widespread implementation of trauma-informed care, including:
- Education on the impact of chronic high levels of stress on providers.
- Proactive rounding, which focuses on high-stress areas such as intensive care, emergency, and labor and delivery.
- Schwartz Center Rounds, a social/emotional grand rounds panel discussion that highlights the emotional nature of work in health care and elevates the importance of compassion with patients, colleagues and oneself. More than 150 physicians, nurses, social workers, clergy and others attend each month.
Support for trauma survivors
The Ohio State STAR Trauma Recovery Center is one of the first of its kind in the Midwest. It provides comprehensive services designed to assist survivors (including co-survivors/second victims) to heal from psychological aspects of trauma.
The center makes a targeted effort to build trust and serve traditionally underserved/under-resourced communities with high exposure to trauma.
Galligher says the center employs a model of care that establishes a trauma-focused therapeutic “home base.” The goal is to help patients access wrap-around services for recovery at no cost.
The center is grant-funded through the Ohio Office of the Attorney General with federal funds from the Victims of Crime Act and American Rescue Plan.
Services include:
- Crisis intervention
- Evidence-based individual and group psychotherapy
- Legal advocacy and assistance in filing police reports and accessing victim compensation funds
- Medication management
- Transportation to care appointments
- Trauma-informed clinical case management
Patients at the trauma center receive care from a wide range of specialists, including:
- Crisis intervention clinicians
- Clinical case managers
- Trauma-focused psychotherapists
- Community outreach and engagement coordinators
- Certified victim advocates
- Certified nurse practitioners
- Dedicated trauma-informed administrative and support staff
Deploying BEST for business and community members
The BEST (Brief Emotional Support Team) model translates to community members, too. The Trauma Recovery Center provides quarterly trainings for community members that are more extensive to ensure participants understand trauma-informed care principles, Galligher says.
The STAR Program also provides BEST training for corporations, schools and nonprofits. The training is available for any organization that would benefit from having a supportive culture embedded in their team.
Often when a crisis occurs, employers and other community groups do a great job of providing support like counselors and therapy dogs, while colleagues give one another grace for a few days afterward, Galligher says. But 72 hours later, those supports are gone.
“Many people don’t feel the impact of these stressors until days, weeks or months later,” Galligher says. “That’s the differentiator with BEST. We have follow-up built into the training; this is not a one-time conversation.”
Researching the impact of a holistic approach
The STAR Program leads and takes part in multiple projects to study the best ways to improve care for those dealing with trauma and chronic stress. Current research includes testing the efficacy of the BEST program.
Another important research focus involves survivors of violent crime. The STAR Program studies the unique needs and challenges faced by survivors to establish responsive care models and best practices. It’s working to understand the:
- Impacts of social determinants of health
- Needs of this population
- Reasons that traditional care formats don’t always work for these patients
“In general, we know that a lot of folks who have been victimized are not well-served in a traditional ambulatory setting,” Galligher says. “We want to learn more about how best to engage patients into services that meet their needs more holistically.”
