Transforming Culture, Policy and Practice


Developed by Patrick E. Boyle, Christina M. Delos Reyes, and Paul M. Kubek

This poster highlights SAMHSA's Four R's for trauma-informed organizations (i.e., realize, recognize, respond, resist re-traumatizing). Transform the culture, policies, and practices of your organization. Improve health and behavioral health outcomes for people with mental illness, substance use disorders, and co-occurring disorders. Display this poster for everyone to see.

Why Trauma-Informed Care?

Trauma has emerged as an important topic because it has long-term adverse effects upon physical health and mental health. People in our communities experience trauma in complex ways. Professionals who interact with the traumatized often have their own trauma histories. They also experience the effects of secondary trauma through the behaviors, stories, and struggles of others.

We have also developed a smaller, 8.5x11” poster to hand out to employees and clients, as well as a 5x11” reminder card that features 13 questions to help you build this self-awareness about trauma-informed approaches to your work.

Download the 18x24” poster.
Download the 8.5x11” poster. 
Download the 5x11” reminder card.