Abstract
INTRODUCTION: Person-centered, trauma-informed care (PCTIC) is a combined, holistic service model promoting the well-being and empowerment of trauma survivors. PURPOSE: This study examined the PCTIC knowledge, skills, and abilities needed by West Virginia (WV) Medicaid Home and Community-Based Services (HCBS) direct service professionals (DSPs) to serve clients that may have experienced trauma. METHODS: Semi-structured interviews were conducted with diverse stakeholders (n = 32) from 19 organizations that provide HCBS services in all 55 counties. Interviews focused on identifying current training, needs and knowledge gaps, and priority areas for additional PCTIC training. ATLAS.ti software was used to manage and code. Validity was established by using multiple data coders, gathering insights from multiple roles, and theory triangulation. Thematic analysis identified training needs and knowledge gaps for PCTIC approaches. RESULTS: Stakeholders identified knowledge gaps and training needs to address knowledge and empowerment of trauma, positive behavior reinforcement, and access to mental health services. Knowledge gaps included standardized operational definitions related to trauma and PCTIC and the importance of assuring accessibility for evidence-based training for all staff levels. In addition, tailoring for various educational backgrounds and skills was recommended to achieve new performance levels among DSPs. Areas to strengthen current trainings included facilitation of culture change, self-care, listening skills, setting boundaries, and problem-solving/critical thinking. IMPLICATIONS: Results confirm PCTIC training needs for DSPs to strengthen the WV Medicaid HCBS workforce. However, HCBS training implementation and competency areas should consider factors such as understanding/balancing the training needs and abilities of clinically and non-clinically trained workforce and organizational responsiveness.