The Sanctuary Model: A restorative approach for human services organizations.

Bloom is founder and “guiding light” of the Sanctuary Institute at
Andrus Children’s Center, in Yonkers, New York, USA, associate professor of
Health Management and Policy at the School of Public Health and
codirector of the Center for Nonviolence and Social Justice, at Drexel University,
Philadelphia, Pennsylvania, USA. She summed up the Sanctuary Model:

Most clients who present to human service delivery organizations have
been exposed to significant adversity, chronic stress, and frequently
overwhelming trauma. … [But] they cannot heal within the context of
traumatizing — or traumatized — organizations that may actually create
more, not less pathology. The goal of the Sanctuary Model is to
facilitate the development of an organizational culture that can
contain, manage, and help transform the terrible life experiences that
have molded — and often deformed — the clients in care. But no one
person can change an organizational culture — at least not for the
better. Living systems are comprised of living people who tend to
support what they help to create — and who fail to support change
efforts that exclude them.

In 10 days of inpatient psychiatric treatment, said Bloom, “People had a very different experience from the past. They were able to internalize an alternative that included respect and participation in a community. They learned that they were not sick, crazy or bad but injured, and as a result they had problems. They became part of a community based on shared responsibility that supported them in their efforts to stop doing the things that made them feel bad. Traditionally, they had merely been given a label and a diagnosis, but that didn’t help them know what to do to help themselves. Our systems of care were not trauma-informed so we were pretty much at sea. As we became informed about the effects of trauma, we taught people what their overwhelming experiences had done to their bodies and minds.”

Bloom and her colleagues developed and taught clients how to use the S.E.L.F. tool (part of the Sanctuary Tool Kit), which represents four key aspects of recovery from bad experiences: Safety, Emotional Management, Loss and Future.

Staff also created and supported “ritual passages” to promote healing. “People need structured ritual passages to move through their lives — funerals, birthdays,” said Bloom. So they devised a series of levels for people to move through, beginning with a ceremony of admission to the program, then marking a patient’s movement into doing their own work, becoming a mentor for others and finally preparing to go home.

The Sanctuary Model worked so well in these treatment settings that Bloom decided to share it with other organizations. She and colleagues at the Sanctuary Institute developed the Sanctuary Model training and implementation process currently being adopted by over 100 human-service delivery organizations worldwide. Bloom said that the institute has trained over 100 programs, including large state programs funded by the Pennsylvania Department of Public Welfare and New York State Office of Children and Family Services; residential, children and family services, acute care, domestic violence programs, developmentally disabled and group home programs, juvenile justice facilities, voluntary agencies and homeless shelters. “Sanctuary can apply to any social services program,” she said.

Essential to the Sanctuary Model is a culture of communication and collaboration between members of an organization. The model’s very implementation process cultivates collaboration:

Teams of five to eight people, from various levels of the organization, come together to learn from our faculty, colleagues from other organizations and one another and begin to create a shared vision of the kind of organization they want to create. …. This Core Steering Committee Team therefore not only plans together how best to share what they are learning with the larger organization, but also plans how to train all agency personnel and clients in the Sanctuary principles, how to integrate the Sanctuary Toolkit into the day-to-day operation of the organization and how to evaluate how these initiatives are taking hold in the organization. … By looking at shared assumptions, goals, and existing practice, staff members from various levels of the organization are required to share in an analysis of their own structure and functioning, often asking themselves and each other provocative questions that have never been overtly surfaced before. As this happens, the development of more democratic, participatory processes begin to emerge.

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