INDUSTRY: Public Health & Community Services
PARTNERS: Los Angeles County Department of Public Health (DPH)
REACH: 656 DPH leadership, staff, and community partners across Los Angeles County
THE CHALLENGE
When Traditional Trauma-Informed Care Isn’t Enough: Bridging Trauma Awareness and Systems Change in Public Health
Public health workers are on the frontlines of addressing the compounding effects of systemic marginalization, chronic stress, and trauma in communities—yet the systems they work within often mirror these same dynamics. The Los Angeles County Department of Public Health (DPH) recognized a critical gap in their approach to serving diverse communities, particularly populations disproportionately impacted by social and systemic determinants of health.
While traditional trauma-informed care provides frameworks for system change, it often falls short when leaders and workforce share similar traumas with those they serve. It asks them to create safe spaces for others without equipping them to access internal safety themselves. This environment leads to well-intentioned policies and procedures becoming compliance-driven rather than collaborative, performative rather than embodied. The department needed an approach that would equip their workforce with the embodied skills necessary to truly live trauma-informed principles.
Recognizing this, DPH engaged Lumos Transforms in 2024 to create a capacity-building program that acknowledges shared trauma while supporting sustainable, relationship-centered solutions. As part of a department-wide initiative to promote trauma-informed and culturally competent practices, Lumos implemented a multi-tiered training and coaching series rooted in its embodied trauma-informed resilience-oriented (eTIRO) framework, an approach designed to transform systems by first building the capacity of individuals.
THE SOLUTION
Internal Safety for External Impact: Building Capacity from Inside Out
Lumos designed, implemented, and facilitated a foundational eTIRO capacity-building program over four months. This innovative approach moves beyond traditional trauma-informed frameworks by foregrounding the development of individual embodied resilience skills—the capacity for self-awareness, self-regulation, emotional intelligence, and empathy—as the foundation for organizational transformation.
The program featured two distinct curricular arcs: a virtual four-session, 14-hour training series for DPH Leadership and a virtual three-session, 10.5-hour series for Staff and Community Partners. Participants could self-select training cohorts based on their professional role (leadership, managers, general staff) or identity (BIPOC, LGBTQIA, Disabled), with General cohorts open to all workforce members and one-on-one coaching for leadership. The virtual format allowed flexible access across diverse departments and roles, while the option to self-select cohorts, based on identity or professional focus, fostered inclusion and reinforced peer learning. One in-person cohort also met in Koreatown to expand accessibility.
The welcoming and supportive environments created by Lumos facilitators were repeatedly praised. Participants felt affirmed and encouraged to bring their full selves to each session. Thoughtful attention was given to cohort dynamics, accessibility, and shared agreements, creating spaces that modeled the eTIRO principles in action.
Key elements included:
- Trauma-Informed Pedagogy: The curriculum combined lectures, experiential activities, and peer learning to build both theoretical knowledge and practical embodiment of eTIRO principles.
- Comprehensive Foundational Training Delivery: 36 total cohorts were offered (2 for leadership, 28 for staff, 6 for community partners), with all sessions delivered virtually except one in-person Community Partner cohort. The program totaled an impressive 385 hours of facilitation across all groups, and the Lumos facilitators received consistently glowing feedback for their skill, presence, and care.
- Identity-Affirming Design: The program honored diverse experiences by recognizing how trauma manifests differently across communities and identities, while also being a universal shared experience. Inviting participants to self-select cohorts aligned with their professional roles or personal identities centered choice and created psychologically safer spaces that encouraged deep connection and reflection while fostering peer learning. Identity-based cohorts allowed participants to express themselves more authentically through culturally relevant, shared understanding. Role-based cohorts acknowledged the different learning needs between leadership, managers, and general staff. Leadership needed to understand how to implement eTIRO in policies, staff supervision, and organizational change. Managers faced unique challenges of being “in the middle” – implementing decisions from above while supporting staff below. Inclusive general cohorts across role and identity allowed participants to focus on personal resilience, applying eTIRO principles in their work with communities, fostering cross-cultural learning, and strengthening organizational cohesion.
- Individual Leadership Coaching: 16 DPH leaders received 60 hours of one-on-one eTIRO coaching to deepen knowledge and provide thought partnership on real workplace challenges. Lumos coaches served as strategic advisors and helped coachees apply eTIRO approaches to real-life problem-solving. This individualized approach recognized that transforming an organization requires leaders who can not only understand eTIRO conceptually, but embody and model these principles in their daily leadership practices.
656 people registered for this optional training (8% of DPH’s total workforce), giving a sense of both the scale of DPH as an organization and the significant reach this program achieved in a short four-month timeframe.
THE RESULTS
Closing the Gap: Transforming Leaders, Staff, and Organizational Culture Through Trauma-informed Embodiment
Evaluation showed that the eTIRO program significantly impacted participant confidence, knowledge, and behavior. What set this training apart was its emphasis on internal transformation as a precondition for organizational change, and leaders and staff alike reported lasting shifts in how they show up for themselves and others.
“I feel reenergized by this training and am leaving with a renewed commitment to focus on strengthening my own internal practices of resilience and to work on recognizing my own self-agency.” — DPH Staff participant
The program achieved remarkable outcomes, with all participants showing statistically significant improvement across cognitive, behavioral, and affective measures. Perhaps most notably, the training revealed and addressed critical leadership gaps that had previously gone unrecognized.
Key outcomes included:
- Closing the Leadership Gap: Leadership initially scored 2-20% lower than staff on foundational skills like self-regulation, accessing internal safety, and relational attunement. By program completion, they had not only closed this gap but exceeded staff performance in several areas.
- Universal Skill Development: Staff showed 11-23% improvement in post-training responses, with participants reporting enhanced capacity for self-awareness of stress and trauma reactions and improved ability to self-regulate. Participants gained critical thinking skills to understand the systemic nature of trauma and its manifestations across interpersonal and organizational domains. This enabled deeper empathy and improved workplace communication. Across all cohorts, participants reported improved capacity to manage burnout and vicarious trauma. They also expressed strong confidence and motivation to implement eTIRO practices in their work environments. One community partner participant expressed it this way: “It’s a magnificent course…beneficial for self-awareness and self-regulating techniques…in order to provide the right amount of support and the proper approach to the families we serve.”
- Strong Implementation Readiness: There was a clear increase in participants’ understanding of the eTIRO model and how it aligns with movements for health equity and systemic transformation. Leadership saw a 24% increase in the ability to differentiate between compliance and culture change. Moderate to extreme satisfaction with the training was reported by 86-100% of participants across all groups. Participants expressed feeling confident, ready, and motivated to implement eTIRO approaches.
CONCLUSION
From Awareness to Action: A Model for Systemic Change in Public Health
The DPH eTIRO program demonstrates that authentic organizational transformation requires more than policy changes—it demands investing in the embodied capacity of individuals to truly live trauma-informed principles. Not only did the program close pre-existing knowledge and skill gaps between staff and leadership, but it also revealed opportunities for broader culture and systems change. The program’s ability to achieve significant outcomes despite operational constraints underscores both its robustness and the urgent need for organizations to prioritize the internal capacity building that makes external change possible. As a model, the eTIRO program offers a roadmap for public health systems seeking to move from trauma awareness to trauma-informed action.
