SAMHSA’s 2014 Concept of Trauma was a landmark publication that has influenced service provision beyond the areas of behavioral health and health care. In 2014, SAMHSA also released Treatment Improvement Protocol (TIP) 57, Trauma-Informed Care in Behavioral Health Services.
Trauma continues to be a cross-SAMHSA priority, given its significant role in behavioral health prevention, treatment, and recovery. The primary goal of this practical guide is to expand the discussion presented in SAMHSA’s earlier resources, specifically focusing on tools and strategies for implementing a trauma-informed approach (TIA).
This guide highlights the need for organizational assessment of readiness and capacity before implementing TIA and describes strategies for such assessments. The guide focuses on implementation strategies across the following 10 domains:
1. Training and Workforce Development
2. Governance and Leadership
3. Cross Sector Collaboration
4. Financing
5. Physical Environment
6. Engagement and Involvement
7. Screening, Assessment, and Treatment Services
8. Progress Monitoring and Quality Assurance
9. Policy
10. Evaluation
The guide is intended for anyone involved in organization-level change, including practitioners, state and local officials, policymakers, federal and non-federal funders, peers, and family members.

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Page last modified or reviewed by athealth.com on May 21, 2026.

Dr. Miriam E. Delphin-Rittmon was formerly the Assistant Secretary for Mental Health and Substance Use in the U.S. Department of Health and Human Services and the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). As the Assistant Secretary, Dr. Delphin-Rittmon was charged with addressing the behavioral health of the nation and improving the lives of individuals living with mental and substance use disorders and their families.

Dr. Delphin-Rittmon led SAMHSA in standing up the 988 Suicide and Crisis Lifeline, which offers free 24/7 crisis support, and in addressing overdose SAMHSA increased nationwide naloxone distribution by 33%, contributing to a 15% reduction in overdose deaths – the first decrease we have seen in over five years.

She previously served as Commissioner of the Connecticut Department of Mental Health and Addiction Services (DMHAS) from 2015 to 2021. Prior to this role, she served as Deputy Commissioner, Senior Policy Advisor, and Director of the Office of Multicultural Healthcare Equity at DMHAS. In her role as Commissioner, Dr. Delphin-Rittmon was committed to promoting recovery oriented, integrated, and culturally responsive services and systems that foster dignity, respect, and meaningful community inclusion.

In addition, Dr. Delphin-Rittmon served on the faculty at Yale University in the Department of Psychiatry for 20 years, most recently as Adjunct Associate Professor and previously as Assistant Professor. While at Yale, Dr. Delphin-Rittmon also served as the Director of Cultural Competence and Health Disparities Research and Consultation with the Yale University Program for Recovery and Community Health.

In May 2014, Dr. Delphin-Rittmon completed a two-year White House appointment working as a Senior Advisor to the Administrator of SAMHSA with the U.S. Department of Health and Human Services. While at SAMHSA, she worked on a broad range of policy initiatives addressing behavioral health equity, workforce development, and healthcare reform.

Dr. Delphin-Rittmon has earned numerous awards for her work including a 2025 Presidential Citation from the American Psychological Association, the 2024 National Leadership Award from the Community Anti-Drug Coalitions of America, the 2024 College of Health and Human Sciences Distinguished Alumni Award from Purdue University and the 2024 Visionary Leadership Award from the American Psychiatric Association.

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