The Traumatic Stress Institute fosters the transformation of organizations and service systems to trauma-informed care (TIC) through the delivery of whole-system consultation, professional training, coaching, and research.

Attitudes Related to
Trauma-Informed Care (ARTIC) Scale

The ARTIC Scale is one of the only psychometrically-valid measures of trauma-informed care (TIC) currently available. It is a measure of professional and paraprofessional attitudes toward TIC. To date, the ARTIC has been used by over 150 entities in 10 countries, translated into 4 languages, and administered to over 15,000 professionals. It was developed by the Traumatic Stress Institute of Klingberg Family Centers and Dr. Courtney Baker of Tulane University.

About the ARTIC Scale

 

ARTIC Webinar – 6.12.18

Frequently Asked Questions

Why was the ARTIC developed?

The ARTIC was developed because, until recently, there was no objective way to determine the extent to which a system or individual was trauma-informed. The many definitions of TIC tended to be vague with little guidance about how to operationalize the concept. We believed that the TIC field was primed to move from conceptual thinking to data-driven decision making, but was blocked by the absence of valid instruments. The ARTIC is a low-cost, practical, and immediate way to measure TIC within organizations and schools, and for individuals.

Why measure staff attitudes related to trauma-informed care?

The ARTIC is based on the theory that professionals’ attitudes are an important driver of their behavior. If their attitudes about TIC change, then their their moment-to-moment behavior with clients or students will also change and this would be a critical factor in successful implementation of TIC. Therefore, if TIC interventions could impact staff beliefs, it could lead to meaningful TIC change.

For what purpose can the ARTIC be used?

Organizations and schools can use the ARTIC to assess readiness for TIC implementation. They can also use it to measure change as a result of TIC interventions. It can help monitor change over time, spurring organizations to deepen their commitment to TIC, and prevent the backsliding in TIC practice that can commonly occur.  Finally it can help determine what TIC messages need reinforcement in the system and which staff need additional training and supervision.

In what settings can the ARTIC be used?

Participants in the original ARTIC study worked in human service and education settings. However, the ARTIC has now been used successfully in a wide variety of other sectors such as corrections, primary care, whole-community TIC efforts, youth development, and law enforcement.

What Is the evidence supporting the ARTIC?

Items for the ARTIC were generated by content experts via a community-based participatory research approach and tested on a sample of 760 service providers in human services and education. Item analysis resulted in a 45 item version with seven subscales (ARTIC-45), a 35 item version (ARTIC-35) with five subscales, and a 10-item short form (ARTIC-10). Confirmatory factor analysis revealed that the seven-factor model fit the data well. Internal consistency was excellent for the ARTIC-45 (α = .93) and ARTIC-35 (α = .91), and very good for the ARTIC-10 (α = .82). Subscale alphas ranged from respectable to very good. Test-retest reliabilities were also strong on all three versions.

Does the ARTIC have norms we can compare our scores to?

Measurement norms tell you how an individual score compares to that of a normed sample that also completed the measure. For example, it would tell you that your score was in the top 10% compared to others who have taken the measure.

As the ARTIC Scale is a relatively new measure, we do not have norms. Creating norms for a measure is costly and takes many years to develop.

With a large enough sample from and organization or a service system, it is possible to create “local norms.” So, for example, in a school this would enable you to say that an individual’s score was in the top 10% compared to the 500 other school staff that took the ARTIC, or in a mental health system that a clinician’s score  was in the top 10% compared to 200 other clinicians. You would need a skilled researcher to do this type of analysis.

What are the versions of the ARTIC Scale? How do I determine which to use?

There are 6 versions of the ARTIC scale: three for human service organizations and three for education settings. Organizations and schools select the version that is most appropriate for their setting and how they plan to use the ARTIC. All versions are included when you purchase the ARTIC.

ARTIC FOR HUMAN SERVICES

1. ARTIC-45 — Human Services

• 45-item scale. Takes 15-20 minutes to complete. Includes an overall score and scores on five primary subscales and two supplementary subscales.
• To be used in human service settings where staff are at least somewhat familiar with term and concept of TIC.

2. ARTIC-35 — Human Services

• 35-item scale. Takes 10-15 minutes to complete. Includes an overall score and scores on five primary subscales, but excludes the two supplementary subscales.
• To be used in human service settings where staff are not familiar with the term and concept of TIC.

3. ARTIC-10 — Human Services

• 10-item short form. Takes 5 minutes to complete. Includes overall score only.
•  To be used in human service settings where there are time or resource limitations that make the ARTIC-45 and ARTIC-35 not feasible.

ARTIC FOR EDUCATION

1. ARTIC-45 — Education

  • 45-item scale. Takes 15-20 minutes to complete. Includes an overall score and scores on five primary subscales and two supplementary subscales.
  • To be used in education settings where staff are familiar with the term and concept of TIC.
  • Language modified to fit education settings (i.e. “student” rather than “client”).

2. ARTIC-35 — Education

  • 35-item scale. Takes 10-15 minutes to complete. Includes an overall score and scores on five primary subscales, but excludes the two supplementary subscales.
  • To be used in education settings where staff are not familiar with the term and concept of TIC.
  • Language modified to fit education settings (i.e. “student” rather than “client”).

3. ARTIC-10 — Education

• 10-item short form. Takes 5 minutes to complete. Includes overall score only.
•  To be used in education settings where there are time or resource limitations that make the ARTIC-45 and ARTIC-35 not feasible.
• Language modified to fit education settings (ie. “student” rather than “client”).

What are the subscales for the ARTIC?

Core Subscales (ARTIC-35 and ARTIC-45) (There are no subscales in the ARTIC-10)

  1. Underlying Causes of Problem Behavior and Symptoms. Emphasizes behavior and symptoms as adaptations and malleable versus behavior and symptoms as intentional and fixed.
  2. Responses to Problem Behavior and Symptoms. Emphasizes relationships, flexibility, kindness, and safety as the agent of behavior and symptom change versus rules, consequences, and accountability as the agent of change.
  3. On-The-Job Behavior. Endorses empathy-focused staff behavior versus control-focused staff behavior.
  4. Self-Efficacy at Work. Endorses feeling able to meet the demands of working with a traumatized population versus feeling unable to meet the demands.
  5. Reactions to the Work. Endorses appreciating the effects of secondary trauma/vicarious traumatization and coping by seeking support versus minimizing the effects of secondary trauma/vicarious traumatization and coping by ignoring or hiding the impact.

 Supplementary Subscales (ARTIC-45 only)

6. Personal Support of Trauma-Informed Care. Endorses being supportive of, and confident about, implementation of TIC versus concerns about implementing TIC.

7. System-Wide Support of Trauma-Informed Care. Endorses feeling system-wide support for TIC versus NOT feeling supported by colleagues, supervisors, and the administration to implement TIC.

How is the ARTIC Scale scored?

When you purchase the ARTIC Scale, you will receive detailed instructions about scoring. Most people collecting ARTIC data use a statistical program such as SPSS to score and analyze the data. We do, however, include an ARTIC Excel Scoring Spreadsheet with your purchase.

As a general overview, the ARTIC uses a bipolar Likert scale. Items are scored from 1 to 7 and there are items that need to be reversed because a lower score is more favorable on those items. The Scoring Spreadsheet does this work for you. Mean scores (not total scores) are used for scoring. Higher scores are more favorable, or better, scores. Lower scores are less favorable. On Questions 36 to 45 (Subscales 6 and 7) “N/A” is offered as an option for people who do not work at an organization that has implemented trauma-informed care. These items are scored as missing.

If you collect ARTIC data via Qualtrics, you can download an Excel data file and either enter it into the ARTIC Excel Scoring Spreadsheet or a statistical program such as SPSS. It is possible to manage and analyze your data in Qualtrics. However, we do NOT provide information or support regarding that process.

Is there a way to administer the ARTIC Scale Online?

We do not yet have an online platform for administering the ARTIC Scale. We are currently developing a fully automated online platform for the ARTIC that will allow organizations to benefit from online administration of the measure and receive detailed reports of findings on individualized dashboard. This will be available in Spring 2019.

Currently, you can use Qualtrics to collect data and we can send you a Qualtrics-compatible version at no additional cost. For information about the Qualtrics platform for data management, go to the Qualtrics website. As a note, the free version of Qualtrics does not work for administering the ARTIC Scale.

Does TSI provide consultation on program evaluation/research using the ARTIC Scale?

Yes, TSI can provide paid consultation for program evaluation and research projects. Many schools, agencies, and service systems are now being required to evaluate their trauma-informed care initiatives. The ARTIC Scale, as well as other key measures, can be used to do that evaluation.

Our services include: online data collection; data analysis; creation of local norms for the evaluation; display of BOTH individual staff results and organization-wide results on an online dashboard tailored to your organization; resources for staff on how to address areas where they scored in the low range; data-driven recommendations about how to further implement, sustain, and deepen trauma-informed system change.

Contact Steve Brown, Psy.D. at steveb@klingberg.com to discuss this service.

What is included in a purchase of the ARTIC?

You will receive:

  • All versions (10-, 35-, and 45-question) for human service and education settings.
  • Instructions on how to use the ARTIC.
  • Scoring instructions, including SPSS syntax.
  • A scoring spreadsheet allowing easy and accurate scoring.
  • Qualtrics-compatible files for the ARTIC. Visit the Qualtrics website for their fee information.
What is the cost of the ARTIC?

The ARTIC is currently licensed to purchasers based on the expected number of respondents. Pricing tiers start at $500 for up to 600 respondents and the ARTIC may be used as many times as you would like per respondent. If you purchase the ARTIC and eventually expand your scope beyond your license, we ask that you contact us about additional fees.

The quickest way to purchase the ARTIC is by credit card via our secure online payment system. When you purchase online, you will receive your materials immediately by e-mail, along with a receipt. If you need to pay by check, please contact us at tsisupport@klingberg.com to request an invoice.

If you work in a research institution and the cost of the ARTIC is prohibitive, a fee waiver may be possible. We will consider other fee reductions depending on the situation. Please click here to apply for consideration.

Still have questions about the ARTIC?

If you have questions about the ARTIC that have not been answered in the FAQs, please contact us at artic@klingberg.com.

 

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