Includes bibliographical references and index.

Human service organizations: dead or alive? -- "I gotta get out of this place": workplace stress as a threat to public health -- When terror becomes a way of life -- Parallel processes and trauma-organized systems -- Lack of safety: recurrent stress and organizational hyperarousal -- Loss of emotional management -- Organizational learning disabilities and organizational amnesia -- Miscommunication, conflict, and organizational alexithymia -- Authoritarianism, disempowerment, and learned helplessness -- Punishment, revenge, and organizational injustice -- Unresolved grief, reenactment, and decline -- Restoring sanctuary: organizations as living, complex adaptive social systems.

Describes what happens to human service delivery programs under the impact of unrelenting stress and multiple losses. Many social services of every size, shape, and variety are collapsing under over thirty years of system fragmentation even while public costs have escalated dramatically. The authors propose a framework for creating truly trauma-informed services.