The Sanctuary Model

New Book 2010


Sandra L. Bloom, M.D. and Brian Farragher, LCSW, MBA

Destroying Sanctuary:

The Crisis in Human Service Delivery Systems

Product Description

The Sanctuary ModelFor the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems their clients seek relief from. Just as the lives of people exposed to chronic trauma and abuse become organized around the traumatic experience, so too have our social service systems become organized around the recurrent stress of trying to do more under greater pressure: they become crisis-oriented, authoritarian, disempowered, and demoralized, often living in the present moment, haunted by the past, and unable to plan for the future.

Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. Healing is possible for these clients if they enter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide.

This thoughtful, impassioned critique of business as usual begins to outline a vision for transforming our mental health and social service systems. Linking trauma theory to organizational function,Destroying Sanctuary provides a framework for creating truly trauma-informed services. The organizational change method that has become known as the Sanctuary Model lays the groundwork for establishing safe havens for individual and organizational recovery. The goals are practical: improve clinical outcomes, increase staff satisfaction and health, increase leadership competence, and develop a technology for creating and sustaining healthier systems. Only in this way can our mental health and social service systems become empowered to make a more effective contribution to the overall health of the nation.

Destroying Sanctuary is a stirring call for reform and recovery, required reading for anyone concerned with removing the formidable barriers to mental health and social services, from clinicians and administrators to consumer advocates.

Editorial Reviews

"Health care and human services have become commodities, and caregivers are forced into a factory system where productivity has nothing to do with patient care. This volume forms the diagnosis; we can eagerly look forward to the next volume in which the authors promise a treatment plan."
-Judith L. Herman, MD, Cambridge Hospital

"This should be required reading for clinicians, administrators, public policy makers, and the general public. Sandra Bloom and Brian Farragher do nothing less than describe in gripping detail what is wrong with the mental and medical health service delivery systems as they have become profit-driven and dehumanized."
-Christine A. Courtois, PhD, Associate Editor of Psychological Trauma: Research, Theory, Practice & Policy

"Sandra Bloom and Brian Farragher provide reflective readers with a wonderful description of human development and the observable steps by which we grow into content, productive people or become chronically distressed and physically ill. Destroying Sanctuary is particularly timely as we rethink various aspects of the U.S. medical care system, especially the cost of our comfortable inattention to the far-reaching impact of traumatic life experiences. "
-Vincent J. Felitti, MD, Kaiser Permanente Medical Care Program and University of California

"Bloom and Farragher challenge administrators to think in terms of reform and recovery, rather than falling back on our emphasis on 'fixing people' when in fact our systems need to be fixed. This is a rallying call for creating and sustaining healthier service systems."
-Angie Logan, Pennsylvania Department of Public Welfare

"Packed with wisdom, scientific evidence, and concepts that are vital to understanding and healing the 'chronic public health disaster' that is a consequence of endemic traumatic stress and adversity. Read it once and it and learn more."
-Robert Anda, MD, MS, Adverse Childhood Experiences (ACE) Study

"Bloom and Farragher remind us that the essential task of our human services and mental health organizations is to create and maintain environments that provide physical, psychological, social, and moral safety. They make a strong case that our current policies and programs produce institutions that are toxic for both staff and patients and this toxicity destroys any potential for emotional growth, stability, or safety."
-Michael Nunno, DSW, Cornell University

"The concept of Sanctuary has served as the guiding star of Dr. Sandra Bloom's determined quest to find better ways to offer solace, succor, and hope for people experiencing the ravages of violent and traumatic experiences. In this book series, she brings these unique talents together in creating a vision of how we can all move ahead together toward dreams that we hold dear for our individual and collective futures."
-Susan Salasin, Center for Mental Health Services, SAMHSA

"This powerful, disturbing and highly readable new book shows, with poignant examples, that toxic stress affects not only individuals but also impairs the function of organizations, including those that are supposed to provide sanctuary for traumatized children and adults."
-Bruce McEwen, PhD, The Rockefeller University


VIDEO: Watch Office of Mental Health, New York Statewide Grand Rounds, Understanding PTSD as a Gateway to More Effective Treatment with Dr. Sandra Bloompanelist Dr. Raul Silva and Moderator, Dr. Richard McCarthy.


AUDIO: Listen to Dr. Bloom and mental health workers from Iraq on NPR news with Maiken Scott.

Download description of the Iraqi visitors to Philadelphia sponsored by the Center for Nonviolence and Social Justice.


ARTICLE IN NONPROFIT WORLD: McSparren, W. and Motley, D. (2010). How To Improve the Process of Change. Non-Profit World 28(6): 14-15.


The Sanctuary Model

The Sanctuary Model

From November 29 – December 1, 2010, the Juconi Foundation – a member of the Sanctuary Network celebrating their twentieth anniversary of helping children in Puebla, Mexico and Guayaquil, Ecuador – welcomed participants from a number of countries, to the 1st International JUCONI Conference - For a World Without Violence.

Dr. Sandra Bloom gave the opening and closing plenary addresses, while Carol Tracy, Executive Director of the Women’s Law Project in Philadelphia; Dr. Elizabeth Kuh and Dr. Lyndra Bills each offered workshops.

Juconi page

Bloom interview

Tracy Interview


New York NPR channel,, does radio report on New York State juvenile justice including interviewing Finger Lakes Residential Center, Alvin Lollie about implementing the Sanctuary Model.

The Sanctuary Model

Radio Interview

Written report from WNYC, December 22









The Sanctuary Model

Center for Nonviolence and Social Justice receives 2010 Drexel University President's Award










Living Proof Podcast Series

Living Proof is the podcast series of the University at Buffalo School of Social Work. The purpose of this series is to engage practitioners and researchers in lifelong learning and to promote research to practice, practice to research. Living Proof features conversations with prominent social work professionals, interviews with cutting-edge researchers, and information on emerging trends and best practices in the field of social work.

Sandra L. Bloom, M.D., co-creator of the Sanctuary Model, discusses a trauma-informed approach to treatment and systems change. Dr. Bloom describes the paradigm shift needed to understand the psychobiology of trauma and its impact on recovery from mental illness.


Dr. Bloom honored by Creative Alternatives of New York

Read Dr. Bloom’s comments.Read article. Watch the video.

Broadway at the Boathouse...Encore!

Thank you to everyone who made this CANY's most successful event ever!

Monday, May 17, 2010
Loeb Central Park Boathouse

Hosted by
CADY HUFFMAN, Tony Winner, The Producers
DICK LATESSA, Tony Winner, Hairspray

Dr. Sandra Bloom
Creator of The Sanctuary Model for trauma-informed care
Co-Director, Center for Non-Violence & Social Justice, Drexel Univ.

Featuring performances by the stars of Promises, Promises

Special Guest
MATTHEW MORRISON, star of hit TV series “Glee"

Guest Auctioneer: Stephanie Landess




Dr. Bloom Honored by Reclaiming Youth International

The Sanctuary ModelSpirit of Crazy Horse Award Recipients

The Spirit of Crazy Horse Award Recipients

The sculptor, Korczak Ziolkowski, came to the Black Hills of South Dakota at the request of Native Americans to create a mountain memorial that would honor the spirit of Crazy Horse. In 1949, Korczak wrote these words about Crazy Horse:

"Crazy Horse was a great leader of his people. He wanted only peace and a way of living for his people without having to live on the white man's reservations. Crazy Horse defended his people and their way of life in the only manner he knew, but only after he saw the treaty of 1868 broken. This treaty, signed by the President of the United States said, ‘Paha Sapa, the Black Hills, will forever and ever be the sacred land of the Indians'. Crazy Horse's tenacity of purpose, his modest life, his unfailing courage, his tragic death set him apart and above the others.’”

Reclaiming Youth International presents The Spirit of Crazy Horse Award to honor those who have a tenacity of purpose in creating courage for discouraged children and youth through their practice, policy development, or research. Beginning in 1994, The Spirit of Crazy Horse Award has been given to the following individuals whose distinguished contributions have helped reclaim our most vulnerable children:

  • Jerry Adams, Executive Director, Urban Native Youth Association, Vancouver, British Columbia
  • Muhammad Ali, Humanitarian & World Heavyweight Champion, Berrien Springs, Michigan
  • Mubarak Awad, Peace Activist, Founder, Nonviolence Int'l and Nat'l Youth Advocate Progr., Gaithersburg, MD
  • Bonnie Benard, Founder, Resiliency Associates, Berkley, California
  • Peter Benson, President, The Search Institute, Minneapolis, Minnesota
  • Marita Bergsson, Director, Jakob Muth School, Essen, Germany
  • Mary Beth Blegen, National Teacher of the Year, Worthington, Minnesota
  • Sandra Bloom, Founder of the Sanctuary Institute, Philadelphia, Pennsylvania
  • Larry Brendtro, Founder, Reclaiming Youth International, Nemo, South Dakota
  • Martin Brokenleg, Co-Founder, Reclaiming Youth International, Victoria, British Columbia
  • Waln Brown, Founder, The William Gladden Foundation, York, Pennsylvania
  • Jack Calhoun, Founder, National Crime Prevention Council, Washington, DC
  • Duncan Campbell, Founder, Friends of the Children, Portland, Oregon
  • Richard Curwin, Co-Founder, Discipline with Dignity, San Francisco, California
  • Virginia Driving Hawk-Sneve, Children’s author, Rapid City, South Dakota
  • Lesley du Toit, Founder, Child and Youth Care Agency for Development, Pretoria, South Africa
  • Frank Fecser, Executive Director, Positive Education Program, Cleveland, Ohio
  • Geraldine Fraser-Moleketi, Minister for Public Service and Administration, Cape Town, South Africa
  • Thomas Garfat, Youth Consultant/Co-Founder, CYC-Net, Rosemere, Quebec
  • Lil Garfinkel, Youth Advocate, PACER, Minneapolis, Minnesota
  • Arnold Goldstein, Founder, Center for Research on Aggression, Syracuse, New York
  • Judge Ernestine Gray, National Juvenile & Family Court Judges Association, New Orleans, Louisiana
  • Mark Greenberg, Prevention Research Center for the Promotion of Human Development, Pennsylvania State University
  • Eleanor Guetzloe, Professor, University of South Florida, St. Petersburg, Florida
  • Mariano Guzmán, Deputy to the Superintendent of Region 9, New York City, New York
  • McClellan Hall, Founder, National Indian Youth Leadership Program, Gallup, New Mexico
  • Brian J. Hancock, Deputy Division Director, Department of Children and Families, State of New Jersey
  • Margaret Harrison, Founder, Homestart International, London, England
  • Kris Juul, Professor, Southern Illinois University, Carbondale, Illinois
  • Azim Khamisa, Founder of CANEI and Tariq Khamisa Foundation, La Jolla, California
  • Jack Kirkland, Professor, Washington University, St. Louis, Missouri
  • Cathann Kress, Director of Youth Development, National 4-H Office, Washington, DC
  • Linda Lantieri, Founder, Resolving Conflict Creatively Program, New York, New York
  • Scott Larson, Founder, Straight Ahead Ministries, Westboro, Massachusetts
  • Zvi Levi, Founder, Haddisam Youth Village, Haddisam, Israel
  • Harry Leibowitz, Founder, The World of Children Awards, Lake Tahoe, Nevada
  • Larry Long, American Troubadour, Minneapolis, Minnesota
  • Nicholas Long, Founder, Life Space Crisis Intervention Institute, Washington, DC
  • The Honorable George McGovern,Former United Nations Ambassador, Rome, Italy
  • Allen Mendler, Co-founder, Discipline Associates, Rochester, New York
  • Paul Mones, Attorney and author, Portland, Oregon
  • Arlin Ness, President Emeritus, Starr Commonwealth, Albion, Michigan
  • Gordon Neufeld, Psychologist/Consultant, Vancouver, British Columbia
  • Dan Olweus, Professor, University of Bergen, Norway
  • The Honorable Landon Pearson, Canada’s Senator for Children and Youth, Ottawa, Canada
  • Joe Padilla, Deputy, Office of Athletics and Youth Development, National Guard Bureau, Arlington, Virginia
  • Bruce Perry, Senior Fellow, Child Trauma Academy, Houston, Texas
  • Father Val Peter, Director, Father Flanagan Girls and Boys Town, Omaha, Nebraska
  • Phil Quinn, Founder, ICARE, Hermitage, Tennessee
  • The Honorable Janet Reno, Former United States Attorney General, Washington, DC
  • Warren Rhodes, Professor, Morgan State University, Dover, Delaware
  • Father Chris Riley, Founder, Youth Off The Streets, Sydney, Australia
  • Nathan Rustein, Founder, The Institute for Healing Racism, Amherst, Massachusetts
  • Keith Spencer, Superintendent of Schools, Nisga’a, British Columbia
  • Joe Stewart, Trustee, W. K. Kellogg Foundation, Battle Creek, Michigan
  • Carl Taylor, Professor, Michigan State University, East Lansing, Michigan
  • William Treanor, Founder, Youth Today, Washington, DC
  • Fred Tully, Founder, Black Hills Children’s Home, Rapid City, South Dakota
  • Harry H. Vorrath, Founder, Positive Peer Culture Model, awarded posthumously
  • Tobias Wolff, Professor, Stanford University, Stanford, California
  • Mary Wood, Founder, Developmental Therapy Institute, Athens, Georgia
  • Peter Yarrow, “Peter Paul and Mary” New York, New York


Listen to Omaha, Nebraska Radio Broadcast of "Not Alone" about the
Sanctuary Model with Dr. Sandra Bloom

The Sanctuary ModelThe Kim Foundation and station KCRO, channel 660 AM based out of Omaha, Nebraska, have partnered to produce a live, talk radio program focused on behavioral health and recovery. Titled Not Alone, the broadcast was developed by The Kim Foundation through the support of C&A Industries, Inc. in an effort to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all.

June 15 – Trauma Informed Care

Dr. Sandra Bloom, founder of the Sanctuary Model, and author of Creating Sanctuary will discuss trauma informed care and trauma informed methods for creating or changing organizational culture in order to provide more cohesive healing from psychological and social trauma. Trauma informed care recognizes that by working with youth on how to identify triggers that lead to negative behaviors, and teaching them coping skills to reduce or eliminate those negative behaviors allows for a more idyllic healing process.


Listen to Dr. Ted Corbin and Dr. John Rich discuss the Healing Hurt People Program at Hahnemann Hospital in Philadelphia. WHYY, Radio Times podcast, March 16, 2010


Listen to Dr. Ted Corbin and Dr. John Rich on WHYY Newscast, June 8, 2010


Listen to Dr. Sandra Bloom, Dr. Ted Corbin and Dr. John Rich discuss an innovative, trauma-informed emergency room program for victims of violence, Healing Hurt People recorded on July 26, 2010 WHYY, Philadelphia Public Radio Station episode of "Voices In The Family"

The Sanctuary ModelIn a city like Philadelphia, emergency room staff handle a never-ending onslaught of shooting and stabbing victims. For many victims, the violence that brought them to the hospital is a constant presence. Often, a violent incident leads to more violence. A Philadelphia program called "Healing Hurt People" tries to offer emotional support and resources after a violent attack. It is run by the Center for Nonviolence and Social Justice at Drexel University, and guest host Maiken Scott will talk with leading staff from the center. Our guests are Sandra Bloom, Theodore Corbin, and John Rich. Sandra L. Bloom, M.D. is an internationally recognized expert on trauma, and co-author of "Bearing Witness: Violence and Collective Responsibility". Dr. Theodore Corbin is an Assistant Professor in the Department of Emergency Medicine at the Drexel University College of Medicine. He also serves as the Medical Director of the Healing Hurt People Program. John A. Rich is Professor and Chair of Health Management and Policy at the Drexel University School of Public Health. His recent book about book about urban violence is called "Wrong Place, Wrong Time: Trauma and Violence in the Lives of Young Black Men." Also featured is an article from Health and Science titled, Program offers resources and support to young victims.

Philadelphia Inquirer article

Healing Hurt People article Drexel


Listen to Dr. John Rich talk about his latest book, Wrong Place, Wrong Time: Trauma and Violence in the Lives of Young Black Men.

The Sanctuary ModelThe statistics startle: homicide death rates are more than 17 times higher for young black men than their white counterparts. Rich, chair of the department of health management and policy at the Drexel University School of Public Health, considers the impact of posttraumatic stress disorder on the survivors. His account is professional, as he finds analogies between his subjects and combat veterans and victims of sexual assault, and personal, as he reports how spendingn hours and days with these young men transformed him. Two particularly detailed moments stand out: one follows a young man through emergency room protocols, another follows Rich through prison visit procedures. Although Rich's research spans two decades, he focuses most sharply upon four young men he encountered at Boston City Hospital. The high level of violence in their communities makes young men feel physically, psychologically, and socially unsafe, Rich observes; thus, ironically, these violent young men seem to be looking for safety in a violent world. Rich joins the ranks of Rachel Carson, Michael Harrington and Ralph Nader for bringing attention to a pervasive social problem with a fresh perspective and warranted urgency. (Dec.)


New Publication from Center for Nonviolence and Social Justice and the California Endowment:

Rich, J.A., Corbin, T., Bloom, S. L., Rich, L., Evans, S., Wilson, A. (2010). Healing the Hurt: Trauma-Informed
Approaches to the Health of Boys and Young Men of Color. Los Angeles: The California Endowment


Sanctuary Model in California Endowment Report


S. L. Bloom: New Publications

Bloom, S. L. (submitted) Creating Sanctuary: An Organizational Approach to Services for Traumatized Children.
Child and Adolescent Trauma.


Bloom, S. L. (submitted) The Sanctuary Model: A Trauma-Informed Organizational Approach to Services for Traumatized Children and Youth. In Steele, W. and Malchiodi, C. (Eds.) Trauma-Informed Practice for Children and Adolescents. New York: Routledge


Bloom, S. L. (2010) Bridging the Black Hole Of Trauma: The Evolutionary Significance of the Arts. Psychotherapy and Politics International 8(3): 198-212


Bloom, S. L. and Sreedhar, S. Y. (2008) The Sanctuary Model of Trauma-Informed Organizational Change.
Reclaiming Children and Youth: From Trauma to Trust, 17(3): 48-53.


The Sanctuary Model

Bloom, S. L. and Farragher, B. (2010). Destroying Sanctuary: The Crisis in Human Service Delivery Systems. New York. Oxford University Press.

The Sanctuary Model

Bloom, S. L.(2010) Trauma-organized systems and parallel process. In N. Tehrani (Ed). Managing Trauma in the Workplace – Supporting Workers and the Organisation. London: Routledge (pp. 139-153).

The Sanctuary Model

Bloom, S. L. (2010). Sanctuary: An Operating System for Living Organizations. In N. Tehrani (Ed) Managing Trauma in the Workplace – Supporting Workers and the Organisation. London: Routledge (pp. 235-251).

The Sanctuary Model

Bloom, S. L. (2010). Organizational Stress as a Barrier to Trauma-Informed Service Delivery. Becker, M. and Levin, B. A Public Health Perspective of Women’s Mental Health, New York: Springer (pp.295-311).

The Sanctuary Model

Bloom, S. L. (2010). The Mental Health Aspects of IPV: Survivors, Professionals and Systems. In Giardino AP, Giardino ER (Eds). Intimate Partner Violence, Domestic Violence, and Spousal Abuse: A Resource for Professionals Working With Children and Families. St. Louis, MO: STM Learning (pp.207-250).

The Sanctuary Model

Bloom, S. L. (2009) An Elephant In The Room: The Impact Of Traumatic Stress On Individuals and Groups. In Brown, K. and Bergo, B. (eds) The Trauma Controversy: Philosophical and Interdisciplinary Dialogues. Albany: SUNY, 2009 (pp.143-169).

The Sanctuary Model

Bloom, S. L. (2009) Domestic Violence. In O’Brien, J. (Ed) Encyclopedia of Gender and Violence. Thousand Oaks, CA: Sage Publications (pp.216-221).

The Sanctuary Model

Corbin, T., Rich, J, Bloom, S. L., Rich, L., Evans, S., Wilson, A. (2010). Healing the Hurt: Trauma-Informed Approaches to the Health of Boys and Young Men of Color. Los Angeles: The California Endowment