Trauma-informed care is an essential skill for healthcare providers to prevent retraumatization. It also takes into consideration patient-centered communication and the trauma experienced in childhood, often referred to as adverse childhood experiences. Trauma-informed care and patient-centered care are important tools for service providers to use with patients who have experienced trauma including childhood trauma and human trafficking.
Trauma-informed care refers to a way of providing services, including healthcare, social services, and education, that takes into consideration the profound impact of trauma.
It employs a universal approach of treating everyone as if they may have experienced trauma at the individual-level through the careful use of language (e.g., avoiding calling an exam table a bed) and actions (e.g., empowering patients to determine the order of events in a clinical exam).1 Many institutions also have policies, procedures, and training to ensure an organizational approach where the organization makes a commitment to addressing trauma for those it serves as well as its employees.2
A trauma-informed approach is a strengths-based service delivery approach grounded in understanding and responding to the impact of trauma that emphasizes physical, psychological, and emotional safety for both providers and survivors to rebuild a sense of control and empowerment.2
A trauma-specific intervention refers to tailored interventions specifically to individuals with known trauma to redress their trauma and its sequelae.2
A trauma-informed approach incorporates the 4 “R’s”2
1
Realizing
Realizing the widespread prevalence of trauma and understanding paths for recovery.
2
Recognizing
Recognizing how trauma affects all individuals involved with the program, organization, or system (including within its own workforce).
3
Respond
Respond by fully integrating knowledge about trauma into policies, procedures, and practices.
4
Resist
Seek to actively resist re-traumatization.
What can cause re-traumatization?
- Mislabeling symptoms as personality or other mental disorders, rather than as traumatic stress reactions
- Being overly authoritative when interacting with service participants
- Using a confrontational approach
- Challenging or discounting reports of abuse or other traumatic events
- Labeling service participant’s behavior/feelings as pathological
- Being unaware that the service participant’s traumatic history significantly affects their life
6 key principles of a trauma-informed approach2
1
Safety
Ensuring physical and emotional safety by maximizing control for the patient/client
2
Trustworthiness and Transparency
Making sure people’s desires and opinions are heard and understood
Directly addressing limits (e.g., of confidentiality)
3
Peer Support
Encouraging survivors of trauma to engage in mutual self-help
4
Collaboration and Mutuality
Recognizing everyone has a role to play
Leveling of power differentials
5
Empowerment, Voice, and Choice
Supporting the development of self-advocacy and self-empowerment
6
Cultural, Historical, and Gender Issues
Recognition of the historical trauma leveraged against individuals based on culture, race/ethnicity, gender, and other marginalized identities
Trauma-informed care changes everyone’s WAY OF RESPONDING from2
“What’s wrong with you?” to “What happened to you?”
For more information on trauma-informed care trainings for your organization, please see the University of Michigan CASCAID Group.
1. Substance Abuse and Mental Health Services. (2014)
Trauma-Informed Care in Behavioral Health Services
Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD. Retrieved May 29, 2018 fromhttps://store.samhsa.gov/shin/content/SMA14-4816/SMA14-4816.pdf
2. Bloom, S. (n.d.)
The Sanctuary Model
Retrieved October 1, 2018 from http://www.sanctuaryweb.com/TheSanctuaryModel.aspx
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