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.
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
Realizing the widespread prevalence of trauma and understanding paths for recovery.
Recognizing how trauma affects all individuals involved with the program, organization, or system (including within its own workforce).
Respond by fully integrating knowledge about trauma into policies, procedures, and practices.
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
Ensuring physical and emotional safety by maximizing control for the patient/client
Trustworthiness and Transparency
Making sure people’s desires and opinions are heard and understood
Directly addressing limits (e.g., of confidentiality)
Encouraging survivors of trauma to engage in mutual self-help
Collaboration and Mutuality
Recognizing everyone has a role to play
Leveling of power differentials
Empowerment, Voice, and Choice
Supporting the development of self-advocacy and self-empowerment
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 from https://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