Author: Angela Powell, MA, LPC Trauma informed care is an approach by people in the field of human services which assumes that everyone they come across may have a trauma background. This form of care considers the impact of trauma on a person’s function and promotes an environment of healing and recovery without engaging in practices that may potentially re-traumatize and individual. All too often, trauma survivors are re-traumatized by well-meaning caregivers. By practicing trauma informed care, we can have the paradigm shift from “what is wrong with this patient?” to “What has happened to this person?” The intentions is not to treat the issues relating to the different types of trauma including sexual, physical or emotional abuse but rather a way of providing services to people with an approach of compassion, consideration, boundaries and understanding that the events that have occurred in a person’s life may impact how they respond to different situations. Re-traumatization can occur if the client is exposed to a person or situation which resembles to individual’s trauma either symbolically or literally. When triggered, the emotions and behavioral reactions related to being in that trauma can occur. Some practices to consider which may be potentially re-traumatizing include use of restraints, isolating the client, sexual comments and gestures, loud noises, specific smells, sounds, cluttered spaces, lack of cleanliness and quick body movements. Individuals who have experienced re-traumatization are less likely to engage in treatment and follow through with treatment plans. The more frequently re-traumatization occurs the more likely the person is to have exaggerated trauma-related symptoms. It can be very difficult for a person to have to explain their trauma to every health professional they encounter as it brings up multiple emotions and past experiences. Having to remind the same professional of the same past trauma experiences leads the person to believe and feel that they are not being heard and not worth being listened to. When a person is treated as a number, they do not feel safe or cared about. By taking time to read each person’s chart before seeing them and sitting with each individual person and talk to them about what is going on with them helps the person recognize how much you care and validates their experiences. Why would they trust someone who doesn’t show enough care to know them by name or what they are being seen for? If a person has to disrobe, this can make the individual feel insecure and unsafe. Limit the need to disrobe to only when necessary and make sure that the individual understands why disrobing needs to occur, for how long, and what will occur when disrobed to help the individual feel more secure. Also, when a person is only seen as their diagnosis it harms the ability to be collaborative in care. Each person is more than a label; work to find out things that the person enjoys, dislikes and what makes them an individual. A person is more than PTSD or Bipolar they are individuals with specific struggles and successes. The loss of power and control is prevalent in many forms of trauma. When we do not offer choices in treatment planning it can take away any sense of control over a person’s rights and health. You are not providing a service for each client, patient or individual; you are working with each person to collaborate ways to improve their health and well-being. Allow for each person to have the opportunity to provide feedback on the services rendered. This helps them to be heard and reduces the belief that they are being coerced. Retraumatization Infographic Transcript(80 KB) Chart by the Institute on Trauma and Trauma-Informed Care (2015) There are some key components of trauma informed care that when implemented can provide an environment that is safe, private and respectful. These include:
- Creating common areas that are welcoming, calm, relaxing and where privacy is respected.
- Ensure that everyone has a clear understanding of their rights and responsibilities.
- Involving the individual in the planning and executing of services.
- Being respectful and ensuring that professional boundaries are maintained.
- Provide an atmosphere in which the client feels affirmed and validated
This is just the basics of being a trauma informed professional. There are many different aspects of trauma informed care and the more you understand about trauma and how it impacts others the better provider you can be.
1. Substance Abuse and Mental Health Services Administration. (2014). Concept of Trauma and Guidance for a Trauma-Informed Care Approach. U.S. Department of Health and Human Services. 2. Bloom, S. L. (1997). Creating sanctuary: Toward the evolution of sane societies. New York: Routledge. 3. Harris, M. & Fallot, R. D. (Eds.) (2001). Using Trauma Theory to Design Service Systems. New Directions for Mental Health Services. San Francisco: Jossey-Bass. 4. Jennings, A. (2015). Retraumatization [PowerPoint slides]. Retrieved from http://theannainstitute.org