Trauma can result from experiences that overwhelm an individual’s capacity to cope. Trauma can result from multiple experiences, including abuse and neglect, family conflict, poverty, life-threatening illness, repeated and/or painful medical interventions, accidents, witnessing acts of violence, grief and loss, and intergenerational events.
Trauma can result from experiences that overwhelm an individual’s capacity to cope.

Trauma can result from multiple experiences, including abuse and neglect, family conflict, poverty, life-threatening illness, repeated and/or painful medical interventions, accidents, witnessing acts of violence, grief and loss, and intergenerational events.

TRAUMA-INFORMED CARE (TIC) 101

Trauma-Informed Care considers the universal nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize youth. Providing trauma-informed care that is expansive enough to address complex trauma requires a philosophical and cultural shift within an organization.[1]

Being trauma-informed is about creating safety and trustworthiness within health care practices, our physical/emotional environments, and daily interactions with clients, families, and staff. A trauma-informed approach is distinct from trauma-specific services or trauma systems. A trauma-informed approach includes trauma-specific interventions, assessment, treatment or recovery supports, yet it also incorporates key trauma principles into the organizational culture.[2] All staff members— from the decision makers to clinicians to support staff— need to be knowledgeable about trauma-informed approaches and must be willing to shift their fundamental approach to providing services.

TIC ASSUMPTIONS AND KEY PRINCIPALS

According to SAMHSA’s Concept of Trauma and Guidance for Trauma-Informed Approach, a trauma-informed organization is essential for all organizations, and it understands the impact of trauma and trauma recovery. SAMHSA’s concept of a trauma-informed approach is grounded in four assumptions and six key principles.[2]

THE FOUR “R’S: ASSUMPTIONS 

  1. REALIZATION ABOUT TRAUMA AND ITS EFFECT ON PEOPLE AND GROUPS

    Understand how trauma can affect families, groups, organizations, communities, and individuals. People’s experiences and behavior are understood in the context of coping strategies designed to survive adversity and overwhelming circumstances. Whether these occurred in the past, they are currently manifesting, or they are related to the emotional distress resulting from hearing about the firsthand experiences of another. 

  2. RECOGNIZING THE SIGNS OF TRAUMA

    These signs may be gender, age, or setting-specific. They may be manifested by individuals seeking or providing services in these settings. Trauma Screening and assessment assist in recognizing trauma, as do workforce development, employee assistance, and supervision practices.

  3. RESPOND TO TRAUMA

    The program, organization, or system integrates an understanding that the experience of traumatic events impacts all people involved, whether directly or indirectly. This can be accomplished through staff training and leadership that realizes the role of trauma in the lives of their staff and the people they serve.

  4. RESISTING RETRAUMATIZATION

    Organizations often inadvertently create stressful or toxic environments that interfere with the recovery of clients, staff well-being, and the fulfillment of the organizational mission. A trauma-informed approach reflects adherence to six key principles which, if employed, can prevent retraumatization. 

SIX GUIDING PRINCIPLES

These principles can be generalized across multiple settings; however, terminology and application may be setting- or sector-specific. Trauma-informed services and supports build on the best evidence available and empowerment and collaboration with youth with lived experience.

1. SAFETY

All participants of the organization should feel physically and psychologically safe. The physical setting should promote a sense of safety through interpersonal interactions. Safety should be a high priority and should be defined by those served. 

2. TRUSTWORTHINESS AND TRANSPARENCY

The operations of the organization and decisions should be conducted transparently and focus on building and maintaining trust with clients and family members, staff, and all people of the organization.

3. PEER SUPPORT 

Support is critical, especially from peers. It helps establish hope and safety, building trust and enhancing collaboration. In addition, utilizing lived experiences and testimonies can promote recovery and healing among peers/survivors.

4. COLLABORATION AND MUTUALITY 

It is essential to partner and balance the power in organizations and decision-making. The healing process concerns the participants and everyone within the organization, i.e., workers, staff, etc. Everyone has a role to play in a trauma-informed approach.  

5. EMPOWERMENT, VOICE, AND CHOICE 

Staff should not control the recovery process but instead facilitate the recovery process.  Build on individuals’ resilience and promote recovery from trauma within communities, organizations, and individuals. Shared power is where everyone mutually agrees on decisions, goals, and choices. It is critical to invest in a strengths-based approach within an organization. 

6. CULTURAL, HISTORICAL, AND GENDER ISSUES

Staff actions and programs must not be influenced by cultural stereotypes and biases. Instead, historical trauma should be recognized and addressed. In addition, race, ethnicity, sexual orientation, age, religion, gender identity, geography, etc., should be explored and incorporated within the organizational structure. Finally, the organization must ensure that individuals have an inclusive space to heal and respond to the racial, ethnic, and cultural needs of the individuals served. 

References

1. Hooper, E. H., Olivet, J. O., & Bassuk, E. B. (n.d.). TRAUMA-INFORMED CARE FOR STREET-INVOLVED YOUTH. Homeless Hub. https://www.homelesshub.ca/sites/default/files/attachments/Ch1-4-MentalHealthBook.pdf

2. Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.