The statistics on abuse and violence in the US are alarming. Reportedly, 25% of all children experience some type of physical, sexual, or emotional abuse. 25% of the women in the US have experienced domestic violence, and 20% have experienced rape at some point in their lives. Additionally, a small percentage of men have experienced rape at some point. An alarming number of abused men and women were younger than 10 years of age when the rape occurred. Discounting the number of abuse cases that go underreported, it’s safe to say that a very large number of people have suffered serious trauma during their lives.
Trauma informed care focuses on responding to the symptoms, signs, and risks associated with trauma. This helps mental health professionals better meet the needs of patients who have suffered from traumatic experiences.
What is Trauma Informed Care?
The goal of trauma informed care is to avoid re-traumatizing a person. Failing to realize previous trauma can lead to re-traumatizing patients by unintentionally recreating conditions similar to their previous trauma. This can cause them to relive it in that moment which inhibits proper physical and mental health care. Trauma informed care means helping people find meaning and purpose in their lives, so they see themselves as more than the trauma they’ve experienced. It means helping them identify and seek ways to reduce trauma-caused distress and problems, so they experience personal autonomy and self-determination in making choices. For medical and mental health professionals, it means shifting away from the question, “What’s wrong with you?” to asking, “What happened to you?”
The Different Types of Traumas
Trauma comes in many forms, and not all trauma has physical symptoms. Trauma informed care keeps an open-minded approach and provides the compassion all patients need and deserve. It means understanding that anyone can have a history that impacts how they interact with the medical and mental health community. Providers should recognize that a large number of their patients may have a history of abuse, including physical, emotional, and sexual abuse. It is equally important to understand that serious illnesses, negative medical experiences, and violence in any form can cause trauma. Some of the most common types of traumas include:
- Domestic Violence: Domestic violence is defined as a partner or spouse who harms or threatens to harm their past or current spouse or partner.
- Bullying: Bullying is an unsolicited and deliberate action that is inflicted on another person with the sole intent of causing social, physical, emotional, or psychological harm to another person who is perceived to be “less powerful.”
- Natural Disasters: Hurricanes, wildfires, tornadoes, earthquakes, floods, and other extreme weather events such as extreme heat, blizzards, and droughts can be the source of trauma.
- Severe Illness or Injury: Medical treatment can inflict traumatic stress and elicit a physiological and psychological response in children and adults alike. This type of trauma occurs as the result of single, multiple, or ongoing medical events.
- Death of a Loved One: Some people tend to work through the grieving process when someone they love dies. For others, the trauma is long-lasting and makes it difficult to complete ordinary daily tasks. It can also cause them to have difficulties recalling positive memories of their loved ones.
- Witnessing an Act of Violence: Just witnessing an act of violence toward another person is traumatic. The trauma experienced when witnessing acts of violence affects one’s mental and emotional health as if they were the victim of the violent act.
- Sexual Violence (rape, sexual assault, sexual harassment): Sexual abuse is any interaction between two or more individuals that is unsolicited or unwanted. In most instances, victims of sexual violence are used for the sexual stimulation of a perpetrator or another observer.
- Watching Traumatic Events (television, news, films, social media, or in person): Observing acts of violence through media outlets, including TV, social media platforms, or videos, is no less traumatic than witnessing the act in person.
Helping Patients Recover from Trauma
Oftentimes, people who have endured traumatic events, witnessed acts of violence, or suffered trauma, may feel a wide range of emotions, including fear, embarrassment, sadness, anger, and/or blame. Patients who receive a positive emotional response may feel empowered. Receiving appropriately focused health care and mental care can help them heal from their trauma rather than cling to it, or run from it. It is essential that providers avoid re-traumatization using strategies such as:
- Maintaining emotional safety. Providers should approach patients who have experienced trauma with non-judgmental support. Assess patients in order to recognize strengths the patient may possess, so they can be formulated into an appropriate treatment plan.
- Provide supportive, compassionate responses to patients who have a history of trauma or other adversities without the need to elicit specific details.
- Educate and Empower by providing simple things that can be done each day to recognize how stress affects their body. Help them regulate their own stress response system and teach them how to buffer the negative impacts of trauma and toxic stress.
- Provide Referrals to mental health professionals when necessary. They are trained in evidence-based trauma therapy.
The Principles of Trauma Informed Care
With trauma being so rampant in the world and patients experiencing it at every turn and on every level, it is time to transform the health care setting. The core principles of Trauma informed care provide a new approach to care. The basic principles include:
- Patients and staff should feel both physically and psychologically safe.
- Individuals have both choice and control.
- Sharing power with the individual and making decisions with them, not for them.
- Task clarity, consistency, and interpersonal boundaries help build respect and trust.
- Provide an atmosphere that validates individuals and affirms them with every contact.
Benefits of Trauma Informed Care
Using a trauma informed approach offers a number of benefits. These are felt by patients as well as by staff and providers. Oftentimes patients who have suffered trauma have a difficult time maintaining healthy relationships with health care and mental health providers. Trauma informed care provides patients with opportunities to engage more fully in their health care, improve long-term health outcomes, and develop a trusting relationship with their provider.