Trauma-Informed Care
Introduction[edit | edit source]
Due to a high prevalence of unidentified trauma and Adverse Childhood Experiences (ACE) within the population, Trauma-Informed Care (TIC) has become a valuable part of patient care. Especially in settings of conflict or natural disasters, a mindset within the professional health and social services, which is attentive towards past trauma in care-seekers, can prevent retraumatization and improve treatment outcome. Individuals who have experienced trauma or ACE are more vulnerable to a variety of health implications and diseases, e.g. mental health disorders, substance abuse, cardiovascular diseases, chronic pain disorders, etc.[1] Often, trauma is not detected or dealt with and subconsciously affects the patients' response to treatment. Mindfulness towards trauma and ACE can help to lessen the long-term effects on physical and mental health in affected individuals by addressing the underlying conditions in a sensitive and respectful matter.
“Trauma-informed services do no harm i.e. they do not re-traumatise or blame victims for their efforts to manage their traumatic reactions, and they embrace a message of hope and optimism that recovery is possible. In trauma-informed services, trauma survivors are seen as unique individuals who have experienced extremely abnormal situations and have managed as best they could”. (Dr Cathy Kezelman)[2]
Principles[edit | edit source]
To promote TIC, service providers and systems of clinical practice and social services should follow the basic principles. Depending on the source, five to seven principles can be found.[3][4][2]
- SAFETY The first and most important principle of TIC is to ensure a feeling of physical, psychological and emotional safety - for both staff and patients.
- COLLABORATION It is essential to involve the patient into treatment plans. In general, decisions should be shared between staff of different levels/ professions and the individual.
- TRUSTWORTHINESS (& TRANSPARENCY) An important aspect includes clarity in communication and decision-making in order to build trust.
- EMPOWERMENT Both, patients and professionals need to be able to make use of their strengths. This principle supports the resilience and self-efficacy within therapy/ the process of healing by giving back control to the individual.
- CHOICE One vital aspect is to provide and encourage opportunities to make individual choices for all involved patients and professionals, along all stages of treatment.
- PEER SUPPORT Bringing together patients and professionals with similar experiences can help to achieve integration of individuals into the service or therapy.
- HUMILITY AND RESPONSIVENESS/ RESPECT FOR DIVERSITY Trauma based on discrimination (e.g. of gender, skin colour, ethnicity,...) are recognized, bias and stereotypes are addressed, and diversity is respected in every way during treatment by both patients and staff.
Definition of Trauma[edit | edit source]
As defined by the Substance Abuse and Mental Health Service Administration (SAMSA) in their Concept of Trauma and Guidance for a Trauma-Informed Approach, "trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being".[5]Trauma can affect any person from any cultural, socio-economic, ethnic, religious or educational background and is non-specific to gender or age.
Key Components to Implement Trauma-Informed Care[edit | edit source]
To implement a TIC, training of clinical and non-clinical staff is necessary.[6] The framework should strongly be founded on the above-mentioned principles to TIC. Standard clinical and administrative procedures should be reviewed under those aspects, and should also be reviewed from a patient-centred point of view.
Further Resources[edit | edit source]
Physiotherapy Assessment of Pain within a Trauma-Informed Care Model
For more information and practice implementation strategies, visit the websites of the Trauma-Informed Care Resource Centre or the Californian Department of Health Care Service ACEAWARE. The official Concept of Trauma and Guidance for a Trauma-Informed Approach by SAMHSA can be found under this link.
- ↑ SAMHSA. Trauma-Informed Care in Behavioural Health Services. Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Abuse Treatment (US). Rockville (MD); 2014. Available from:https://www.ncbi.nlm.nih.gov/books/NBK207195/ (last accessed 27 March 2022).
- ↑ 2.0 2.1 NSW Health. What is Trauma-Informed Care? Available from: https://www.health.nsw.gov.au/mentalhealth/psychosocial/principles/Pages/trauma-informed.aspx (last accessed 27 March 2022).
- ↑ University at Buffalo Centre for Social Research. What is Trauma-Informed Care? Available from:https://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html (last accessed 27 March 2022).
- ↑ Trauma-Informed Care Implementation Resource Centre. What is Trauma-Informed Care? Available from: https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/ (last accessed 27 March 2022).
- ↑ Substance Abuse and Mental Health Service 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. Available from:https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf (last accessed 27 March 2022).
- ↑ Menschner C, Maul A, Center for Health Care Strategies. Key Ingredients for Successful Trauma-Informed Care Implementation. April 2016. Available from: https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf (last accessed 27 March 2022).
