What is trauma?
Trauma can be many different things. A traumatic experience can be dehumanizing or terrifying. It can stem from one event or multiple events compounding over time. However, it often includes betrayal of a trusted person or institution and a loss of safety. Trauma impacts one’s spirituality and relationships with self, others, communities and environment, often resulting in recurring feelings of shame, guilt, rage, isolation and/or disconnection. Despite all this, healing is possible.
What is trauma-informed care?
Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives. Trauma-informed care seeks to change the paradigm from one that asks, “What’s wrong with you?” to one that asks, “What has happened to you?”
Although exact prevalence estimates vary, there is consensus in the field that most consumers of mental health services are trauma survivors and their experiences help shape their responses to outreach and services.
Trauma-informed organizations, programs and services are based on an understanding of the vulnerabilities or triggers of trauma survivors that traditional service delivery approaches may exacerbate, so that these services and programs can be more supportive and avoid re-traumatization.
What are trauma-specific interventions?
Trauma-specific interventions are designed specifically to address the consequences of trauma in the individual and to facilitate healing. Treatment programs generally recognize the following:
- The survivor’s need to be respected, informed, connected and hopeful regarding their own recovery.
- The interrelation between trauma and symptoms of trauma (e.g., substance abuse, eating disorders, depression and anxiety).
- The need to work in a collaborative way with survivors, family and friends of the survivor, and other human services agencies in a manner that will empower survivors and consumers.
Qualities in Trauma-Informed vs. Non-Trauma-Informed Interventions
- Culture of transparency, monitor & support staff, engage youth advocacy
- Recognize high prevalence of trauma in clientele
- Assess for trauma histories and symptoms
- Recognize primary and co-occurring trauma diagnoses
- Recognize organizational culture & practices that re-traumatize
- Staff understand the adaptive function of behavior
- Collaborative process
- Language is respectful, neutral, inclusive
- Power and control minimized
- Avoid shaming/humiliating at all times
- Ask “What’s the matter?”
- Use safety plans
- Aware of triggers
- Include youth voice
- Culture of secrecy, poor monitoring of staff, no advocates for youth
- Lack of training on trauma prevalence & precautions
- Cursory/no trauma assessment
- Over-diagnose conduct disorder, bipolar disorder, schizophrenia, singular addictions
- Tradition of toughness valued as best care approach
- Behavior is seen as needy, manipulative
- Staff believe their key role is “rule enforcer”
- Warn or threaten consequence/punishment
- Ask “What’s wrong with you?”
- Physical intervention, seclusion, restraints
Source: National Center for Trauma-Informed Care
Qualities in Trauma-Informed vs. Non-Trauma-Informed Interventions (Chart) (PDF)