What is Trauma-Informed Care?

Trauma occurs when people that are supposed to protect us instead fail us.  It happens when the people that are supposed to love us, hurt us.  These traumas, especially when they happen to us as children, shape how we see ourselves and the world around us.  It can make it hard to trust people, because trust that was previously given was used against us.  Our ability to nurture healthy and healing relationships can also be affected by trauma, which can mean that we end up continually harmed by others.

Trauma is healed within the context of healthy relationships.

What is trauma-informed care?

Trauma-informed; rather, it simply acknowledges that many of us have experienced trauma care (or TIC) is a way of creating an environment that leads to relationships that are validating, supportive, and healing.  TIC is not trauma treatment at some point in our lives, and those experiences may affect how we are able to cope in the present day.  All trauma treatment should be trauma-informed, but so should medical care, our workplaces, and our social groups.  Trauma-informed care moves us from asking “what’s wrong with you” to “what’s happened to you?” and it prevents us from being retraumatized by people and systems that behave just like the person that hurt us.

If you’ve experienced trauma, you DESERVE to have the people and professionals in your life be trauma-informed.  So what does that look like?  How do you know a person or place is trauma-informed?

There are multiple principles of trauma-informed care:

Safety

Safety means safe relationships AND safe spaces. 

Safe relationships are consistent, reliable, and predictable.  You are not judged or shamed in a safe relationship.  When you are asked questions about your experiences, those questions are open and genuine.  If you have trouble speaking up, you are encouraged to share your thoughts and needs.  You are not expected to “comply” or “follow orders.”

Safe spaces include everything in the environment.  When you make a phone call to an office, the person on the other end is warm and welcoming.  If you get a phone menu, it doesn’t feel robotic and cold.  The décor of the office is soothing, and perhaps includes plants or pleasant artwork.  Safe spaces also ensure that individuals with disabilities can easily access services.  You know you are in a safe space when you feel comfortable and confident that you will be cared for.

Trustworthiness

Trustworthiness acknowledges that seeking help can be really hard.  A trauma-informed setting will recognize the potential for shame or embarrassment, and work hard to create a relationship that can be relied on.  The relationship is transparent and clearly defined.  Difficulty trusting is not seen as a something bad; instead, it is accepted as a response to trauma and one that can only be overcome by consistency and clarity.  You will know you are in a trauma-informed setting when any hesitancy or uncertainty is acknowledged, and you are given an opportunity to ask questions and get clear and consistent answers.

Choice

Even though choice is third on this list, it is one of the most important elements of trauma-informed care.  As an active participant in your care, you have a choice in what you do or don’t do.  You should never be expected to blindly follow along if you have questions or concerns.  A trauma-informed environment will give you choice about how much to share and when, what is most important to address, and how to meet your goals.  Even if someone on your care team has a recommendation for you to follow, a trauma-informed setting recognizes that you ultimately get to make the final decision and you can do so without receiving confrontation, demands, or frustration. 

Collaboration

Collaboration means that you are given information, not advice.  The person taking care of you should be the one asking questions because you are the expert on yourself.  You must be given the opportunity to be independent and make your own decisions.  You are in the driver’s seat of your care as the most important person on the care team.  When you leave an appointment with someone skilled in collaboration, you feel like you were involved in the process, not that it was done to you.

Empowerment

And finally, empowerment is the belief and encouragement that you are perfectly okay as you are and you can do great things.  Your trauma may have been painful and may continue to cause you pain, but there are so many possibilities ahead.  To empower someone, we use ‘person first’ language.  This means that we don’t label people based on something they experienced because we are all so much more complex than that.  You aren’t an addict; you are a person with a substance use problem.  You aren’t “bipolar;” you have a bipolar disorder. 

Too good to be true?

We can expect that the vast majority of therapists are trauma-informed, as an understanding of trauma is a basic part of our education. However, even people and places that aren’t in a position to assess for trauma can still be trauma-sensitive.  This means that the person taking care of you may not have asked you about your history of trauma, but still came from a place of support and compassion just in case. This may seem incredibly unfamiliar to many of us when we think about our doctors, our dentists, or even our bosses. 

Like many people, I had many years of dentist appointments that were NOT fun.  Who hasn’t been shamed for not flossing enough, right?  You’re kept there with your mouth open so you can’t ask questions, in a room that smells like chemicals and is full of pokey, proddy things, and you feel completely vulnerable.

Until I met a dentist that truly functions as trauma-sensitive.  Now I can’t say whether he and his staff have gone through any training or they’re just naturally good at it but let me tell you about the difference.

They make me feel safe when I am there.  There is beautiful art on the walls, a softly scented candle burning in the hallway, and every person I interact with is friendly and kind.  And they are ALWAYS friendly and kind.  I never wonder whether someone is having a bad day or what mood they’ll be in.   

The dentist and hygienists are trustworthy.  I get the same, consistent information and education, regardless of who I am seeing.  They acknowledge that coming the dentist is hard, and that many of us have had bad experiences in the past.  They make it okay to discuss what is uncomfortable or what worries me.

They empower me to make my own choices.  I truly believe that they collaborate with me, giving me options, education, and suggestions, and support the decisions I make.  They praise small wins, and encourage me to keep flossing! 

I actually look forward to going to the dentist now, because I am 100% confident that they will be compassionate, helpful, and make the experience as good as possible.  These experiences have gone a long way in reducing the stress that built up over the years about going to the dentist.

You can feel the difference of trauma-informed or trauma-sensitive care

Basically, you can FEEL when you are in an environment that acknowledges that most people have experienced trauma.  My dentist example was pretty simple, so imagine how much different it would feel if you are attempting your first pap smear after a sexual assault.  Or you are brave enough to finally bring up your depression to your doctor.  Or you have a weird lump or bump, and you’re afraid because you’ve lost someone you love to cancer.  Your experience will be dramatically different when you are cared for by a person, a team, and in an environment that is trauma-informed.

I know this can feel really hard to find, and I accept that this is an area where we still need a lot of growth and improvement as a society.  However, I want you to know that just because trauma-informed care may be a bit harder to find, that does NOT change the very simple fact that you deserve that type of care.  The status quo is not always helpful and is not always right, though it can feel like we are the ones in the wrong when we question whether it works for us.

You deserve to have safety, trustworthiness, choice, collaboration, and empowerment in all of your care.

The Hopeful Path Way

Hopeful Path Counseling works very hard to bring all five of these elements into our work together.  Part of why I love telehealth is your ability to find wherever feels safe for you.  I don’t use phone trees, and if you call me, you’ll a voicemail with my voice and a return call directly from me.  I will be consistent and predictable, so you always know what to expect when we’re together.  If something needs to change, or there’s something out of the ordinary, you’ll be informed so you can make whatever choices help you to feel empowered.  At the end of the day, any work we do together is directed by you.  I may suggest some things, or recommend what may help you meet your goals, but I am not here to tell you what to do.  I respect you too much to do that.  Instead, I will help you figure out your goals and give you the resources and tools you need to get to where you want to go.

Need help?

If you’re ready to start therapy, or just want to learn more about the process, I’d love to speak with you.  Your 15-minute consultation is always at no cost to you because it is incredibly important to me that you find just the right person to share in your journey.  Use the link below to schedule your consultation or give me a call.  I’m here for you.

Take good care of yourself,

Sarah

Are you still curious or skeptical and want to check out my information?  Please do!  Here are some references I used throughout this post:

1. Bloom, S. (2013).  Creating sanctuary: Toward the evolution of sane societies.  (Rev. ed.) Routledge.
2. Guarino, K., & Decandia, C. (2015). Trauma-informed care: An ecological response. Journal of Child and Youth Care Work, 24, 7-32.
3. Levenson J. (2017). Translating trauma-informed principles into social work practice. Social Work. 65(3), 288-298. http://doi.org/10.1093/sw/swaa020