Trauma informed care has been applied to clinical practice in a variety of ways. Trauma informed care considers the trauma an individual has experienced and how that impacts their thoughts, feelings, and behaviors. Becoming mindful of an individual’s past trauma informs how they will receive treatment, determines the best practices for the individual, and allows a clinician to meet the client where they are in terms of treatment.
To understand trauma informed care, one must learn the definition of trauma. Trauma results from an event, a series of events, or a set of circumstances that threaten an individual’s physical or emotional safety (Tudor, 2023). In some cases, trauma has threatened the physical and emotional safety of an individual. Trauma has the potential to have harmful effects on an individual’s everyday functioning. Other areas of life such as emotional, physical, spiritual, and social well-being have the potential to be affected by the trauma an individual experiences.
Ensuring that treatment is collaborative with the individual who is seeking service is an important aspect of trauma informed care. This supports the client and “Having their voices heard is often contrary to the silencing that many trauma survivors have experienced” (Freeman 2001 as cited in Clark et al., 2014). Collaboration can look like establishing treatment goals together rather than ruling over their treatment plan. Providing constant information about the treatment a trauma survivor will be participating in helps them become more active in the process and establishes a sense of trust and safety.
Safety is important in the therapeutic relationship with a trauma survivor as it empowers the individual to regain control in their life. Ensuring safety for the individual can occur in multiple ways. The first is being aware of the physical space that you and the individual will be in for therapeutic sessions. The environment a trauma survivor is placed in has the potential to trigger memories, emotions, and behaviors related to their traumatic experience(s). For example, following the individual’s lead when it comes to greeting at the beginning of sessions (handshake or a “hello”), letting them choose where to sit in the room, and asking them if they prefer the door to be open or closed during the session (Clark et al., 2014). Providers should also consider asking the trauma survivor what steps they can take to enhance their sense of safety because “…when meeting with a survivor for the first time, not feeling safe is…understandable and normal” (Clark et al., 2014). A trauma survivor may not have an answer to this question, but it communicates that their sense of safety is important to the provider.
When implementing trauma informed care, the provider must stay mindful that the trauma survivor is the expert in their own story. This does not stop the provider from helping the individual process trauma, rather it allows the individual to process at a pace that is appropriate to them. When a provider is able to give the trauma survivor full control in recounting their experiences, this can eradicate the provider’s ability to make assumptions of the thoughts, feelings, and behaviors of the individual surrounding their trauma. In a study done by Deutsch et al. (2015), in collaboration with the Native Women’s Shelter of Montreal, members of the urban Aboriginal community were asked to take pictures of people, places, and things that were special to them. Participants concluded that being able to tell their stories in their own words and pictures helped them process their trauma in a way that provides a “…sense of hope, belonging, and meaning for people in light of traumatic experiences” (White & Epston, 1990 as cited in Deutsch et al., 2015). Riverbend is a non-profit organization in northeast Massachusetts that provides a spectrum of substance use and mental health treatment services. Gianna Sandelli, Riverbend’s division director of Community Outreach Services shares the importance of allowing the trauma survivor to be the expert in their own stories in when engaging in outreach services: “Trauma informed care includes meeting a person where they currently are and providing a safe space to support the emotional and physical well-being of an individual who has decided to share their story with you”.
Delivering clinical practice using a trauma informed perspective assists a trauma survivor in exploring and processing their traumatic experiences. Understanding how trauma impacts a person’s well-being, ensuring safety, collaboration in treatment goals and plans, and allowing the client to be an expert in their own stories can help aid the client in becoming empowered. Empowering clients guides them to make their own choices and gives them the opportunity to take their power back after traumatic experiences. Trauma informed care aims to accomplish this so trauma survivors can begin to consider what they may want for themselves when moving forward from trauma.
References
Clark, C., Classen, C. C., Fourt, A., & Shetty, M. (2014). Treating the trauma survivor: An Essential Guide to Trauma-Informed Care. Routledge.
Deutsch, R., Woolner, L., & Byington, C. (2015). Storytelling and Trauma: Reflections on “Now I See It,” a digital storytelling project and exhibition in collaboration with the Native Women’s Shelter of Montreal. McGill Journal of Education / Revue Des Sciences De L Éducation De McGill, 49(3), 707–716. https://doi.org/10.7202/1033555ar
Tudor, R. (2023). ‘Making Cuts that Matter’ in Social Work: A Diffractive Experiment with Trauma-informed Practice. Ethics and Social Welfare, 17(4), 350–365. https://doi.org/10.1080/17496535.2023.2198774