“Trauma-informed care embraces a perspective that highlights adaptation over symptoms and resilience over pathology.” – Elliot et al., 2005
A trauma-informed practice acknowledges and understands the effect of trauma on people. Being trauma aware does not mean that you must assume everyone has a history of trauma, but rather that you anticipate the possibility from your initial contact and interactions, in-take processes, and screening and assessment procedures.
The core trauma-informed principles are:
- Acknowledgement – recognizing that trauma is pervasive – Trama Informed Care (TIC) is a structured organizational and treatment framework which involves recognizing, understanding and responding to the effects of all kinds of trauma. It emphasizes the physical, psychological and emotional wellbeing of survivors to rebuild a sense of control and empowerment. The total life experiences of patients impact their beliefs, coping mechanisms, reactions and health. TIC does not segment singular experiences of a patient, but recognizes that each experience accumulates over a lifespan, leaving the patient with a set of complex challenges.
- Safety – Creating cultures of trauma informed care means creating spaces where people feel emotionally, physically and culturally safe. Safety and trustworthiness can be established through such practices as empowering intake procedures, kind and respectful interactions, having the ability to control some aspects of the physical space, providing clear information about the programming, ensuring informed consent, creating safety plans, and demonstrating predictable expectations.
- Trust – Meaningful sharing of power and decision-making. Transparent operations and decisions maintain trust. Ensuring trustworthiness through clarity and consistency.
- Choice and control – Voice and choice. The aim here is to strengthen staff’s, participants’, and families’ experience of choice. There is recognition of the need for an individualized approach. There is active participation in decision-making regarding services. It is understood that offering built-in small choices make a real difference.
- Compassion – Compassion can be defined as a deep and non-judgemental awareness of the suffering of others, with the felt desire to relieve that suffering and increase well-being. Of course compassionate attention can have positive effects on everyone; its impact on those who have experienced trauma is particularly noteworthy. Trauma, especially interpersonal violence and victimization, can result in alienation from others and oneself, it can create expectations of further maltreatment, and other long lasting negative impacts on connections and relationships. Compassionate attention by a caring other encourages these connections and can be reparative.
- Collaboration – There is true partnering and leveling of power differences between staff and clients and among organizational staff from direct care staff to administrators. There is recognition that healing happens in relationships and in the meaningful sharing of power and decision-making. Recognize that everyone has a role to play in a trauma-informed approach. One does not have to be a therapist to be therapeutic.
- Strengths-based – Strengths-based approaches concentrate on the inherent strengths of individuals, families, groups and organizations, deploying personal strengths to aid recovery and empowerment. In essence, to focus on health and well-being is to embrace an asset-based approach where the goal is to promote the positive.
Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma‐informed or trauma‐denied: Principles and implementation of trauma‐informed services for women. Journal of Community Psychology, 33(4), 461-477.
Substance Abuse and Mental Health Services Administration (2014). Trauma-informed care in behavioural health services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: SAMHSA.