A recent training conference sponsored by New York University’s Silver School of Social Work, “Core Principles of Trauma-Informed Care: The Essentials” provided essential information about trauma-informed care, starting with a clear definition of trauma from the Substance Abuse and Mental Health Services Administration (SAMHSA). According to SAMHSA, individual trauma results from an:
- Event, series of events, or set of circumstances that happen
- Experienced by an individual as physically and/or emotionally harmful or threatening and that has lasting adverse
- Effects on the individual’s functioning and/or physical, social, emotional, or spiritual well-being.
Most People Have Experienced Trauma
The Social Work Career website says that 61% of men and 51% of women report exposure to at least one-lifetime traumatic one lifetime. In public behavioral health settings, 90% of clients have experienced trauma. So, it’s wise to presume clients have a history of traumatic stress and abide by generally successful procedures for delivering trauma-informed care.
On the TIC Training Center website, Lisa Bonsall, MSN, RN, CRNP, says, “Traumatic events, such as sexual abuse, domestic violence, elder abuse, and combat trauma, can have serious long-term detrimental effects on the physical, emotional, and mental well-being of an individual. These life events may lead to depression, distrust, smoking, substance abuse, shame, and low self-esteem.”
A trauma-informed approach is an approach that realizes the prevalence of trauma, recognizes how it affects people, resists re-traumatization, and responds by putting this knowledge into practice. The core principals of a trauma-informed system of care include:
- Safety: Ensuring physical and emotional safety
- Trustworthiness: Maintaining appropriate boundaries and making tasks clear
- Choice: Prioritizing choice and control (people want choices and options for people who have had control taken away, having small choices makes a big difference)
- Collaboration: Maximizing working together and cooperating
- Empowerment: Prioritizing empowerment and skill-building
Trauma can change your brain and alter your cells, explains Judith P. Siegel, LCSW. When your body cannot process trauma, it gets expressed via your body. Children who have been through a trauma but have protective and loving parents do well.
Nelba L. Marquez-Greene, LMFT, is a trauma survivor. Her 6-year old daughter, Ana, was killed during the shooting at the Sandy Hook Elementary School in Connecticut in December 2012. She offers several suggestions for mental health professionals:
- Educate clients about their bodies’ natural flight, freeze, or fight response
- Encourage clients to connect with their friends and family for support
- Be curious without being voyeuristic
- Do not let the story get too big for the client; interrupt client (suggest wiggling toes in shoes or other grounding technique to allow the client to self-regulate)
- Offer hope (For example, you might say something like, “You’re going through the most horrible event in your life but I know you’re going to make it.”)
- Try to be available for more than just 50 minutes/per week
- Be helpful with practical needs and still be around six months later