Trauma-Informed Care

What is Trauma-Informed Care?

Trauma-informed care is a service delivery approach focused on an understanding of and responsiveness to the impact of trauma. It promotes positive outcomes by emphasizing physical, psychological, and emotional safety and enhances wellbeing by empowering individuals to define their needs and goals and make choices about their care and services.

Trauma-informed care is a universal framework that any organization can implement to build a culture that acknowledges and anticipates that many people we serve or interact with have histories of trauma and that the environment and interpersonal interactions within an organization can exacerbate the physical, mental, and behavioral manifestations of trauma. Trauma-informed care requires that all staff are trained to be aware of trauma and avoid processes and practices that may re-traumatize survivors.

Employment Support Gone Wrong

Trauma Informed's Mark O'Brien and Morgan Gliedman demonstrate how not to do trauma-informed care.

Not a One-Size-Fits-All Approach

Trauma-informed care is not a one-size-fits-all approach to service delivery. It’s not a program. It’s a set of principles and approaches that can shape the ways that people interact within an organization, with clients, patients, customers, and other stakeholders, and with the environment.

Identity and Culture Matter

Identity and intersectionality are powerful contexts in which a person’s experience of trauma are shaped and a significant reason that the same event can be traumatic for one person but not for another. Historical, racial, and other intergenerational traumas are a part of a person’s experience, and being trauma-informed means recognizing and respecting this reality and showing humility about the aspects of a person’s cultural experiences that are different from your own and that you might not fully understand.

Principles of Trauma-Informed Care

Infographic: 6 Guiding Principles to a Trauma-Informed Approach, U.S. Centers for Disease Control and Prevention.

Safety

Safety means that throughout the organization, the people we serve and the people we work with, feel physically and emotionally safe. Not only is the physical setting safe, but interpersonal interactions also promote a sense of safety. We strive to understand safety from the perspective of the people we serve.

Trustworthiness and Transparency

Trustworthiness and transparency are critical elements of trauma-informed care. The goal is to build and maintain trust with people served and their family members, among staff and leadership, and with all others involved in the organization. This is about building a culture of honesty, where people follow through on their commitments to each other and the people they serve.

Peer Support

Peers are people with lived experiences of trauma. If we’re working with children, we may involve adults who experienced trauma and children or family members of children who experienced traumatic events. A trauma-informed organization includes peers in service delivery and ensures they have input into how services are designed and offered. SAMHSA tells us that “Peer support and mutual self-help are key vehicles for establishing safety and hope, building trust, enhancing collaboration, and utilizing stories and lived experience to promote recovery and healing.”

Collaboration and Mutuality

Collaboration and mutuality is about placing importance on partnering and leveling power differences between ourselves and the people we serve and among organizational staff, recognizing that healing happens in relationships and in the meaningful sharing of power and decision-making. Everyone, especially the person receiving services, has a role to play in deciding what services are needed and how they are delivered. Through collaboration and mutuality, survivors experience the return of control and agency that trauma removed.

Empowerment, Voice, and Choice

Empowerment and choice means recognizing and building on people’s strengths and experiences and cultivating a culture that upholds the centrality of the people served. It means demonstrating a belief in resilience, and in the ability of individuals, organizations, and communities to heal. Trauma-informed organizations and professionals focus on shared decision-making, identify and offer choices for service delivery, and listen to understand the meaningful goals of the people they serve.

Cultural, Historical, and Gender Issues

Trauma-informed organizations acknowledge and respond to cultural, historical, and gender issues. And it’s actually a balancing act that we recognize has some inherent tensions built into it. They balance the need to understand, honor, and respond to cultural and intersectional differences and offer culturally competent and gender responsive services while at the same time moving past cultural stereotypes and biases in their expectations and service delivery.