Trauma-informed care

Trauma-informed care is an approach to physical, mental, and emotional medical treatments for people who have survived trauma. Trauma occurs when people are overwhelmed by negative events or situations, such as war, violence, or loss. These people often experience stress, helplessness, and fear, along with a variety of physical symptoms. Although trauma is very common, people only began recognizing and acknowledging it in modern times. The trauma-informed care initiative was designed to build understanding of trauma and its effects to provide trauma survivors with the most effective treatments.

Background

Trauma occurs when negative events or situations in a person's life overwhelm his or her ability to cope. This trauma may take the forms of stress, helplessness, fear, horror, or other intense unpleasant feelings. These feelings may affect the survivor in small and large ways, both in short- and long-term capacities.

Trauma has always been associated with negative experiences in human lives, and may stem from a very wide variety of sources. Trauma is often associated with sudden violent and stressful events. Survivors of vehicular accidents often experience trauma. Wars and natural disasters such as earthquakes and floods may traumatize hundreds or thousands of people within a short time.

Rape and various forms of interpersonal violence frequently cause trauma in the survivors. Such experiences may cause deep-set trauma that never resolves and may reoccur. People who experienced neglect or abuse as children may feel the associated trauma for their entire lives.

Not all trauma stems from direct dangers. Witnessing violence or accidents, or dealing with sick or dying loved ones, may trigger trauma. Nonviolent but significantly negative life experiences, such as losing a job or having a difficult divorce, are often associated with trauma as well.

Many experts believe that trauma from long-ago social and cultural events, such as the Holocaust or the crimes committed against Native Americans, may lead to a communal sense of trauma among the people who were most affected. Cultural and historical trauma may cause groups of people to develop a greater likelihood of symptoms such as depression, low self-esteem, and substance abuse.

Regardless of its forms or sources, trauma may have a wide range of negative effects on the survivor. Some effects are of a mainly physical nature, such as headaches, excessive sweating, upset stomach, or reduced immune system functions. Other effects are emotional and behavioral. People experiencing trauma may have trouble sleeping, lose their appetite, have frightening nightmares, or be easily startled by noises or touches.

Many symptoms are short term, but others may persist and have a lasting effect on a person's life. These symptoms include personality shifts, outbursts, depression or detachment, and feelings of guilt or shame. Trauma may also be linked to life-threatening physical problems including heart disease, cancer, high blood pressure, diabetes, and chronic obstructive pulmonary disease (COPD).

Overview

Although trauma is a universal and influential aspect of the human experience, for thousands of years it was poorly understood and little studied. Many trauma survivors associated their experiences and symptoms with shame or guilt, and tried to keep their situations secretive. At the same time, many medical workers misdiagnosed trauma or focused only on symptoms rather than underlying concerns.

In some cases, attempts to treat trauma-related symptoms led to further trauma, reminders of past trauma, or other additional harm. For example, a person with nervous disorders stemming from the trauma of abuse might be labeled a hysteric and forced into restraints, kept in seclusion, or given potentially dangerous medications.

Only in modern times has trauma been formally identified and brought to mainstream understanding. One of the most important strides in acknowledging and effectively dealing with trauma is the trauma-informed care initiative. Trauma-informed care involves recognizing and understanding trauma as a common part of life and attempting to treat people with trauma using awareness and sensitivity. Medical practitioners of trauma-informed care often try to customize treatments based on not only the symptoms but also likely sources of the trauma.

Trauma-informed care may take many forms, but it is based on the principle that people with trauma have been harmed by other people, events, or situations. This harm may have affected them in physical, emotional, mental, and social ways. Approaching these people with care, understanding, and collaboration can help them receive helpful and effective treatment with a minimized chance of misdiagnoses or additional unintentional harm.

Trauma-informed care generally begins with early screenings and assessments. Identifying trauma as soon as possible can give more time to develop an effective treatment plan and avoid allowing the traumatic symptoms to develop or become ingrained. Medical workers look for signs of trauma in accident or violence survivors. Care providers also frequently ask patients seeking mental or emotional treatment whether they had experienced trauma.

One of the main goals for trauma-informed care is to build safety, both for the patient and the caregiver. Many patients with trauma were survivors of violence or other dangers, and their sense of being safe may have been seriously compromised. Care providers often start their treatments by working with patients to ensure that the patients are safe and realize they are safe. In addition, the care provider must also ensure his or her own personal safety, particularly if the patient is demonstrating great anger or emotional swings.

Another important facet of trauma-informed care is building collaboration between the medical staff and the patient. Using open communication can help to build cooperation and trust that can support the treatments as well as the important sense of safety. By working closely with patients, care providers can help endow them with a sense of power and choice that can greatly aid their recovery.

Trauma-informed care practices have become the norm in most modern medical establishments and procedures. Medical workers often undergo training on trauma and its effects. Many medical establishments apply trauma-informed care principles throughout their entire organization to help build a sense of cooperation. Some also perform community outreach to help build partnerships with other organizations for the overall help of trauma survivors.

Bibliography

Clark, Carrie, et al. Treating the Trauma Survivor: An Essential Guide to Trauma-Informed Care. Routledge, 2015.

Evans, Amanda, and Patricia Coccoma. Trauma-Informed Care: How Neuroscience Influences Practice. Routledge, 2014.

"How to Manage Trauma." National Council for Community Behavioral Healthcare, www.thenationalcouncil.org/wp-content/uploads/2012/11/Trauma-Infographic-Print.pdf. Accessed 18 Dec. 2017.

Richardson, Scott A. "Awareness of Trauma-Informed Care." Social Work Today, www.socialworktoday.com/archive/exc‗012014.shtml. Accessed 18 Dec. 2017.

Steele, William, and Cathy A. Malchiodi. Trauma-Informed Practices with Children and Adolescents. Routledge, 2012.

"Trauma-Informed Approach and Trauma-Specific Interventions." SAMHSA, www.samhsa.gov/nctic/trauma-interventions. Accessed 18 Dec. 2017.

"Trauma-Informed Care." National Council for Behavioral Health, www.thenationalcouncil.org/areas-of-expertise/trauma-informed-behavioral-healthcare/. Accessed 18 Dec. 2017.

"Trauma-Informed Care and Practice (TICP)." Mental Health Coordinating Council, www.mhcc.org.au/sector-development/recovery-and-practice-approaches/trauma-informed-care-and-practice.aspx. Accessed 18 Dec. 2017.