What is trauma-informed care?
The word “trauma” seems like it’s showing up everywhere recently. You may see that a doctors’ office or a therapist is “trauma informed.” When you step into the psychology section at the bookstore, “trauma” is in every other title.
Therapists, psychologists, and psychiatrists commonly use “trauma-informed care” in clinical settings. But the phrase started showing up more in popular culture in 2018 when Dr. Bruce Perry published his book, What Happened to You? Conversations on Trauma, Resilience and Healing, with Oprah Winfrey.
All of this might make you wonder — what exactly does trauma-informed care mean? And if everyone is using the word, how can I tell what offices and clinicians are best prepared to support me?
Trauma-informed care is not a model of therapy or clinical treatment. Instead, it’s an understanding of how life experiences shape the individual. It takes into account how an individual might experience their environment today in light of the past. This then affects how a clinician provides treatment or care.
Typically, this includes specific training — training that goes beyond just a single course in grad school! Our trauma-informed approach at Restoring the Soul is built on the following five pillars.
What are the five pillars of trauma-informed care at Restoring the Soul?
1. Helping you understand the impact of life experiences on the central nervous system (CNS)
All of our life experiences shape our ability to respond to stress, painful events, and outright trauma. The CNS is triggered — we often use the term “activated” — when something brings painful experiences to the surface. Additionally, when your mental health is struggling, your nervous system tends to be more sensitive.
If you try to resolve behaviors without addressing your nervous system’s response, you’ll have difficulty moving forward. That’s why trauma-informed care starts with your story and how it has shaped your CNS.
2. Anticipating where you may be activated or triggered and walking you through that in session
A trauma-informed therapist understands that you are in a vulnerable position when you attend an intensive. Touching on painful stories and issues may bring up difficult emotions and responses in session. This is normal when you come into counseling for anxiety or dysregulation. When you’re triggered, it’s important to understand what’s happening to you and why.
Your trauma-informed therapist will watch for signs of triggers and help you breathe through difficult conversations. They will be with you every step of the way, and they will approach triggers carefully. They’ll help you understand what you’re experiencing in your body and how it connects to what you’re feeling in the moment.
3. Providing a professional relationship of safety, stability, and security
Trauma-informed therapist-patient relationships are designed to help you feel stable in the face of past relational trauma. Many people might not have a background of safe or trusted connections. You may have even experienced difficult relationships with past caregivers. Trauma-informed therapists keep this in mind and work with your attachment style and relational background to help you develop a sense of safety, stability, and security with them.
- Safety means you feel both physically and emotionally safe. It feels right for you to occupy your body in the moment.
- Stability means your therapist is reliable and predictable. They are available for the scheduled time and the schedule is consistent.
- Security means you understand and feel that the therapist is there for you, not the other way around. You are able to struggle honestly and freely in session. The therapist has your back.
4. Specialized training to manage emotions and dysregulation
A key ingredient in trauma-informed care is knowing how to respond when someone is taken outside of their window of tolerance — when they are triggered, dysregulated, or activated. Not only does a trauma-informed therapist anticipate this, but they respond calmly. They evaluate the situation, and identify what tools are uniquely suited to addressing the trigger. They understand that dysregulation is our bodies communicating to us.
5. Equipping and empowering the client with emotional regulation tools for outside of session
It’s one thing to know you’ll be safe in session — but what about when you leave? A trauma-informed therapist can help you through activating experiences and topics, but what about when you’re on your own?
Thankfully, seeing and identifying your triggers is only the first step for a trauma-informed therapist. Next, they’ll help you find techniques and resources that you can tap into when you feel like you’re falling apart. Instead of feeling lost, you’ll have what you need to assess what’s happening to you, explore where it’s coming from, and calm yourself down.
What are some practical examples of trauma-informed care?
- The organization communicates and leads you in a process of transformation. From the moment you walk in the door to the moment you leave, the office explains what will happen and considers what you need to be comfortable.
- The organization involves you in the planning process. For example, they ask you about your preferred schedule and treatments and talk you through payment.
- Key staff members—clinical and non-clinical—are trained. This means that even the check-in staff can notice if someone is nervous and may need extra reassurance that the doctor or therapist will be there soon.
- The organization screens patients for trauma. They may offer regular assessments before appointments, such as the PHQ-9, or they will keep trauma history on file for you.
- The organization knows lots of resources to point you to. Even if they don’t specialize in the care you need, they have referrals to direct you to.
Why trauma-informed care matters
This approach improves how people engage with the treatment. It may help them decide to continue to stick with a treatment for particular issues like abuse and childhood adversity. It also produces better outcomes, helping people stay throughout the course of needed treatment.
Some traumas result in a reluctance to be vulnerable or receive care. Maybe even going to a doctor feels insurmountable because of your anxieties, past experiences, or sensitivities. Trauma-informed care could make getting the care you need feel possible.
Where can I learn more about trauma-informed care?
If you’re interested in learning more about trauma-informed care and what it looks like, Restoring the Soul recommends the following resources:
- Restoring the Soul podcast episode 298 “Trauma-Informed Care Part 1”
- Restoring the Soul podcast episode 299 “Trauma-Informed Care Part 2”
- TED talk by Dr. Nadine Burke Harris, “How Childhood Trauma Affects Health Across a Lifetime”
- The Body Keeps the Score, Bessel Van Der Kolk, MD