By: Shannan Blum, LMFT
Assistant Director
Connections Child & Family Center is a trauma-informed organization as well as one whose clinicians are trained in evidence-based modalities treating specific, unresolved trauma responses.
Are you confused by what ‘trauma-informed’ means and how that differs from providing specific trauma treatment? This blog will help!
All of us as humans experience mental health events – meaning events that challenge us, hurt us, create pain and disruption to some degree. What we are still coming to understand is what makes one disruptive, painful event a traumatic event for one person but not another? “Trauma” has been difficult to define for many decades and yet has a very important role in the fields of mental health, education, economics, social media and politics.
The purpose and intent of this blog is to increase understanding of ‘trauma-informed care’ versus ‘approach’ versus ‘trauma treatment’ and how to determine if an organization has integrated one or the other – and ultimately why all that matters.
Specifically, I’ll address:
- “Three E’s of Trauma” and
- “Four R’s of a trauma-informed approach
Trauma-Informed Care
“Trauma-informed care” (TIC) and ‘trauma-informed approach’ are broad phrases developed in the early 2000s in response to the growing understanding that trauma has a damaging impact on relationships and affects one’s physical, mental, emotional, spiritual and economic well being. Trauma came to be seen as a fundamental and underlying issue for many people seeking mental health and other public health services.
The Center for Disease Control’s (CDC) Office of Public Health Preparedness and Response (OPHPR), in collaboration with the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Center for Trauma-Informed Care (NCTIC), developed and led a new training about the role of trauma-informed care during public health emergencies. The training aimed to increase responder awareness of the impact that trauma can have in the communities where they work.
This broadened into what we, as mental health providers trained in trauma recovery, have known for years and hoped would eventually become more commonplace: trauma affects all aspects of how one relates and feels, perceives the world around them and makes decisions.
In order to facilitate a trauma-informed approach, the follow assumptions and recognitions are designed as part of “Trauma Awareness”:
Universal Trauma Precautions (Trauma Awareness)
- Assume that all people and connected persons with whom you are working are coping with the effects of trauma and modify your practice accordingly.
- Recognizing how your organization, your program, your environment, and your practice could potentially act as a trauma trigger.
- Recognize that you may also have experienced trauma yourself, and you may be triggered by client responses and behavior.
With those foundational assumptions – we move on to the “Four R’s of a Trauma-Informed Approach”:
The 4 ‘R’s” of a Trauma-Informed Approach:
A program, organization, or system that is trauma-informed:
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- Realizes the widespread impact of trauma and understands potential paths for recovery;
- Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and
- Responds by fully integrating knowledge about trauma into policies, procedures, and practices,
- and seeks to actively Resist re-traumatization.
And with that we evolve into “Trauma-Informed Care”:
Elements of Trauma-Informed Care
The 3 E’s of Trauma
- The Event(s)
- The Experience of it
- The Effects of both
The Events, or what objectively occurred and can vary greatly, such as: high levels of change, neglect and unpredictability during childhood, abuse/violence/assaults, natural disasters, systemic oppression, medical events/illness, exposure to death or life-threatening experiences.
The individual’s Experience of these events refers to how they processed or didn’t process the event(s) and can be highly influenced by key factors such as: cultural beliefs, relationships & connection to others, and access to community resources and social supports. How the individual labels, assigns meaning to, and is disrupted physically or psychologically by the event(s) is also important.
The Effects of the events & the experiences refer to both short- and long-term adverse effects.. Considering how the event(s) and the experiencing of the event(s) begin informing beliefs and behaviors, the impact on trust and benefits of relationships, difficulty adapting to stressors, inability to manage memory and attention, etc. All of these can contribute to the development of depression, anxiety signs, and symptoms.
The ‘Three Es’ framework provides therapists, employers and family members with a broad and flexible construct for understanding how trauma, in a variety of ways, impacts individuals, relationships, families and by extension – communities.
What’s the difference between this Trauma-Informed Approach/Care v. Trauma Treatment? And why does it matter?
Understanding the elements of trauma-informed approaches and care is helpful and supportive in creating a collective understanding of the negative impacts of trauma, as well as the necessity of healing and recovering from it.
Understanding specialized training and treatments in trauma is important if you are a client with unresolved trauma wanting to receive treatment and heal.
The primary difference between an approach v. care v. treatment is:
- Approaches- primarily rely on concepts and principles to provide understanding
- Care – some type of attention to physical needs
- Treatment – from a therapeutic sense, involves not only education from a conceptual and principle standpoint, but training that integrates highly specified protocols, interventions, skills and techniques necessary to assist and provide support targeting various symptoms for a determined or open-ended period of time.
For clarity:
- ‘trauma-informed care’ facilities could provide trained, specialized trauma treatment, OR
- ‘trauma-informed care’ facilities could not offer any type of evidence-based modality toward treating unresolved trauma.
This matters because ‘trauma-informed care’ is not treatment but could confuse many because it implies treatment due to the word ‘care’. Using this term as a broad brush has the potential of misleading some clients into the understanding there is specific trauma treatment involved. If you are told that a provider’s office has ‘trauma-informed care’ and expect to receive evidence-based treatment for an unresolved traumatic event, be aware that may not be the case.
“Trauma-informed approach” could be less misleading in that it simply lets clients know of an overarching framework or paradigm perhaps, because it isn’t using the word ‘care.’
These are important decisions and factors to consider as part of informed consent because informed consent is an essential part of healthy therapeutic processes.
Connections Child & Family Center is both a trauma-informed organization as well as one whose clinicians are trained in evidence-based modalities treating specific, unresolved trauma responses.
If you are interested in inquiring about treatment addressing a specific trauma event in your life, contact our Care Coordinator at 281-210-6677 to set up an intake with a clinician!
References:
https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
lbogle (2016-01-22). “Trauma-Informed Care: An Ecological Response”. American Institutes for Research. Retrieved 11.12.21
