Trauma results from exposure to an incident or series of events that is emotionally disturbing or life-threatening. Examples of events that may be traumatic include:
Physical, sexual, and emotional abuse;
Childhood neglect;
Having a family member with a mental health or substance use disorder;
Violence in the community;
Natural or human-made disasters and forced displacement;
Sudden, unexplained separation from a loved one;
Poverty and discrimination
Trauma overwhelms a person’s coping capacity and has long-term effects on functioning and well-being. Normal, protective responses to threats (“fight, flight, or freeze”) are activated regardless of whether these threats are real or perceived. A person who has experienced trauma may continue to experience this defensive response, even in situations that are not threatening.
Not all children or adults who are exposed to potentially traumatic events experience long-term health problems. This may be due to protective factors, which help shield individuals from the lasting effects of trauma. Protective factors include:
parental knowledge of child development;
healthy parent-child attachment;
social connections; and
social and emotional competence
Trauma-informed practice and support shifts the focus from “What’s wrong with you?” to “What happened to you?” A trauma-informed approach acknowledges that providers and support teams need to have a complete picture of a client’s life situation — past and present — in order to provide effective support services that won't trigger or re-traumatise the individual. Trauma-informed practice and support seeks to understand the impact of trauma and understand paths for recovery;
Recognise the signs and symptoms of trauma in individuals, families, and staff;
Integrate knowledge about trauma into policies, procedures, and practices; and
Actively avoid re-traumatisation.
Re-traumatisation is any situation or environment that resembles an individual’s trauma literally or symbolically, which then triggers difficult feelings and reactions associated with the original trauma. The potential for re-traumatisation is always possible and is often unintentional and may involve specific smells, sounds or types of interactions may cause individuals to feel re-traumatised.
Re-traumatisation is a significant concern, as individuals who are traumatised multiple times frequently have exacerbated trauma-related symptoms compared to those who have experienced a single trauma. Individuals with multiple trauma experiences often exhibit a decreased willingness to engage in support.
Benefits of Trauma Informed Practice
There are a number of benefits to using a trauma-informed approach as many clients with trauma have difficulty maintaining healthy, open relationships with a provider. A trauma-informed approach offers clients the opportunity to engage more fully in their health and care plan by developing trusting relationships with their support team and provider.
There are a number of trauma-informed strategies that organisations can adopt to help people overcome the effects of trauma, ranging from organisational changes in the culture and atmosphere of a support setting to full adoption of practices to address trauma at the clinical level. Providers can adopt the following steps in their journey to improve practice:
Building awareness and generating buy-in for a trauma-informed approach;
Supporting a culture of staff wellness;
Hiring a workforce that embodies the values of trauma-informed care; and
Creating a safe physical, social, and emotional environment.
In line with the steps above, providers will also need to consider the following 5 elements contained within a trauma informed model.
Safety-Throughout the organisation, the staff, and the clients and family/carers they serve, all should feel physically and psychologically safe; the physical setting is safe and interpersonal interactions promote a sense of safety.
Trustworthiness and Transparency - Organisational operations and decisions are conducted with transparency and with the goal of building and maintaining trust among clients, family members/carers, staff, and others involved with the organisation. This involves creating clear expectations with clients about what support and services will be available, who will provide them and how support will be provided.
Collaboration and Mutuality - There is true partnering between staff and clients (to help ‘level out’ power differences), and staff recognise that healing can happen through relationships and in meaningful sharing of power and decision-making. This involves collaboration between staff, clients and families/carers in goal setting and support planning.
Empowerment - The individual strengths of clients and their families/carers are recognised, built on, and validated. New skills are developed as needed. Client strengths are used to empower them in the development of their goals and plans.
Voice and Choice - The organisation aims to strengthen the experience of choice for clients, family members/carers, and staff. It recognises every person’s experience is unique and requires an individualised approach.
Working safely and avoiding the risk of re-traumatisation should be at the centre of any support and intervention with due consideration to a persons; physical and psychological needs. Developing a shared understanding and working together to acknowledge the impacts on feelings, emotions and behaviour is an important step in building trust and taking the first steps to recovery. Focusing on strengths is also important as it uses the skills and attributes of each individual and can create a sense of positivity about next steps.