Trauma Informed Care

Prepared by Dr. Drew Summerer

There are many valid definitions and ways of understanding trauma each of which capture unique facets of trauma processes.  One of many ways of understanding trauma is: an experience or series of experiences that forcefully and irreversibly initiate an individual or community into new ways of experiencing the self, others, and the world—these types of experiences greatly deviate from what would be typical or expected within a culture or context, occur in a manner that disregards human boundaries and opportunities for consent, overwhelm an individual or community’s coping resources, can be experienced both as abrupt or gradual, and result in pervasive adverse emotional, relational, and mental processes that interfere with an individual or community’s ability to thrive.  The Substance Abuse and Mental Health Service Administration (SAMHSA) defines trauma as, “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being.”  Trauma can be understood as a subjective response to a variety of circumstances including but not limited to forms of abuse, exposure to violence, experiences of systemic oppression (e.g. racism, cis-heterosexism, sexism, ableism), and experiences in which the body and mind’s sense of safety and security is significantly threatened.  Sometimes trauma can produce processes that are medically classified as Post-Traumatic Stress Disorder; however, trauma-related processes and expressions may also underlie other syndromes of distress and can manifest in a variety of individual, contextual, and culturally-specific ways.

Broadly, Trauma Informed Care aspires to recognizes the pervasiveness and widespread impact of trauma; identifies and responds to trauma processes in patients, staff, and systems through integrating knowledge about trauma into the formation of policies and treatment practices; and finally cultivates environments and practices that support paths to healing, recovery, and resilience.

Trauma Informed Care recognizes processes often considered as pathological symptoms can be understood as adaptations and creative adjustments of the individual or community used in attempts to cope, protect against re-traumatization or overwhelming distress, and express underlying emotional or psychological harm or injury in need of support.  Responsiveness to the unique meaning and expression of trauma must include an understanding of the context in which the trauma occurred and integrates individual, family, sociocultural, and historical factors into the understanding and care of trauma processes.  Trauma frequently erodes the experience of autonomy, agency, and the ability to trust both the self and others—for this reason, trauma informed practice seeks honor the holistic and innate wisdom of the individual or community, and seeks to courageously engage trauma recovery practices in a manner that prioritizes the experience of safety, collaboration, transparency, consent, and respect for individual autonomy.  Trauma informed practice seeks to reestablish a capacity to listen, interpret, and trust the cues and messages of the mind and body to regulate distress and move towards actions that support human thriving and the development of resilience.

For a more in-depth review of Trauma Informed Care, please see the SAMHSA document “Trauma-Informed Care in Behavioral Health Services”