Why Providing Trauma-Informed Care Is Critical for Your Patients
When Trauma Doesn’t Look Like Trauma
Consider this. . .
A young boy is struggling to pay attention in his second-grade class. He makes careless mistakes on his schoolwork, is constantly fidgeting, and often speaks out of turn. As a result, the teacher might identify this child as “misbehaved,” and decide to call his parents. What that teacher doesn’t know is this boy’s parents have been fighting at home. Perhaps his mother is often drunk, or his father is violent, and by calling them, the boy’s home experience would only worsen.
Unfortunately, trauma is not uncommon, and it can look different for everyone. One study even found that 67% of children have experienced at least one adverse childhood experience (ACE) in their lifetime — and their trauma responses are often misdiagnosed as ADHD or even simply “bad behavior.”
Take another example. . .
A woman goes to the gynecologist for a routine visit. As the doctor is beginning the examination, this woman’s voice shifts, sounding like a little girl — or maybe, she stops responding to the questions altogether. Some doctors may dismiss this behavior as “spacing out” or standard nervousness, but often, this is a key indicator of a trauma response such as dissociation.
These are just two examples of how trauma can impact different parts of a client’s life. But when someone has been traumatized, they don’t get to pick and choose where they bring it or what triggers them. That’s why recognizing the prevalence of trauma has to be one of the first steps to adopting a trauma-informed approach to care.
A Trauma-Informed Approach to Working with Racial Stress
Trauma comes in many forms, from one deeply impactful event to a repetitive stress. But for some clients, especially those of color, the repetitive stress they face is systemic. We often hear about microaggressions, but from a trauma-informed perspective, a better term might be “racial trauma encounters.” And sometimes, these encounters even occur in our office.
The majority of therapists’ training – especially in the United States – is based in a white, Eurocentric approach. So sometimes, the therapeutic approaches we believe would be most helpful for a client actually de-validate their cultural experiences.
Consider a client who has trouble asserting their needs in relationships. This might be an adult client who serves as a caregiver to their elderly parents, and they often sacrifice their own social life or career aspirations in order to continue personally handling that care. We are often quick to fit certain labels, like codependency, to that client’s experience. From an individualist standpoint, the solution may be working with that client to establish more concrete boundaries, perhaps even hiring a different caregiver for the parents.
But, say the client is from a collectivist culture with heavy values on familial relationships. Such suggestions may undermine the client’s personal values, disrupting the solid foundation on which they can build decisions in times of uncertainty. So, without understanding the cultural nuances, we might unintentionally cause the client more harm.
We cannot claim to provide trauma-informed care unless that work is inclusive of all types of trauma our clients may face. And while we can’t overturn the systemic barriers to care overnight, taking the time to continuously re-evaluate our practices and foster our own cultural humility can make a major difference in our clients’ experiences.
How to Integrate Trauma-Informed Care into Treatment
Of course, not everyone who experiences trauma develops PTSD or Post-Traumatic Stress. But for those who do, it is critical that we are prepared with an approach that fosters a sense of safety, puts the patient in control, and avoids triggering the client’s trauma.
In a therapy setting, taking a comprehensive developmental history in early sessions can be helpful in identifying where alternative approaches may be necessary for a specific client — but not every patient who is suffering from trauma even knows that trauma is part of the problem.
That’s why it’s so important to continuously be aware of how a client reacts to any given approach.
Take, for example, eye contact.
As humans, we tend to engage in eye contact instinctually. Between an infant and a caregiver, it can be a major part of developing attachment and bonding, and later in life, it makes a conversation more persuasive and memorable. So, therapists often intuitively try to utilize eye-contact to activate the social engagement system, helping clients feel safe and validated. But for a client with a history of trauma, direct eye-contact may appear threatening, perhaps even triggering fight, flight, freeze, or any other defensive response.
A trauma-informed approach would then look for alternative ways of activating the social engagement system, such as vocal prosody or posture.
Moving Forward with a Trauma-Informed Approach
Trauma-informed care cannot be achieved through a singular training or filling out a checklist. It requires constant attention and re-evaluation. But with the right care and support, trauma doesn’t have to be a life-sentence for our clients.
That’s why what you do is so important. When we help someone heal from trauma, we change not just that person’s life — we also help their spouse, their children, their friends, their community, and we change the course of civilization.
Want more ideas and strategies you can use with your clients today?
To learn more about the latest strategies for trauma treatment, check out one of our courses:
The Advanced Master Program on the Treatment of Trauma
12 CE/CME Credits Available
The Treating Trauma Master Series
10 CE/CME Credits Available
Integrating Compassion-Based Approaches into Trauma Treatment
3.25 CE/CME Credits Available
Why the Vagal System Holds the Key to the Treatment of Trauma
2 CE/CME Credits Available