The concept of trauma-informed care for a mental health approach has become important over the years. Due to trauma experienced by many individuals throughout their lifetime, more evidence has led researchers to analyze the lasting impact of traumatic experiences from the minor to the extreme. These traumas may lead to physical or mental health issues or both. Furthermore, trauma-informed care plays a key role in behavioral health organizations and providers as the impact of a traumatic event and trauma-sensitive services go hand in hand.
To further understand, we will examine the difference between what trauma is and the trauma-informed care approach, along with its four assumptions and six principles, and why it is important.
What is Trauma?
The American Psychological Association (APA) defines trauma as “an emotional response to a terrible event.” Trauma doesn’t discriminate against race, ethnicity, gender, age, sexual orientation, or cultural, socioeconomic, or psychological background.
Some traumatic events may happen from a one-time occurrence, such as facing a natural disaster and losing a home, physical assault, the sudden death of a family member, school shootings, or sexual violence. Other times, trauma events are repetitive, such as experiencing constant physical or emotional abuse (both for children and adults), gang violence, war, or terrorist events. Lastly, a traumatic event may happen due to a chronic condition, such as child neglect or malnourishment.
What the Numbers Say
The Centers for Disease Control and Prevention (CDC) states that violence is an “urgent public health problem.” In addition, experiencing violence may lead to trauma in individuals. The CDC provided statistics about different types of violence individuals may face in their lifetimes:
- Sexual violence: Over half of women and almost 1 in 3 men have experienced sexual violence involving physical contact during their lifetimes.
- Child abuse and neglect: About 1 in 7 children experienced abuse and neglect in the last year.
- Intimate partner violence: This refers to the abuse or aggression of partners involved in a romantic relationship. According to the CDC, about 1 in 5 women and 1 in 7 men report experiencing physical violence, 1 in 5 women and 1 in 12 men experience sexual violence involving a romantic partner, and 10% of women and 2% of men reported having been stalked by an intimate partner.
All of the above would be considered event(s) that lead to experiencing the negative effects of trauma. Furthermore, the National Institute of Mental Health (NIH) estimated that 3.6% of US adults had post-traumatic stress disorder (PTSD), and in the past year, it was higher for females at 5.2% than males at 1.8%.
The above information shows the three “E’s” of the concept of trauma: event, the experience of events, and effects. We will go over these in further detail below.
The “E’s” of Trauma
The Substance Abuse and Mental Health Services Administration (SAMHSA) published a guide in 2014 where it established the three “E’s” that may lead to trauma: events, the experience of events, and effects.
As mentioned above, an event can be a one-time occurrence, it can happen for a longer period, or from a chronic condition. Because individuals are unique, many times they don’t respond to a terrible event the same way as others. For example, some military soldiers who deployed together to the same war zone may experience a traumatic event, such as losing a comrade, while others do not. Each experience, situation, and individual is different. How the event is experienced plays a role in how individuals suffer from the effects of a traumatic event, which has an impact on the body and mind.
For some individuals, the effects of a traumatic event may be temporary while others may experience prolonged reactions that lead to mental health issues such as post-traumatic stress disorder, anxiety disorder, or substance abuse disorder that will require behavioral therapy treatments to identify negative behavior patterns and how to replace them with positive behaviors.
For mental health professionals, understanding trauma is only the first step toward helping individuals who have suffered a traumatic event. An understanding of trauma-informed care helps address the process of helping an individual.
What is Trauma-Informed Care for Mental Health?
Dr. L. Elizabeth Lincoln defines trauma-informed care as a “practice that promotes a culture of safety, empowerment, and healing.” Because many individuals experience trauma at some point in their lifetime, trauma-informed care provides evidence-based and best practice information. As such, behavioral and mental health professionals and providers can work effectively with individuals, families, and/or communities to address “trauma-related prevention, intervention, and treatment.”
According to SAMHSA, a trauma-informed care approach incorporates the four “R’s” assumptions and six principles used in the prevention and intervention of behavioral services.
The Four “R’s” Assumption and Six Principles of Trauma-Informed Care
SAMHSA established four “R’s” assumptions: realization, recognition, response, and resist re-traumatization. To quote the SAMHSA’s 2014 guide, the four “R’s” come into play as follows:
“A program, organization, or system that is trauma-informed 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 resist re-traumatization” actively.
SAMHSA established the six principles of a trauma-informed approach which include safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and cultural, historical, and gender issues. Below, we will explain each fundamental principle for a trauma-informed care approach:
- Safety: Individuals who have experienced and are suffering the effects of trauma should be treated in an environment that provides both physical and psychological safety parameters.
- Trustworthiness and transparency: To create trust, there must be transparency between patients and health care providers. As such, patients should be involved as much as they are able in their mental health treatment.
- Peer support: Individuals should try to understand they are not alone, and other individuals deal with the same or similar issues due to trauma. Depending on the treatment plan, peer support and group therapy provide benefits that will help in their recovery.
- Collaboration and mutuality: Refer to the partnership between a mental health organization, patients, and any professional staff as each plays a role in the healing process.
- Empowerment, voice, and choice: Mental health organizations can promote empowerment in their patients by providing support and having them be part of the decision-making for treatment plans. Giving individuals a choice and setting goals for an action plan helps them during the recovery journey.
- Cultural, historical, and gender issues: Mental health and trauma don’t discriminate based on race, ethnicity, age, religion, sexual orientation, cultural, historical, or gender identity. As such, health professionals and providers must incorporate cultural, historical, and gender issues to correctly diagnose and create a treatment plan that includes these needs without cultural stereotypes and biases.
Why Is Trauma-Informed Care Important?
According to the “Trauma-Informed Care in Behavioral Health Services” book, “trauma, psychological distress, quality of life, health, mental illness, and substance abuse are linked.” Because individuals may suffer from trauma at some point in their lifetime, implementing a trauma-informed care approach helps patients in their recovery journey. In addition, those who have experienced trauma face mental disorders, such as anxiety, mood disorders, depression, and substance use disorders.
Trauma-informed care approach is important as it uses intervention and an organizational approach to how trauma affects an individual, family, and community and their responses to behavioral health treatments.
At Alvarado Parkway Institute, we believe in using a trauma-informed care approach, and our team of mental health care providers and staff supports and delivers trauma-sensitive services, including cognitive-behavioral therapy for addictive and mental health disorders. We treat alcohol addiction, opioid use disorder, prescription drug addiction, and other substance use disorders, as well as bipolar disorder, depression, psychosis, and anxiety.
If you or a loved one has experienced trauma and requires mental health treatment, visit our Center for Mental Health and Addictive Disorders for more information. Our trained call center staff is also ready to assist you at 619-333-7050 and is available 24/7.
Sources:
- https://www.apa.org/topics/trauma
- https://www.cdc.gov/violenceprevention/sexualviolence/fastfact.html
- https://www.cdc.gov/violenceprevention/childabuseandneglect/fastfact.html
- https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html
- https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd
- https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf
- https://www.health.harvard.edu/blog/trauma-informed-care-what-it-is-and-why-its-important-2018101613562
- https://www.ncbi.nlm.nih.gov/books/NBK207195/
