The core guiding principles of Trauma Informed Care are based on are:
- Acknowledgement (Acknowledging the pervasiveness of trauma)
When organizations and systems are committed to integrating these principles at every level of the organization they should consider the following (Dr. Nancy Poole):
- Power and Control – Whose needs are being served and do policies, empower those being served or those providing the service?
- Doing with and not doing to
- Explaining What, Why and How
- Offering real choices
- Understanding and being able to identify Fight, Flight and Freeze responses
- Focusing on strengths not deficits
- Examining power issues within the organization and promoting democratic principles
These principles can be developed and articulated further through the following concepts:
Knowledge and Awareness.
Building awareness of the effects of trauma among staff and clients. This knowledge would include the physical (including neurological affects), mental, relational and spiritual affects of trauma and the interactions between trauma, coping behaviours such as substance abuse, and mental and physical health.
Attention to Staff Wellness.
Staff may themselves have experienced personal trauma and may be traumatized by clients' experiences. Providing supervision, opportunities for debriefing, support, and consultation are part of a trauma informed approach. This ensures that the same care and compassion given to clients is extended within the organization to the staff as well, facilitating their extending this approach to clients.
Consideration of Developmental Trajectories.
A trauma informed approach recognizes that development is affected by trauma. It can delay development in children or regress them to a previous level of development. The major life transitions of adults will also be affected.
Being trauma informed means putting the individual first above other concerns and having and demonstrating compassion to all individuals. Encouraging self compassion in clients will also alleviate guilt and give precedence to healing the self.
Recognition of the Complexity of People and Issues.
The trauma informed approach understands and works with the complexity of people and trauma. It does not take a simplistic or reductionist view. Individuals are complex systems made up of physical, psychological, social, and spiritual components. Trauma has multidimensional impacts on all of these components and individuals' internal and external resources and experiences will determine the direction and extent of that impact. Reducing individuals to single issues and compartmentalizing treatments for specific issues leads to incomplete intervention which in turn leads individuals to relapse and re-accessing of services.
Evidence Based Approaches.
Trauma informed services are aware of different therapeutic approaches and evidence of their effectiveness. Evidence based approaches are preferred over unsupported approaches. The approaches used change with new research evidence as to the effectiveness or lack thereof of specific methods.
Language of Respect.
Trauma informed services use respectful language that identifies individuals as people as whole beings who have experienced the effects of trauma rather than solely as a disease, condition, or behaviour they manifest. Language used is also non-sexist, non-racist, non-ageist, non-heterosexist and otherwise non-discriminating.
Services that are culturally competent work against stereotypes and biases regarding culture, gender and age. They recognize and respect the value of traditional connections and resources and work collaboratively with these resources for the benefit of the client. Historical trauma is recognized. Understanding a person's culture can help service providers understand their response to trauma and thus facilitate the therapeutic process.
Strength Based and Person Centered Approach.
Focusing services on individuals’ strengths in terms of resources, abilities, skills, and capacities maintains a positive perspective that encourages further positive developments. Building skills and capacities increase self efficacy which in turn encourages pursuit of goals and leads to greater goal attainment. A strength based approach identifies individuals’ resilience in the face of adversity and builds resources that will increase this resilience.
A collaborative relationship between service providers and clients will ensure clients choice and control over their therapy and engagement in the process. A collaborative approach is a nondirective non-hierarchical approach. It should include cross sector collaborations that would facilitate system navigation for the clients.
Appreciating the Interconnectedness of the Mind, Body and Spirit.
Recognizing the interconnectedness of the mind, body and spirit and treating people as whole beings. Understanding of the context in which they live.
Choice, Control and Autonomy.
Empowering clients by respecting their choices and decisions for their lives, sharing information is part of being trauma informed. Choice and control over the pace of disclosure and process of change, and the type of interventions used will increase their investment in the recovery process and give them a sense of agency that experiences of trauma have taken away.
Safety and Trust.
Ensuring a physically and psychologically safe environment includes predictability of environment and procedures, allowing time for the building of trust between clients and service providers, through a respectful, compassionate genuine and authentic relationship and a sincere desire to be present with and relieve another person’s suffering and making conscious efforts not to re-traumatize individuals.
Universal Precautions and Screening.
Given how pervasive trauma is service providers should assume that everyone seeking their services has been affected by a traumatic event sometime during their life.Programs should have consistent ways of identifying who have been exposed to trauma and include trauma related information in planning services.
Trauma Informed Care is a Fundamental Right.
Every person seeking services should expect that the service provider is trauma informed and has a basic understanding of the physical, mental, emotional, relational and spiritual affects of psychological trauma.
The impact of trauma is deep, broad and touches all life domains.
Trauma can have a profound effect on people’s physical, mental, social and spiritual health and well being. Trauma affects the way people approach potentially helpful relationships.
Trauma is an Injury.
Trauma is viewed as an injury and not an illness, sickness, weakness or character flaw. This shifts the focus from asking people “What is wrong with you” to “What has happened to you”. Trauma is also a defining and organizing experience that shapes the core of a person’s identify.
Trauma is pervasive.
It is estimated that between 55 and 90% of all people have experienced at least one traumatic event in their life. Trauma preys particularly on the vulnerable. Trauma is the root cause of many of public health and social problems that challenges our society.
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