What is Trauma-informed Care and Practice?

Regardless of its mandate, every system and organization is impacted by trauma and will benefit from being trauma-informed. Service organizations are confronted by the signs and symptoms of trauma every day, and yet often fail to see it and make the necessary connections. Trauma hides in plain view. Every system and organization has the potential to re-traumatize people and interfere with recovery, and to support healing. Service providers and service organizations regardless of their role and mandate can support and nurture recovery, hope, and resiliency.

Trauma-informed Care

Trauma-informed systems and organizations provide for everyone within that system or organization by having a basic understanding of the psychological, neurological, biological, social and spiritual impact that trauma and violence can have on individuals seeking support. Trauma-informed services recognize that the core of any service is genuine, authentic and compassionate relationships.

The Four “R’s” in a trauma informed-approach¹

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,
• Responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to
• Resists re-traumatization.

Although trauma may be central to many people’s difficulties and awareness of it pivotal to their recovery, in public mental health and social service settings their trauma is seldom identified or addressed

Harris & Fallot, 2001

Becoming trauma informed is not about becoming a trauma specialist. Rather it understands the role that each person can play in supporting a person’s recovery, from the first person to greet someone as they enter a building for the first time, the building engineer to the CEO or Executive Director. Everyone has a role to play and can make a difference in creating a culture and climate that promotes safety, trust and compassion. These are the hallmarks of being trauma informed. Remember the smallest acts of kindness and understanding can be the most powerful.

When a human service program or system seeks to become trauma-informed, every part of its organization, management, and service delivery is assessed and modified to ensure a basic understanding of how trauma impacts the life of an individual who is seeking services. Trauma informed organizations and systems are based on an understanding of the particular vulnerabilities and/or triggers that people affected by trauma experience (that traditional service delivery approaches may make worse), so that services can be more supportive, compassionate, effective and avoid re-traumatisation.[2]

Paradigm Shift

Working from a Trauma informed way requires a shift in thinking and language. Unfortunately, the behaviour and responses of those with trauma experiences are often misunderstood and labeled in stigmatizing and deficit-based ways. Practitioners play a very important role in offering another way of understanding trauma responses – as attempts to cope and adapt to the overwhelming impact of trauma; normal responses to an abnormal event.

The following table helps us to shift our perspective from a Deficit-based perspective to a Trauma Informed and Strengths-based perspective:[3]

FROM (Deficit Perspective)	TO (Trauma Informed & Strengths Based)
What is wrong?	What has happened?
Symptoms	Adaptations
Disorder	Response
Attention Seeking	The individual is trying to connect in the best way they know how
Borderline	The individual is doing the best they can given their early experiences
Controlling	The individual seems to be trying to assert their power
Manipulative	The individual has difficulty asking directly for what they want
Malingering	Seeking help in a way that feels safer

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[1]  Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

[2] SAMHSA, 2014.

[3] Adapted from Royal College of Nursing, 2008 in Trauma Informed Practice Guide, May 2013