As current generations open the dialogue about mental health issues, the word trauma keeps popping up in conversations. We keep hearing it so often that, I’m concerned at some point, most people will get used to it and trivialize it. We should never be dismissive of trauma. Unfortunately, 70 percent of U.S. adults have experienced trauma, of which, 20 percent developed post-traumatic stress disorder (PTSD). With this prevalence of trauma, it has become for many, an unseen life companion casting a shadow over their wellbeing.
Undiagnosed and untreated trauma ravages people’s mental health despite an appearance of high functionality and an “everything is fine” facade. They may be a seemingly innocuous occurrence away from having all the emotions associated with past traumatic experiences resurface. Without any warning and usually without explanations.
What is trauma and how do you identify it?
Psychological trauma is an emotional response to a stressful event or events that interfere with one’s sense of security and safety. Trauma is the consequence of terrible events like sexual assault and other forms of abuse, accidents, natural disasters, or wars. It can cause a variety of emotional symptoms like:
- Panic attacks
- Lack of trust
- Inability to focus
But it can also trigger physical symptoms, such as:
- Fast heartbeat
- Digestive issues
- Body aches
It is important to remember that not everyone who experiences traumatic events develops trauma. Nevertheless, different types of trauma can manifest in a variety of ways:
Acute trauma – the result of a single distressing or potentially harmful event that creates a long-term impression and manifests itself through one or several trauma-specific symptoms.
Chronic trauma – the result of repeated or prolonged exposure to toxic stress and highly stressful events, such as bullying, domestic violence, and childhood abuse. Untreated acute trauma may develop into chronic trauma.
Complex trauma – the result of constant exposure to multiple traumatic events, usually negative experiences within interpersonal relationships, such as neglect, domestic violence, childhood abuse.
According to the National Sexual Violence Resource Center, one in five women and one in 71 men will experience rape at some point in their lives, and 12% of these women and 30% of these men were younger than ten years old when the aggression happened. The impact of trauma in children can last for a lifetime. It can lead to anxiety, depression, and addictions, and it can prevent people from accessing proper healthcare services. That is why the need for trauma-informed care is imperative and essential for patient wellbeing.
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What is a trauma-informed care approach?
Trauma-informed care acknowledges that the patient may have suffered trauma in the past and creates a safe environment when providing the necessary healthcare services. Healthcare providers need to build trauma awareness and create a deep understanding of trauma at each organizational level, including employees that don’t have a medical role but still interact with patients. The goal of trauma-informed care is to allow the medical establishment to provide optimal treatment strategies while preventing any possible re-traumatization that may stop patients from seeking care in the future.
When treating a client in a trauma-informed environment, healthcare professionals focus on understanding what happened to the patient instead of what is wrong with them. The therapist, nurse, or doctor doesn’t necessarily ask the patient to talk about the traumatic events they have experienced or adverse childhood experiences, but when in the presence of symptoms of trauma, they should assume the patient may have a history of trauma and act accordingly. Healthcare professionals need to create an environment that exudes emotional safety and inspires trust.
Trauma-informed systems may improve patient engagement and treatment adherence to encourage better health outcomes. When treating patients in trauma-informed organizations, the medical care team considers the complete picture of a patient’s life and provides a treatment process that centers around comprehensive healing.
What are the principles of trauma-informed care?
Trauma-informed care demands broad organizational culture change. It needs to be adopted at clinical and organizational levels and offer staff access to knowledge about trauma and the effects of trauma. Everyone from the front desk workers to the medical staff should familiarize themselves with the principles of trauma and work together to provide a safe environment for patients. The foundation of trauma-informed care has six principles:
Patients should feel physical, emotional, and psychological safety when they are in the care of medical professionals. Both the interior and exterior of the medical organizations should inspire safety (e.g., enough space for patients to avoid sitting too close to strangers, well-lit parking lot, security guards close by to offer protection, nurses open to interact and address concerns).
Trustworthiness and transparency
Nurses should create a transparent environment and build a relationship based on trust. Decisions and the reasons behind them should be discussed and made openly and the care process should be explained in detail to patients.
The medical staff must learn and understand various traumatic conditions and the effects of trauma. They need to acknowledge that their patients may have suffered exposure to trauma that prevents them from being open about their health issues and understand their needs. Medical professionals who have experience with certain types of trauma may be able to establish a connection with patients with similar trauma and approach the patient as a “peer”.
Patients should be a part of the conversation when it comes to their healthcare. Therapists, nurses, doctors, and medical organizations should work together with the patients to deliver the best treatment plans. In an environment of trauma-informed care based on mutuality, patients get to participate in healthcare decisions and feel a sense of security that enables them to trust the treatment and follow it through in their daily life.
An organization that delivers healthcare services based on trauma-informed principles gives patients a voice – a voice to tell their stories and have a say in healthcare decisions that concern them.
For trauma-informed care to be efficient, the medical professionals and staff members need to identify and eliminate any potential cultural, racial, or gender issues. Biases and stereotypes based on race, ethnicity, gender, age, sexual orientation, etc. should be recognized and addressed to create a more comfortable environment for patients who have had traumatic experiences. The patient’s cultural needs should be accommodated so that they feel seen, heard, and understood.
Trauma-informed care encourages getting proper healthcare and achieving healing through compassion and open-mindedness. Trauma-informed organizations treat all patients as individuals with a past and present and personalize their care approach to echo their unique needs encouraging them to return to benefit from proper healthcare.