Question
What is trauma, how does trauma-informed care affect practice, and what are some strategies for trauma-informed care?
Answer
Trauma is anything that triggers a protective response from the brain. Any type of trauma can be managed using a trauma informed lens. Trauma is unfortunately very common. Trauma responses can be lifestyles or situational. Adverse Childhood Experiences have a tremendous impact on future violence victimization and perpetration and lifelong health and opportunity
- Trauma informed processes and policies have been shown to build resilience.
- The ability to recover quickly from traumatic or difficult experiences
- Primary care providers who practice trauma informed care have better patient outcomes compared to those who don’t
The four R's of trauma informed care include:
- Realizing the prevalence of trauma
- Recognizing the signs of trauma
- Responding by integrating our knowledge of trauma into policies and practice
- Avoid Re-traumatizing
We never need disclosure of trauma, proceed with a trauma informed lens if in doubt.
Strategies for trauma informed care included the following:
- Consent for every contact
- Don’t assume consent in the past is consent for the present.
- Explain what is going on, why you are doing something, and discuss the length of time it will take you to do something.
- Give the patient a voice, say "if I need to stop, let me know."
- Live up to your words, stop if requested.
- Demonstrate healthy boundaries (are you uncomfortable or unsafe?)
- Physical space: put yourself in the position of the patient. Where is the door? How is the plinth positioned? Are you towering over your patient?
- Set everything up out in the open. Don’t hide things, show them what things are in advance and what the purpose is.
- Provide a safe environment to extent of your ability.
For more information on trauma informed care and how to utilize it in your practice, please view Trauma Informed Care Principles for Rehabilitation Professionals by Jennifer Stone, PT, DPT, OCS, PHC
