Understanding Trauma-Informed Care
A compassionate approach to support, healing, and empowerment.
1. What is Trauma-Informed Care?
Trauma-Informed Care (TIC) is not a specific therapy, but a comprehensive organizational framework and approach. It involves understanding, recognizing, and responding to the effects of all types of trauma. The core idea is to shift the perspective from "What's wrong with you?" to "What happened to you?". This approach emphasizes physical, psychological, and emotional safety for everyone, and helps survivors rebuild a sense of control and empowerment. It aims to prevent re-traumatization by creating safe and supportive environments.
2. The Core Principles
Safety
Ensuring physical and emotional safety. This includes creating a welcoming environment where individuals feel secure and respected.
Trustworthiness & Transparency
Building and maintaining trust by being clear, consistent, and making decisions with transparency.
Peer Support
Utilizing individuals with lived experiences of trauma to provide support, hope, and inspiration for recovery.
Collaboration & Mutuality
Leveling power differences between staff and clients. Healing happens in relationships and in the meaningful sharing of power.
Empowerment, Voice & Choice
Recognizing and building on individual strengths. Providing choice and a meaningful voice in all decision-making processes.
Cultural, Historical & Gender Issues
Actively moving past stereotypes and biases. Offering culturally responsive services that are sensitive to racial, ethnic, and gender differences.
3. How Does It Work?
Realize
Widespread impact of trauma and potential paths for recovery.
Recognize
Signs and symptoms of trauma in clients, families, and staff.
Respond
By integrating knowledge about trauma into policies and practices.
Resist
Re-traumatization by creating safe, empowering environments.
4. How to Implement This?
- Educate Staff: Provide ongoing training on trauma, its effects, and trauma-informed principles.
- Create a Safe Environment: Ensure the physical space is welcoming, clean, and safe. Pay attention to lighting, noise levels, and seating arrangements.
- Review Policies: Screen all policies and procedures for potential triggers or re-traumatizing elements.
- Promote Choice and Autonomy: Always offer options and involve individuals in their own care plans. Use language like, "Would you be comfortable with...?" or "What would work best for you?".
- Foster Open Communication: Create an atmosphere where feedback is encouraged and valued, both from clients and staff.
5. How a Behaviour Support Practitioner Can Help
A Behaviour Support Practitioner (BSP) plays a crucial role in applying Trauma-Informed Care for a person with a disability. Instead of viewing challenging behaviours in isolation, a trauma-informed BSP:
- Understands Behaviour as Communication: Recognizes that behaviours are often a way of communicating distress, fear, or unmet needs stemming from past trauma.
- Focuses on Regulation: Teaches and co-regulates emotional responses, helping the individual feel safe and calm before addressing behaviours.
- Identifies Triggers: Works collaboratively to identify environmental or sensory triggers that may be linked to past trauma.
- Builds Skills: Focuses on teaching new coping skills, communication strategies, and ways to self-advocate, rather than just managing behaviours.
- Creates a Supportive System: Trains family, carers, and support staff to understand the individual’s trauma history and respond in a supportive, non-punitive manner.
6. Adding This Strategy to a Behaviour Support Plan (BSP)
Incorporating TIC into a BSP involves making the plan person-centered and focused on healing:
Trauma History Summary (De-identified):
Include a section that acknowledges past adversity without detailing specific events. Example: "Alex has experiences that have impacted their sense of safety and trust in others."
Proactive Strategies:
Focus on creating predictable routines, safe spaces, and sensory tools that help the person feel regulated throughout the day.
Reactive Strategies:
Shift from consequences to compassion. Outline de-escalation techniques that prioritize safety and emotional connection. Example: "If Sarah becomes distressed, use a calm voice, give her space, and offer a weighted blanket. Avoid physical prompting."
Language and Communication:
Specify the use of empowering and validating language. Example: "Validate feelings by saying, 'I can see this is really difficult for you right now.'"
7. Where This Strategy Can Be Used
Trauma-Informed Care is not limited to clinical settings. It is a universal precaution that can be applied anywhere, especially in environments where individuals may be vulnerable. This includes:
8. Real-Life Scenario & Implementation
Meet Leo
Leo is a 25-year-old man with an intellectual disability and anxiety. He lives in supported accommodation. He often becomes highly agitated and refuses personal care, especially from male staff he doesn't know well. A traditional approach might label this as "non-compliance" or "oppositional behaviour."
A Trauma-Informed Implementation
- Investigate the 'Why': The BSP learns that Leo experienced bullying and physical abuse at a previous residence. His agitation is a protective fear response, not defiance.
- Empowerment & Choice: Staff now ask Leo who he would prefer to assist with his personal care. A roster with photos of available staff is created, so he knows who to expect. He is given the choice of when to have his shower within a flexible timeframe.
- Create Safety: Before personal care, the support worker engages Leo in a preferred activity, like listening to music, to help him feel calm and regulated. They explain every step of the process beforehand to ensure predictability.
- Shift in Response: If Leo shows signs of distress, staff immediately pause and say, "It looks like you need a break. Let's stop for a moment. What would help you feel more comfortable?" This validates his feelings and returns control to him.
Outcome: Over time, Leo's trust in his support staff grows. The frequency of agitation decreases significantly because the environment now prioritizes his emotional safety and respects his past experiences.
9. Other Relevant Considerations
- Vicarious Trauma: It is crucial for organizations to support their staff. Hearing about trauma can be distressing, and staff need access to supervision, debriefing, and wellness resources to prevent burnout.
- It's a Journey, Not a Destination: Becoming trauma-informed is an ongoing process of learning, reflection, and continuous improvement for an entire organization.
- Strengths-Based Approach: Always remember to focus on the individual's strengths, resilience, and capacity for healing. Trauma is part of their story, but it does not define them.