TRC Toolkit: TRAUMA RESPONSIVE CARE

FOUNDATIONAL INFORMATION

Trauma informed care is a patient centered approach to medical care that acknowledges the widespread prevalence of trauma and encourages health care professionals to recognize the impact of past trauma on a patient’s symptoms and behavior. A trauma informed individual can identify signs and symptoms of trauma, and understands how trauma may impact others’ experience, both within and outside the medical system. It assumes that people are more likely than not to have a trauma history. This toolkit uses the term trauma responsive care to emphasize the importance of translating understanding into action. A trauma responsive person is not only informed, but feels competent and confident when responding to patients presenting with trauma-related symptoms. It seeks to reduce the anxiety of the healthcare setting and provide effective treatment while minimizing retraumatization. Trauma responsive care best practices should be embraced at both the clinical and organizational levels to create inclusive environments, improve patient outcomes, and increase safety and security for everyone involved. The National Child Traumatic Stress Network (NCTSN, 2016) describes a trauma-informed system as:

“One in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, adults, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies.”

https://www.nctsn.org/trauma-informed-care/creating-trauma-informed-systems

A key tenet of trauma responsive care involves shifting from a judgmental stance to one of curiosity, from “what’s wrong with you?” to “what happened to you?”

VALUES OF TRAUMA RESPONSIVE CARE

  • Compassion in communication (active listening, open-ended questions, clarification, reflection, other techniques like humor or silence)

  • Demonstrated understanding of the prevalence and impact of trauma

  • Promoting safety

  • Earning trust

  • Embracing diversity

  • Exhibiting dignity and respect for all

  • Empowerment through patient-centered care

IMPLEMENTATION

Creating a trauma-responsive organization requires support from senior leadership and buy-in from the patient-facing workforce. More details and resources for organizational implementation are included below. Implementation components include:

  • Training on the prevalence and impact of trauma.

  • Integrating knowledge about trauma into policies, procedures and practices.

  • Recognizing risk factors, signs and symptoms of trauma for patients, families, and staff.

  • Creating welcoming physical environments that promote calm and safety, to prevent retraumatization.

  • Maintaining communication that is open, consistent, respectful and compassionate.

  • Promoting transparency, mutuality, collaboration and choice in patient interactions.

  • Supporting a culture of staff wellness.

  • Creating space for dialogue about traumatic stress.

  • Engaging patients in organizational planning.

RESOURCES & REFERENCES

Maul, Alexandra; Menschner, Christopher. Center for Health Care Strategies. (2016). Key Ingredient for Successful Trauma-Informed Care Implementation: Key Ingredients for Successful Trauma-Informed Care Implementation (samhsa.gov)

The National Child Traumatic Stress Network. (2016) Creating Trauma-Informed Systems. https://www.nctsn.org/trauma-informed-care

The National Child Traumatic Stress Network. (2016) What is a Trauma-Informed Child and Family Service System https://www.nctsn.org/sites/default/files/resources//what_is_a_trauma_informed_child_family_service_system.pdf

Creating a culture of quality through education, measurement, and collaboration.