Of the many different types of traumatic events that a person can encounter, each one can impact the survivor in different ways. A combat veteran, a sexual assault survivor, and a child abuse victim have all experienced trauma, but how that trauma affects them in the long term will depend on many things: their home environment and support system, the resources available to help them process the event, their general physical and mental health, their own coping skills, and more.
How Common is Trauma?
Trauma takes many forms and can be experienced at any point in a person’s life. Any event that overwhelms a person’s ability to cope is considered trauma. This can include:
- Witnessing or directly experiencing physical assault
- Witnessing or directly experiencing sexual assault
- Natural disasters
- Death of a loved one
- Childhood neglect
- Being raised by an addicted or mentally ill parent
Unfortunately, trauma is extremely common, with more than half of all adults reporting that they have experienced at least one trauma in their lifetimes. Though anyone can experience any type of trauma, women are more likely to report sexual assault and childhood sexual abuse than men, and men are more likely than women to report violent accidents, physical assault, combat, and witnessing deaths or injuries.
What Does it Mean to be Trauma-Informed?
When the person who has been through a trauma utilizes a service (hospital, therapy, residential treatment, etc.), it’s important that the institution and the people who work there understand trauma and intentionally provide an environment that is safe and comfortable. This is what it means to be “trauma-informed” – employees have been trained in the impact of trauma and policies have been created to prevent any unintentional triggering of trauma survivors’ difficult feelings and memories.
Trauma-informed care assumes everyone has been through something traumatic, because it is likely that they have. The Centers for Disease Control and Prevention (CDC) list six principles of trauma-informed care, which include:
- Safety – the person feels and is safe during treatment
- Trustworthiness/transparency – the provider is open and honest with the patient
- Peer support – the client is able to get support from other people who have had experiences like their own
- Collaboration – the patient is part of their own care team and has a voice in their treatment
- Patient empowerment – the patient has the right to understand what is happening to them, to change their mind, and to revoke their consent
- Cultural, historical and gender awareness – clinicians understand how the unique characteristics of each patient may impact their attitudes and behavior
What Happened to You?
One of the guiding principles of trauma-informed care is to approach individuals with compassionate curiosity rather than a “fix-it” attitude. In other words, interactions with a patient are based on the question, “What happened to you?” rather than, “What is wrong with you?” This shift in paradigm makes the assumption that people are behaving in ways that are a reasonable response to their experiences, rather than as a result of that person being defective in some way. By understanding what happened to the person to shape their behavior, it can be easier to support the person in developing healthier coping skills.
What Are Trauma-Informed Practices?
While there are many different ways that an agency can take a proactive approach to trauma, some of the hallmarks of a trauma-informed approach include:
- Screening for trauma and using the information gathered to ensure the client feels safe
- Educating adult patients and parents of child patients about trauma and how it can impact a person long-term
- Allowing patients to have a support person with them
- Ensuring that clients know their rights and the choices they have available
- Hiring staff who understand and implement trauma-informed practices
- Providing a safe environment:
- Quiet waiting rooms
- Well-lit parking lots, stairways, bathrooms, hallways, etc.
- Monitoring who is coming in and out and also who could be lingering near exits
- Ensuring patients always have access to the exits and know they are free to revoke or withhold their consent for treatment that makes them uncomfortable
- Providing security personnel within the building, if needed
- Ensuring that clients know what to expect by being consistent and explaining, in advance, what will be happening during the current and future appointments
Trauma Versus PTSD
Post-traumatic stress disorder (PTSD) is a condition that can result from exposure to trauma, particularly if the person does not receive prompt and appropriate support to get them through the traumatic event or if they experience ongoing traumas. PTSD does not necessarily develop in all those who have experienced trauma. While over half of Americans report that they have experienced at least one traumatic event, only around 6 percent of the population develops PTSD.