Incidents of trauma, ranging from social displacement or experiences of war to childhood sexual abuse, can have profound and deeply destabilising effects that vary considerably from person to person.
The effect of trauma can range from headaches and fatigue to anxiety and depression, nightmares, sleeping and eating issues, and the misuse of alcohol or drugs.
Trauma is often related to gender, in particular in the incidence of sexual assault and family violence, which are predominantly perpetrated by men against women.
Trauma-informed care recognises the high prevalence of experiences of assault and abuse among people accessing mental health services, and takes care to avoid practices or discussions that may trigger memories of previous experiences of trauma.
Trauma-informed services acknowledge people’s lived experiences as the bedrock for therapeutic decision making and promote people’s choice and empowerment as vital to their treatment.
A trauma-informed approach is based on the recognition that many behaviours and responses – once seen as ‘symptoms’ – are in fact adaptive behaviours that can be positively integrated into people’s care.
Trauma-informed care systems value the consumer in all aspects of their care. They use neutral and supportive language, never judge or ‘label’ people, and seek to engage with them on their terms – for example, requesting their permission before contacting their family.
Principles of trauma-informed care
Trauma-informed care systems usually follow a series of guiding principles, including:
- a focus on building therapeutic relationships that are empowering and support individual strengths and learning
- the preparation of comprehensive treatment plans based on professional assessments of a patient’s trauma history
- close collaboration with external agencies and expert consultants who can provide specialised advice and trauma care
- careful consideration of the potential for re-traumatisation through inappropriate work practices and/or any continuing trauma in the person’s personal life
- embedding of trauma-informed care approaches in policies and workplace practices across the service
- staff education and training on the prevalence and impacts of trauma, and the widespread occurrence of violence and victimisation among people accessing mental health services
- an assumption that everyone accessing the service has potentially experienced trauma, and the need to adopt trauma-informed approaches in all aspects of the service’s treatment and care.