What is Trauma-informed Care?

Trauma-informed care has been gaining much attention recently. The need for healthcare professionals to understand trauma and how they can adapt their care procedures to be sensitive to patients’ past traumas is of paramount importance. Trauma is more common than many believe. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than two-thirds of children have experienced at least one traumatic event by 16 years old. What’s more, in 2015 reports indicated there were about 683,000 children who had been abused or neglected. That equates to about 9.2 children out of every thousand. 

That’s a lot of children who are not only being abused but growing up with the scars and difficulties associated with trauma in childhood. The statistics surrounding childhood neglect and abuse are staggering. Here of some from SAMHSA to consider:

• Youth who needed hospital treatment each year for abuse and assault would fill nine stadiums
• One in five high schoolers were bullied at school and one in six were bullied online
• 12% of physically ill youth have post-traumatic stress disorder (PTSD)
• 54% of families in the United States have experienced some type of disaster

The Centers for Disease Control and Prevention (CDC) reports the following when it comes to trauma: 

• One in four youth experience some type of maltreatment including physical, emotional, and sexual abuse
• One in four women have experienced domestic violence
• One in five women have been raped (12% were under 10 years old)
• One in 71 men have been raped (30% were under 10 years old)

As illustrated, trauma impacts many more than most people are aware of today. So just what is trauma? There are different types of trauma that individuals experience. However, all traumatic experiences, particularly in childhood can cause issues that last a lifetime—without the proper treatment. 

What Is Trauma? 

While there are no hard and fast guidelines for what is included in trauma and traumatic experiences, the following are some of the most common types of trauma experienced: 

• Experiencing or witnessing emotional, physical, or sexual abuse
• Being neglected in childhood
• Serving in the military and witnessing violence
• Experiencing or seeing violence in the community
• Having a family member with a mental health disorder
• Having a family member with a substance use disorder
• Living in poverty or experiencing systemic discrimination

SAMHSA defines trauma as follows: 

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

Experiencing trauma—at any age—can lead to PTSD as well as other mental health issues like anxiety and depression. When children experience childhood trauma, they too can develop issues as well. Childhood trauma can lead to substance abuse and addiction. In fact, according to research from the National Center for Biotechnology (NCBI), it was found that in adolescents being treated for substance abuse, more than 70% had experienced some type of trauma. 

This means that not only do those who experience childhood trauma have an increased chance of developing PTSD and other mental health disorders, they also have a higher risk for developing an addiction to alcohol or drugs. 

What are Signs of Trauma in Children and Adults?

It’s vital to be able to recognize signs of trauma and abuse in youth and adults. Some of the ways trauma and abuse present in youth are as follows: 

Children aged 1-5 years: 

• Crying and screaming frequently
• Being upset and fearful when separated from parents or caregivers
• Having poor eating habits; eating too much or not eating
• Having bad dreams or nightmares

Elementary school-aged children:

• Exhibiting anxiousness or fearfulness
• Feeling guilty or experiencing shame
• Experiencing troubles with sleep
• Having difficulty focusing and concentrating

Middle and High school-aged youth:

• Feeling alone or depressed
• Developing eating disorders
• Engaging in self-harm behaviors
• Starting to use alcohol or drugs
• Engaging in sexually promiscuous or risky sex behaviors

Adults: 

• Having significant and often overwhelming fears
• Being depressed
• Feeling guilty or experiencing shame
• Experiencing frequent feelings of anger
• Having mood swings
• Being irritable

As mentioned, there are no set rules that define what is and what isn’t considered trauma. This is the same for signs of trauma in kids and signs of trauma in adults. While the above-listed are some of the more common signs, there are others that indicate trauma in children and adults. It’s important not to see these as the only types of trauma in children and adults. 

Trauma in life can not only impact mental health but studies also show that those who experience trauma in childhood also have detrimental impacts on their health. According to SAMHSA,  experiencing childhood trauma increases the risk for developing the following health issues: 

• Chronic lung disease
• Chronic heart disease
• Liver disease
• Sexually transmitted infections
• Alcohol abuse
• Substance abuse
• Addiction to tobacco

When unhealed trauma leads to substance or alcohol abuse and disorders and other mental health issues like anxiety and depression it is referred to as having a co-occurring disorder. Co-occurring disorders are common in those with substance and alcohol abuse issues. Getting treatment for both the substance or alcohol issues as well as the other mental health disorders, like PTSD, is highly recommended to increase the individual’s chance at long-term recovery. 

How Trauma-informed Care Is Best Implemented

When it comes to healthcare practitioners implementing trauma-informed care a basic shift in approach is suggested. SAMHSA states that the shift should be from “What’s wrong with you?” to “What happened to you?”. This subtle shift can make a big difference in proper identification and thus treatment of trauma in both youth and adults. In addition, healthcare professionals should also implement this shift in focus by the following: 

• Being aware of how widespread trauma is and understanding different ways to recover and heal
• Being able to recognize signs and symptoms of trauma in patients as well as staff
• Integrating trauma knowledge into policies, procedures, etc. 
• Being aware of potential patient traumas and actively seeking not to recreate similar environments that could trigger patients and their past or current traumas

When it comes to implementing trauma-informed care it’s important to realize that all those who interact with the patients from the receptionist to the physician should be educated on trauma, how it presents, and how to be sensitive to these situations. An entire organization from the bottom up needs to be trained in trauma-informed care in order to truly be effective. 

SAMHSA states there are five main ingredients in trauma-informed care. These are as follows:

• Directing and communicating about the transformation process
• Having patients be active participants in the planning
• Training all staff members on trauma-informed care
• Creating a safe environment
• Preventing secondary trauma stress in staff

For more information on these five key ingredients read the whitepaper from SAMHSA, Key Ingredients for Trauma-Informed Care Implementation. 

Why Trauma-Informed Care Matters

Trauma-informed care is important for numerous reasons. Not only does this type of care provide the opportunity for patients to have a more active role in their healthcare (both physical and mental) it also can improve long-term health outcomes. Trauma-informed care can also help healthcare professionals by decreasing burnout and turnover rates. 

It’s vital to realize that many times healthcare settings can re-traumatize individuals who have experienced trauma in childhood or as adults. This results in patients not getting the treatment and care they need to heal both physically and emotionally. When trauma-informed care is implemented correctly, the environment will promote healing and recovery instead of unintentionally re-traumatizing patients. 

If you or someone you care about has experienced childhood or adult trauma it’s important that you have the opportunity to not only heal but have supportive, understanding, and compassionate care as you recover. If you have developed an alcohol or substance abuse issue in your attempts to ease the pain and cope, you deserve to be treated in an environment supportive of you. 

At Futures Recovery Healthcare we treat each patient with compassion, respect, and dignity. Many of our staff are in recovery themselves and have also experienced trauma in childhood and as adults. If you want to learn more about Futures and our programs, reach out online or call us at 866-804-2098. We’re here for you and your loved ones.