What is trauma-informed care?

Typically, when a patient seeks care for a condition or illness, doctors investigate what is occurring. Trauma-informed care focuses, rather, on how it happened to address the issue at its root and unravel its long-term impact on the patient’s life. In this article, Dr Pavan Joshi explains the tenets of trauma-informed care.

Trauma can happen to anyone at the drop of a hat, regardless of where they are and what they’re doing. Trauma is the result of exposure to one or a series of events that are emotionally distressing or threatening. The trauma we experience in our lives can continue to haunt us even after many years, leaving lasting effects on our behaviour and cognition.

What can trauma-informed care do for patients?

Trauma can occur due to events of tragedy, disaster, violence, or injury, and the impact of it can exist in an ongoing cycle of experiences. When caring for a patient with trauma, an indelicate or brusque approach can have detrimental effects on the patient’s well-being and may compound their trauma. Trauma-informed psychiatrists and psychologists are specially trained to navigate discussions and treatment of trauma. Working with their patients, they construct a thorough history of trauma via questionnaires and assessments to best understand how trauma has and continues to impact the patient. This information is then used to formulate a bespoke care plan for the patient.

Addressing trauma can not only better a patient’s mental health, but also their social and physical condition. Trauma has a real biological impact; in the brain, particularly the amygdala (the centre of primitive brain function), it can disrupt rational thinking and decision-making abilities, and it can alter genetics, meaning that trauma can leave a generational impact.

People dealing with trauma may isolate themselves, have low self-esteem, and find it difficult to build relationships, which likely will lead to depression and anxiety disorders. They may become risk-averse, shying away from opportunities and chances, or they may engage in more risky or impulsive behaviours like substance use.

What does trauma-informed care look like?

Trauma-informed care aims to remove or alleviate the adverse influence of trauma on a patient’s mental, physical, social, emotional, and spiritual well-being. There are a few tenets that psychiatrists and psychologists must keep in mind to best care for patients with trauma:

AWARENESS

Psychiatrists and psychologists should have an awareness of trauma and be able to openly discuss with patients about their experiences so that they can accurately link them to present behaviours and occurrences.

SAFETY

Patients should feel safe with their doctor and the space they are in, both psychologically and physically. They should feel secure under the care of their doctor and that there is no imbalance of power or authority.

TRUST

Doctors should be transparent with their patients, who should not feel unsure or unclear about their treatment process and how the information they are divulging is to be used. Patients should feel that they can rely on the consistency of their doctor’s care and support.

COLLABORATION

Patients should have a say in their care and be involved in the decision-making for their treatment. Their concerns or questions should be addressed when raised.

DIVERSITY

Doctors should be informed about how every patient has different circumstances and backgrounds, and that race, gender, class, ability, and sexuality – and how these factors may be stigmatised, and face violence and prejudice by communities and systems – can contribute to or compound trauma, for both individuals and groups as a whole.

PREVENTION

Doctors must undertake actions to prevent re-traumatisation by recognising active triggers and symptoms of prior traumas. Re-traumatisation is the re-experiencing of thoughts, feelings, or sensations as experienced during a traumatic event or circumstance of the past, which will not only remind the patient of the past trauma but can also induce new, concurrent trauma.

EMPOWERMENT

Trauma-informed care should leave a patient equipped to take on the future with confidence. They should feel supported and validated in the struggles they face against their trauma, and doctors should acknowledge their patients’ experiences whilst nurturing their resilience and healing.

If you would like to know more about trauma-informed care, you can consult with Dr Joshi via his Top Doctors profile