Define Trauma-Informed Care
In my previous blog posts, I defined trauma and explained what symptoms of trauma may look like. So, then, how is trauma-informed care defined, and what does it mean for a trauma therapist like myself to provide it? Let me illustrate.
Right after college, I worked in a group home for teenage boys with severe emotional disturbances. During that time, I regularly encountered teens who were engaging in problematic behaviors. For example, many of the residents had difficulty with anger management, or emotion regulation. A few of these residents were known for becoming physically aggressive, usually with their peers but also at times with a staff member or two. What might begin as one teen making a rude comment to another could lead to a yelling match, and then move quickly into posturing and threats of (or actual) physical aggression. These types of behaviors also tended to evoke strong emotions in staff members, who held the responsibility for keeping residents safe. The first response of many when put in this position would be to say, “What’s wrong with you? That’s not how you are supposed to behave – you know the rules. Get it together or else!”
Unfortunately, this kind of reaction is often exactly the opposite of what these young people need - it can increase unwanted behaviors by increasing shame. When children and teens receive these reactions often, they can start to (further) internalize the belief that, “I’m bad. There’s something wrong with me.”
A trauma-informed approach is different. Trauma-informed professionals ask, “What happened to you that you are feeling so angry, so tired, so anxious, so afraid?” In a trauma-informed approach, the emphasis is on understanding the underlying stressors or traumatic events that may be leading to outward problematic behaviors and symptoms. Trauma-informed therapists know that most people have experienced some form of trauma in their lives, and they know how to recognize the symptoms of trauma.
Fresh out of undergrad, I did not know what trauma-informed care was. But I did know that reading the files of the group home residents in the evening grounded me in the knowledge that the severe trauma and neglect they had lived through was driving the outward behavior I was seeing. None of it was about me. This knowledge allowed me to approach with more understanding and compassion, while at the same time remaining firm that certain behaviors were unsafe and needed to be addressed. I now know that those intense anger outbursts and even the physical aggression were symptoms of being triggered into a fight/flight response when they felt unsafe. I also understand now how and why a response of anger from staff could lead to even more unsafe behaviors. Think of it this way. When you are feeling really afraid, does it make it better or make it worse if someone looks at you with anger behind their eyes and raises their voice?
When you are looking for a therapist for yourself or your child, you want it to be someone who will understand where you have been and how that contributes to where you are now. Working with a trauma-informed therapist means that your therapist is taking your past trauma into account, even if you have not yet disclosed it. In doing so, they should offer you information about what to expect from therapy and why they need the sensitive information they ask for as you are getting started. Trauma-informed therapists also involve clients in their own treatment planning and offer clients choices that empower them. These therapists ask their clients what they can do to make a client’s time in therapy feel more helpful and safe, and are open to feedback about what is and isn’t working. They will also be sensitive to your unique constellation of symptoms and the ways that the behaviors you feel most frustrated with in yourself or in your child/ teen may be related to past trauma.
I wish you well as you continue to journey towards healing and peace! If I can help you in that journey, do contact me. It would be a privilege to walk with you.
