T.I.R.E.D.

In a trauma-informed approach, all people at all levels of the organization or system have a basic realization about trauma and understand how trauma can effect families, groups, organizations and communities as well as individuals. people's experience and behavior are understood in the context of coping strategies designed to survive adversity and overwhelming circumstances, whether these occurred in the past or are currently manifesting. 

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There is an understanding that trauma plays a role in mental and substance use disorders but also that trauma is not confined to the behavioral health sector alone but is integral to other systems (primary health care, gynecology, pre and post-natal care, and treatment for infertility) and that it is often a barrier to affective outcomes.

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Intimate contact during well woman and perinatal care can trigger PTSD symptoms (eg, flashbacks, hyperarousal, avoidance). So, a history of sexual trauma comes to the fore in health care encounters with sexual abuse survivors. (Sperlich) 

People in the practice are able to recognize the signs of trauma. these signs may be gender, age, or setting specific and may be manifested by individuals seeking services.

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Understanding your patient population, the prevalence of trauma in that population, and providing a safe space for care to occur should be a primary goal.  Additionally, learning how to recognize the signs of trauma will assist in the next step which is responding to trauma. 

The practice responds by applying the principles of a trauma-informed approach to all areas of functioning. The practice integrates understanding that the experience of traumatic events impacts all people involved whether directly or indirectly. Staff in every part of the practice, from receptionist, to financial coordinator to nurse to doctor will be aware of their language, behaviors and policies to take into consideration the  experiences of patients. 

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The practice should be committed to providing a physically and psychologically safe environment. The practice's response involves a universal precautions approach in which one expects the presence of trauma in lives of individuals being served, ensuring not to replicate it. 

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Trauma-informed care, which recognizes the impact of trauma and its signs and symptoms, and responds by integrating knowledge of trauma in a comprehensive way in service delivery, is spreading to other settings such as primary care, physical therapy and maternity care to address these issues (1-6). 

A trauma-informed approach seeks to resist re-traumatization of patients. Practices often inadvertently create stressful or toxic environments that interfere with the goal of the treatment provided.

 

Because the hallmark feature of PTSD is intrusive re-experiencing of memories of the traumatic event alongside the physiologic and psychologic reactions as though the trauma were happening again, (Sperlich) staff who work predominantly with women and in a specialty involving trust, touch, contact with private parts of the body and in areas in which shame and lack of social supports, should be taught to recognize how practices may trigger painful memories and re-traumatize clients with trauma histories. 

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According to the National Center for Trauma Informed Care (NCTIC), trauma-informed care takes place when services are based on an understanding of the vulnerabilities or triggers of trauma survivors as to be more supportive and avoid re-traumatization. (Sperlich) 

 

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