Trauma Informed Care vs. Trauma Specific Treatment

A majority of persons served in public mental health and substance abuse systems have experienced trauma and have been severely impacted by these experiences. Neglecting to address trauma can have huge implications for the effectiveness of mental health treatment and short-and long-term wellness of the individual (more about the trauma and mental health). Trauma informed care is an approach that aims to engage people with histories of trauma, recognize the presence of trauma symptoms, and acknowledge the role that trauma has played in their lives.

Trauma informed care is grounded in and directed by a thorough understanding of the neurological, biological, psychological, and social effects of trauma and the prevalence of these experiences in persons who seek and receive mental health services. It takes into account knowledge about trauma — its impact, interpersonal dynamic, and paths to recovery — and incorporates this knowledge into all aspects of service delivery. Trauma informed care also recognizes that traditional service approaches can re-traumatize consumers and family members. Additionally, trauma informed care is a person-centered response focused on improving an individuals’ all around wellness rather than simply treating symptoms of mental illness.

Trauma informed care is about creating a culture built on six core principles:

1. Trauma Understanding: through knowledge and understanding trauma and stress we can act compassionately and take well-informed steps towards wellness.
2. Safety & Security: increasing stability in our daily lives and having core physical and emotional safety needs met can minimize our stress reactions and allow us to focus our resources on wellness.
3. Cultural Humility & Responsiveness – when we are open to understanding cultural differences and respond to them sensitively, we make each other feel understood and wellness is enhanced.
4. Compassion & Dependability – when we experience compassionate and dependable relationships, we re-establish trusting connections with others that fosters mutual wellness.
5. Collaboration& Empowerment – when we are prepared for and given real opportunities to make choices for ourselves and our care, we feel empowered and can promote our own wellness.
6. Resilience & Recovery – when we focus on our strengths and clear steps we can take toward wellness, we are more likely to be resilient and recover.

Trauma Informed Care Systems

Systems without Trauma Sensitivity

• Misuse or overuse displays of power – keys, security, etc.
• Higher rates of staff turnover and low morale
• Disempowering and devaluing consumers
• Consumers are labeled and pathologized
• Focused on what’s wrong with you

Systems with Trauma Informed Care

• Recognition that coercive interventions cause trauma and re-traumatization
• Awareness/training on re-traumatization and vicarious trauma
• Value consumer voice in all aspects of care
• All inclusive of survivor’s perspective and recognition of person as a whole
• Focus on what has happened to you

Although often confused, Trauma Informed Care and Trauma Specific Treatment are two different, although related, concepts. Trauma Informed Care takes into account knowledge about trauma into all aspects of service delivery, however it is not specifically designed to treat symptoms or syndromes related to trauma. Trauma Specific Treatment, on the other hand, is evidence based and best practice treatment models that have been proven to facilitate recovery from trauma. Trauma Specific Treatments directly address the impact of trauma on an individual’s life and facilitate trauma recovery- they are designed to treat the actual consequences of trauma.  All trauma specific treatment models should be delivered within the context of a relational approach that is based upon the empowerment of the survivor and create the feeling of safety.

Some examples of Trauma Specific Treatments or Interventions include:

• Addiction and Trauma Recovery Integration Model (ATRIUM)
• Essence of Being Real
• Risking Connection
• Seeking Safety
• Trauma Recovery and Empowerment Model (TREM and M-TREM)

Search for trauma specific interventions that have worked with specific populations or groups.