Trauma-Informed Care (TIC)
*Photo credit to Gaspar Uhas
This blog post aims to help readers understand the terms “trauma-informed” or “trauma-informed care” (TIC), terms frequently used in the world of therapy. Although these terms are common, they are not regulated or protected, meaning anyone can claim to be trauma-informed. This post will assist clients in choosing a mental health professional who truly offers TIC.
An educated trauma informed therapist offers safety, evidence based treatment, empowerment, and a strengths-based approach to their clients. This approach includes a collaborative journey of resilience, healing, and the promotion of reconnection and integration. One who offers TIC assumes the client has likely experienced trauma (often under reported and recognized), which impacts how they are served (Engle, 2023). This perspective considers the impact of trauma on emotions, regulation, behavior, and intergenerational trauma. Clients will be addressed safely and compassionately (Marschall, 2024). TIC avoids re-traumatization, understanding responses like hypervigilance and dissociation, which is critical for effective treatment (Marschall, 2024).
According to Substance Abuse and Mental Health Services Administration, the six main principles of being trauma-informed are 1) Safety, 2) trustworthiness and transparency, 3) Peer support, 4) Collaboration and mutual respect, 5) Empowerment, voice, and choice, and 6) Awareness of cultural, historical, and gender issues (2014).
Why is being trauma informed so important?
A trauma informed therapist is able to:
help the client learn about trauma-educating them on symptoms, triggers, and how therapy can help;
re-establishes safety and prevents re-traumatization;
facilitate coping skills and healing; and
decrease traumatic stress symptoms (Engle, 2023).
The professional relationship is grounded in safety and connection (Engle, 2023). This is an important piece of the therapeutic process as the therapy room may be one of the only “safe” places a client can let their guard down in. Trusting the counsellor creates important connection and even model healthy interactions. In fact, healing is more likely when a client is allowed to experience safety from an expert who understands and validates their feelings- All therapists have these basic skills, but a trauma Informed therapist should have advanced training in treating trauma, and more experience helping clients who have experienced trauma (Engle, 2023).
What can I ask my therapist to help determine if they provide TIC?
Start by asking your clinician what trauma informed training they have have completed. You can also ask:
Do you consider yourself Trauma Informed, and what does this mean to you?
What is your approach to therapy with clients with trauma history?
What kinds of clients do you work with, or what kinds of trauma do you work with?
Are there any types of trauma that you do not feel comfortable or competent to work with? and
What is your pace when treating trauma? (Marschall, 2024).
It is also a good idea to ask them if they have experience working with a specific specialty population if that is applicable to you. Additionally, you can ask if there any presenting concerns they are not competent or confident in working with.
First Responders and Military (Active or Veterans) may benefit from asking these additional questions:
Do you have any training specifically related to First Responders?
How much experience do you have with treating First Responders?
How much consultation and/or clinical supervision have you had to learn about the culture, profession and stressors experienced by First Responders?
How much experience do you have with treating those experiencing the cumulative impact of Operational Stress Injuries (OSI) and trauma?
What evidence based trauma treatment for PTSD do you practise?
What evidence based trauma treatment for PTSD are you trained in?
Do you have experience/training working with dissociation?
A mental health professional advertising as trauma informed should be comfortable talking about their trauma training. Alternatively, not everyone who offers TIC, advertises in that way (Marschall, 2024). Trauma informed professionals should absolutely understand the concept of being Trauma Informed and be able to discuss it. Marschall shares that TIC providers should also focus on competency (being educated and up-to-date in research and best practices for working with clients who have experienced trauma) (2024).
What are recognized trauma treatments?
According to Schrader, the following therapies have significant trauma focus and are the current gold standard for treatment of trauma associated symptoms of Post Traumatic Stress Disorder (PTSD):
Cognitive Processing Therapy (CPT);
Prolonged Exposure Therapy (PE); and,
Eye Movement Desensitization and Restructuring (EMDR) (2021).
Other recognized trauma treatments are Trauma Focused Cognitive Behavioral Therapy (TF-CBT) and Accelerated resolution therapy (ART).
What if my therapist doesn’t offer trauma informed treatment?
If you are looking to participate in trauma treatment specifically, and your current therapist does not have training in that area, your therapist should provide you with referrals to other mental health professional who offers evidence based trauma treatment. You can also do research and find yourself a trauma trained therapist in your area.
Remember that most mental health professionals offer free 15 minute consultations to determine if both individuals are a good fit. This is a great option to utilize when trying to maximize insurance coverage and finances.
In closing, remember that asking questions of your therapist or potential counsellor is perfectly acceptable. I encourage you all to advocate for your needs and treat your mental health as a consumer- it is never a one size fits all approach.
Yours always in authenticity,
Jody
References
Engle, M. (2023, September 28). Trauma-informed therapy: How it works and why it's important. Choosing Therapy. https://www.choosingtherapy.com/trauma-informed-care/
Marschall, A. (2024, March 24). What is trauma-informed therapy? Definition, techniques, and efficacy. VerywellMind. https://www.verywellmind.com/trauma-informed-therapy-definition-and-techniques-5209445
Schrader, C., & Ross, A. (2021). A Review of PTSD and Current Treatment Strategies. Missouri medicine, 118(6), 546–551. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672952/
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville, MD. https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf