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Trauma-informed care

December 13, 2019

Exposure to traumatic events is ubiquitous, even in high-income populations. Trauma-informed care is a form of 'universal precautions' health providers can use to mitigate further harm and help with healing.

Adverse childhood experiences (ACE) and intergenerational trauma are linked with chronic pain, obesity, cancer, substance abuse and mental illness. But training for health providers on ACEs and harm prevention is less common. Trauma-informed care is for everyone.

Trauma-informed care needs an environment of calm, safety and compassion. Care is respectful, cultivates trust, resilience-building and a sense of control. Gerber describes the 4Cs of the practical approach of TIC: Calm, Contain, Care and Cope.

  1. Calm
    Be self-aware, breathe deeply to calm yourself. Reduce chaos where possible and promote a calm, patient attitude to yourself and others. Cultivate an understanding of trauma and how resilience, justice, and equity lead to peaceful, calm communities.

2. Contain.
When enquiring, limit trauma detail & give support without requiring disclosure of trauma. Earn trust by behaving reliably and monitoring emotional/physical responses to education and enquiry about trauma. Work closely with others to minimise risk of trigger or re-trauma.

3. Care
Share messages of support when trauma is disclosed, normalise and destigmatise trauma symptoms and harmful coping behaviours. Practice cultural humility, minimise power differentials and promote self-care, compassion and equity for all.

4. Cope
Emphasise positive relationships and interventions that build resilience, document a 'coping strategies' list as well as a 'problem list'. Increase social support, identify and treat mental health, substance use and other sequelae of trauma.

Trauma-informed practice is a journey of learning for all clinicians - about how trauma affects our patients, and a strengths-based approach to provide the support they need. We can make a difference. More full-text resources here: http://bit.ly/tic-resources

Trauma-Informed Healthcare Approaches. Gerber M. 2019. Link | Review

Originally published by Danny Tucker on LinkedIn and as a Twitter 'Tweetorial’ (link).

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