Understanding the concept of trauma-informed care

By Cassie Weiss, Features Editor

Have you ever considered the word trauma — seriously considered it? It seems like a pretty obvious word, with a pretty obvious definition, but let me tell you, it is so much more than that. Trauma can be large and ugly. Truthfully, that is what we expect when we think of the word. We can think of an extreme case that wracks a person’s nightmares, keeping them awake throughout the night. But the thing is, trauma can also be quiet. So quiet, in fact, that you don’t even know it is there.

A common phrase in the social services sector, trauma-informed care centers around what has happened to a person, rather than what is wrong with them. Additionally, one of the first things taught in psychology is the ins and outs of mental health, and how important it is for a child to grow up in a caring and secure environment.

If you take those facts and apply them to the people you have crossed paths with throughout the course of your life, what percentage of those people do you think can say they grew up in a caring and secure environment? Now, take it one step further and add in research done on Adverse Childhood Experiences (ACE).

Conducted by the CDC-Kaiser Permanente, beginning in 1995, the ACE studies consist of three separate categories. They can range from any level of childhood abuse, to one or more parental figures suffering from substance abuse or mental illness, or even something as common as living with separated or divorced parents. If a person was deemed to have four or more ACEs, they were labelled at higher risk of developing chronic health problems, mental illness and substance use in their late teens to adulthood.

Knowing these facts, you can immediately see that so much of what we can’t see below the surface of a person’s exterior defines so much of who that person grows up to be. Yet, on the surface, we watch our friends struggle with relationships, or alcohol dependence or things deemed much worse, and we simply shake our heads in confusion — we just can’t really understand why they are engaging in such self-destructive behaviour.

And it doesn’t just have to be our friends — it could be relatives, parents, siblings or people much more removed from our core circle. It could be the person experiencing unemployment, homelessness or addiction — the people you don’t know in any capacity, except maybe an underlying fear when you see them at night on the train platform.

Am I registering for any of you yet?

I grew up in a very conservative home, and I moved to Calgary with an open but uneducated mind. I was scared, even in broad daylight, of strangers who would pass me on the sidewalk. I didn’t understand why or how they could end up where they had — I had never even heard the word trauma, let alone thought about it.

Now, it’s not just the word that surrounds me, but an entire phrase — a phrase that I think should be on the lips of just about every single person in the world. Entering university and working in the social services sector has shed light on the concept of trauma-informed care. It seems so obvious — as obvious as most trauma would seem — but yet most people I mention it to have no idea what I’m talking about.

According to Alberta Health Services, “The purpose of the Trauma Informed Care Project is to increase knowledge about trauma and the impact it has by creating connection, sharing knowledge, and resources.”

What this means is that individuals struggling with any type of hardship could very easily be struggling because of something that happened to them in their developmental years, and it is our responsibility to understand that. We are not sure of what that could be, especially if we are not close to the person, so who are we to judge who that person is now?

Many organizations in the social services sector are slowly shifting their practices to that of one that focuses on being trauma-informed, which can help to improve client engagement and the health outcomes of those clients, as well as provider and staff wellness, states a webpage linked to Trauma Informed Care.

If these organizations can begin to understand the impact of trauma, in turn, it would help them understand the proper paths needed for recovery, as well as integrate knowledge about trauma into policies, procedures and practices to help actively avoid re-traumatization.

The webpage goes on to mention that “a comprehensive approach to trauma-informed care must be adopted at both the clinical and organizational levels,” but I think it needs to go one step further, into the level that we sit in now — neither clinic nor organization, but still with an important position.

When is the last time you interacted with a person experiencing homelessness? It could have been on the train, or downtown or anywhere in the city really. Maybe it didn’t make you feel uncomfortable, but maybe it did.

Now, it’s important to ask yourself why it made you feel uncomfortable and what you did to soothe your own discomfort. Was it because of the unknown, not knowing the person or what they could do to you? Was it that they were obviously intoxicated? Did you move away from them, no eye contact, hurrying by so they would leave you alone?

Luckily, trauma-informed care is not about how you used to act, but about what you can do now. You don’t need to know someone’s story to approach a situation with an open mind. Just remember that they have a story, and even though you may not be privy to it, it doesn’t make that story any less real. By all means, I am not an expert on trauma-informed care, but it is a concept that I am highly passionate about, because what we all need a lot more of in this world is compassion.

Most of us have some form of trauma that haunts our subconscious, and maybe we are in the place we are now because we did receive compassion. Maybe we don’t struggle as much anymore because we had people to back us and understand us when we needed it most.

Trauma-informed care doesn’t mean giving the shirt off your back. It simply means seeing another human as just that.

If you would like more information on the Trauma Informed Care Project from Alberta Health Services, there is a group of learning modules, free of charge, for all non-AHS staff, available through their website. There is also a fantastic certification, labelled The Brain Story, that goes highly in-depth into the concept of trauma informed care, also free of charge, available through Alberta Family Wellness.