This document provides information about trauma informed care. It defines trauma and discusses how psychological trauma is more severe if it is human caused, repeated, unpredictable, inflicted in childhood, or perpetrated by a caregiver. A trauma informed approach realizes how prevalent trauma is, recognizes how it affects people, and responds by applying this knowledge. Key aspects of trauma informed care include safety, choice, collaboration, consistency, and respecting each person.

1. Trauma Informed Care
St. Elizabeth’s Wellness Collaboration
August 18, 2011
Honickman Center

2. 
Imagine trying to read a book that has no
plot. There are no organizing themes, no
recurrent patterns. Every page has a new
and unpredictable set of events that seem
unconnected to the events on the
previous page, there is no way of
guessing, much less predicting, what will
happen next. At first the book might seem
entertaining and even exciting but
eventually it just seems like too much
effort to read. Now imagine that that book
is your life . Nothing makes sense, and
you cannot plan or take control of even
the simplest activities.

Harris & Fallot 2001

3. Defininition of Trauma
Trauma is defined by extreme stress that
overwhelms a person’s ability to cope.
An individual’s subjective experience determines
whether an event is or is not traumatic.
It can be the individual experience of an event
AND/OR enduring conditions.
Trauma is experienced when the individual’s ability
to integrate her emotional experience is
overwhelmed.
A traumatic experience or enduring condition
occurs when the individual experiences
(subjectively) a threat to life, bodily integrity, or
sanity.
Giller, 1999 , Pearlman & Saakvitne, 1995

4. Psychological effects tend to be
most severe if the trauma is…
Human caused
 Repeated
 Unpredictable
 Multifaceted
 Sadistic
 Undergone in childhood
 Perpetrated by a caregiver


Esther Giller, 1999

5. Trauma: the gift that keeps on
giving…

The lasting effects of trauma often
result in the following diagnoses:
◦
◦
◦
◦
◦
◦
Substance abuse/dependence
Personality disorders
Depression
Anxiety (including ptsd)
Eating disorders
Etc, etc, etc.
◦ Esther Giller, 1999

6. What will we see?
Sense of powerlessness
 Fear
 Hopelessness
 Constant state of alert/watchfulness
 Compromised relationships
 Compromised sense of self
 Compromised communities
 Recurring feelings of
shame, guilt, rage, isolation, disconne
ction.


7. Joe said it
Let’s stop asking …
“What’s wrong with
you?”
And start asking …
“What happened to
you?”

8. Why do we need a trauma
informed approach?
“When an individual is bombarded with
repeated traumas that constitute threats to her
personal integrity and worldview, then that
individual comes to question even the most
fundamental assumptions about the world. In the
wake of trauma, that person must construct a new
theory of how the world works and how people
behave.
Humans seek to make sense out of their
experiences, no matter how horrific or bizarre that
experience might be. We want things to have
meaning and when events occur that challenge our
view of the world, then we must struggle to find a
new way to organize and understand our
experience. “
Harris & Fallot, 2001

9. Definition of “Trauma
Informed”
… is an approach to engaging people
with histories of trauma.
 … is a system in which all components
are developed and evaluated in light of
the role that violence plays in the lives of
those seeking services.
 … is a system that designs services
which accommodate the vulnerabilities of
trauma survivors.
 …is an approach designed to avoid
inadvertent re-traumatization of
consumers in treatment.


10. Trauma informed vs. trauma
specific
Trauma specific services are designed
to treat the actual symptoms
associated with exposure to trauma.
 Examples:

◦ Seeking Safety
◦ TREM groups
◦ EMDR

11. The 3 r’s of Trauma Informed
Care
Realize the prevalence of trauma
Recognize how trauma affects all
individuals involved with
org, prog, system, etc
Respond by putting this knowledge
into practice

samsha 2012

12. ACES study

13. What are the benefits of tic?

14. SAMSHA definition of TIC

A program, organization, or system
that is trauma informed realizes the
widespread impact of trauma and
understands potential paths for
healing; recognizes the signs and
symptoms of trauma in
staff, clients, and others involved in
the system; and responds by fully
integrating knowledge about trauma
into
policies, procedures, practices, and

15. TIC vs. Non-TIC
TIC
 Provides safety
 Offers choice
 Embraces
collaboration
 Rooted in
trust, consistency
and transparency
 Respects the person
Luest, 2011
Non-TIC
 Labels/pathologizes
 Sees individuals as
manipulative/attentio
n-seeking
 Fosters culture of
secrecy, poor
monitoring
 Staff sees their role
as “rule enforcer”
 Emphasizes
compliance rather
than collaboration.

16. Whatever you, whatever your job
is…
Tell people what you’re going to do
before you do it.
 Recognize a flashback and manage it
with words instead of action
 See trauma responses as adaptions


17. Small Group activity
identify three things to make this
project reflect a trauma informed
system of care.
 Don’t worry about how small or large
your ideas are.
 Use your imagination!
