Principles of Trauma-Informed Care
By screening for ACEs, providers can better determine the likelihood a patient is at increased health risk due to a toxic stress response, a critical step in advancing to trauma-informed care.
Trauma-informed care recognizes and responds to the signs, symptoms, and risks of trauma to better support the health needs of patients who have experienced ACEs and toxic stress.
- Understanding the prevalence of trauma and adversity and their impacts on health and behavior;
- Recognizing the effects of trauma and adversity on health and behavior;
- Responding by incorporating trauma-informed principles throughout clinical practices and community support systems;
- Resisting re-traumatization; and
- Integrating knowledge about trauma and adversity into policies, procedures, practices and treatment planning.
Principles of Trauma-Informed Approaches to Care
The following key principles of trauma-informed care should serve as a guide for all health care providers and staff:
- Establish the physical and emotional safety of patients and staff
- Build trust between providers and patients
- Recognize the signs and symptoms of trauma exposure on physical, psychological and behavioral health
- Promote patient-centered, evidence-based care
- Train leadership, providers and staff on trauma-informed care
- Ensure provider and patient collaboration by bringing patients into the treatment process and discussing mutually agreed upon goals for treatment
- Provide care that is sensitive to the racial, ethnic, cultural, and gender identity of patients
Screening for trauma requires patients to reflect on and revisit upsetting parts of their life, which may activate distressing feelings or thoughts for patients and for providers conducting the screenings. People who have experienced ACEs or other trauma may feel shame, blame, anger, sadness, and/or embarrassment.
Therefore, it is important for providers to administer screenings in a trauma-informed manner that avoids re-traumatization.
There are several ways providers can avoid re-traumatization:
- Adhere to a recommended time frame for the ACE screening tools to maintain emotional safety for patients and providers.
- Refer patients to mental health providers who are trained in evidence-based trauma therapy if they want to discuss traumatic events in detail. Providers can provide supportive, compassionate responses to trauma without focusing on specific details.
- Practice compassionate resilience to maintain provider well-being while caring for patients to combat staff compassion fatigue, burnout, secondary traumatic stress, various trauma, and other workforce concerns.
- Allow self-reporting to give patients more control over the screening process by allowing them to disclose the number of ACEs that apply to them, not which experiences apply. This ensures patients give necessary health information to a provider without going into details or the specific types of experiences.
- National Council for Behavioral Health – Fostering Resilience & Recovery Change Package
- American Academy of Pediatrics – Trauma Toolbox for Primary Care
- Center for Health Care Strategies – Implementing Trauma-Informed Care in Pediatric & Adult Primary Care
- Center for Health Care Strategies – Trauma-Informed Care Champions: From Treaters to Healers (Videos)