What is trauma-informed practice?
Content warning: Please be advised that this blog contains information that may be distressing for some readers
Trauma has been defined as a “state of high arousal in which normal coping mechanisms are overwhelmed in response to the perception of threat” (Cozolino, 2002). Trauma can happen at once or be repeated and is the word used to describe the experience. The word trauma is also used to describe the effects of extreme stress associated to the event. Events that threaten one’s survival are traumatic; however whilst not all traumatic events are life-threatening, once our nervous system perceives threat, it can be traumatic.
Some facts on trauma
- Traumatic experiences are common with up to 75% of Australians experiencing a traumatic event in their lifetime
- 62-68% of young people have experienced at least one traumatic event before they are 17 years old
- Approximately 1 in 6 adults endure 4+ traumatic events during childhood
- Women and people from minoritized communities face a greater risk of trauma
- People with disability experience and witness trauma more often than those without disability
- Trauma that is repeated, extreme and ongoing is called complex trauma
- Interpersonal trauma can arise from something a person does to another person at home or in relationships. It can also happen in services and systems such as employment, education, medical and legal systems and institutions
- Trauma can affect whole communities and occur between generations
- It is important and helpful to know that not everyone who experiences abuse, neglect, exploitation, and violence will experience long-term trauma impacts. Many people can and do recover.
Providing trauma-informed care and working in a trauma-informed practice framework applies to all supports and services, not just those clinicians working in trauma care. It is not about the treatment of trauma or its associated symptoms, but a recognition that trauma experiences are a possibility for anyone. For this reason, it is important for all working in health and disability care to become trauma-informed. Working in ways that understand and respond to the impact of trauma can prevent further trauma and reduce the likelihood of intergenerational trauma.
Trauma-informed care is a strengths-based framework for human service delivery that is based on knowledge and understanding of how trauma affects people’s lives, their service needs and service usage. They do not re-traumatise or blame people for their efforts to manage their traumatic reactions, and they hold notions of hope and that recovery is possible.
Providing trauma-informed support looks like:
- Viewing the person who has experienced the trauma as the expert
- Working with the person’s strengths
- Always thinking about the possibility of trauma in someone’s life
- Recognising possible trauma and understanding it’s impacts
- Understanding that trauma responses, symptoms and presentation may be an adaptation to trauma rather than a pathology, “behaviour”, or barrier to connection and participation
- Understanding that trauma survivors have experienced extremely abnormal situations and have done their very best to manage with the resources they have available to them
The fundamental principles of trauma-informed practice:
- Focus on assisting people to recover from trauma. This can be achieved via nurturing resilience through greater social support and self-efficacy. It also promotes a compassionate environment with a focus on safety for everyone.
- Seek to reduce and prevent re-traumatisation wherever possible. This can be achieved via everyone supporting those who have experienced trauma being informed about trauma, recognising trauma and possible triggers for re-traumatisation.
- Empowering people.
- Respecting diversity and practicing cultural sensitivity; we need to understand and accept the differences between cultures, being aware of similarities and differences between our culture and others.
Further resources for becoming more trauma informed:
There are many resources available to help build knowledge around trauma and trauma-informed care:
Blue Knot Foundation (BKF) provides information and training on complex trauma, trauma-informed practice and vicarious trauma, available from their website: https://professionals.blueknot.org.au/professional-development-training/ . This includes a range of guidelines for organisations and services providers, as well as the general public.
Phoenix Australia provides self-paced online training for community leaders and people who have responsibility for staff, clients or workplace wellbeing https://training.phoenixaustralia.org/offerings/tic-2022
The Mental Health Coordinating Council offers a free introductory course designed to develop core principles of Trauma Informed Practice https://mhcc.org.au/course/introduction-to-trauma-informed-practice/
1800RESPECT provides information and support specifically for people who have experienced sexual assault or domestic and family violence. Information can be accessed from: https://www.1800respect.org.au
Copeland et al. 2007; McLaughlin et al. 2013
Cozolino, L. (2002). The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain. New York: Norton.
Kezelman, C.A. and Dombrowski, J.K. (2021). Disability Guidelines for Trauma-Informed Practice: Supporting people with disability who have experienced complex trauma. Blue Knot Foundation.
About the author
Joanne Mainsbridge is the Psychosocial Clinical Lead at KEO. Jo started her career as an OT in mental health over 20 years ago. Jo has worked in various roles across Australia, NZ and the UK, including inpatient and community mental health roles, occupational rehabilitation and occupational health.
She has various special interest areas including trauma, substance use and ethics in healthcare, and has always been passionate about psychosocial disability, working in a client-centred manner and promoting recovery.
In her role as Psychosocial Clinical Lead at KEO, Jo’s priority is ensuring the team feels psychologically safe and empowered to support their participants to achieve their goals, whilst supporting them in their professional development and growth.