What Is Trauma Informed Care?
Below you can find general information about trauma informed care (TIC). The information here is especially useful for individuals new to TIC. Included are guiding considerations, principles and definitions offered by experts in the field.
Background Information About Trauma Informed Care
TIC is based on growing knowledge about the negative impact of psychological trauma. Trauma is common in society and among service recipients. The service system can retraumatize individuals affecting their willingness to participate and engage.
To better understand some of the terminology that is commonly used to address the widespread impact of trauma, download this Key Terms resource. The intention of the list is to be valuable, inclusive, and honor the array of potentially toxic experiences that exist.
Harris and Fallot1 introduced the idea of TIC in their influential publication, Using Trauma Theory to Design Service Systems: New Directions for Mental Health Services. Since that time, significant effort has been made to define and clarify a trauma informed approach and incorporate this framework in policies, practices, and workforce development.
Although service providers and agency leaders are anxious to implement trauma informed practices, much of the conversation about trauma informed care remains abstract. As more becomes known about the application of TIC, the service sector will benefit from practical and concrete examples for implementation.
Definition of Trauma Informed Care
Despite years of work in this field, there is not a common definition of TIC. The field should strive to create a definition that includes the following:
- An awareness of the prevalence of trauma;
- An understanding of the impact of trauma on physical, emotional, and mental health as well as on behaviors and engagement to services; and
- An understanding that current service systems can retraumatize individuals.
The Substance Abuse and Mental Health Administration3 offers the four Rs as a helpful way to think about TIC (see box). TIC will look different in every setting, based on unique individuals and organizations. Whether viewed as a culture shift, a framework, or a lens through which services can be viewed - a commitment must be made to:
- Culturally responsive principles
- Service recipient involvement
- Workforce development
A trauma informed approach “would be experienced by all involved as a profound cultural shift in which consumers and their conditions and behaviors are viewed differently, staff respond differently, and the day-today delivery of services is conducted differently.” (Jennings, 2004, p. 21)4
One example by Hopper, Bassuk & Olivet2 combines definitions of TIC from several experts in the field and provides what they call a consensus definition.
“Trauma-informed care is a strengths based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment.”
(Hopper, Bassuk, & Olivet, 2010)
Principles of Trauma Informed Care
Many principles, values, and beliefs have been used to guide TIC practice. Those listed below are well accepted in the field. TIO has also created a resource about the principles of trauma informed care to help you learn more.
Trauma Awareness: Those who are trauma informed will understand the prevalence and impact of trauma among their service recipients and within the workforce. Policy and practice reflect this awareness and may be supported with activities such as screening and assessments.
Safety: Policy and practice reflect a commitment to provide physical and emotional safety for service recipients and staff.
Choice & Empowerment: to facilitate healing and avoid re-traumatization, choice and empowerment are part of trauma informed service delivery, for both service recipients and staff.
Strengths Based: With a focus on strength and resilience, service recipients and staff build skills that will help them move in a positive direction.
(Hopper, Bassuk, & Olivet, 2010)
- Harris, M., & Fallot, R. (Eds). (2001). Using Trauma Theory to Design Service Systems: New Directions for Mental Health Services.
- Hopper, E. K., Bassuk, E. L., & Olivet, J. (2010). Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings.
- Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s Working Definition of Trauma and Principles and Guidance for a Trauma-Informed Approach.
- Jennings, A. (2004). Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services.