Trauma Informed Services

In this article, you will learn more about the features of trauma informed services

The World Health Organisation views substance dependence, not as a legal problem but as a health problem and that treatment services should be delivered as part of an overall response for dealing with health and social problems. Evidence from high-income countries suggests that significant improvements in patient outcomes can be achieved by improving a country’s trauma care services. This trauma-informed approach can be achieved in almost any setting and represent a cost-effective way of improving patient care.

In 2014, the Substance Abuse & Mental Health Services Administration (SAMHSA), reported that trauma is a widespread, harmful, and costly health problem which occurs as a result of experiencing physically or emotionally harmful or threatening events that have lasting adverse effects on the individual. Trauma doesn’t discriminate with regard to age, gender, ethnicity, or sexual orientation (27).

Over the past two decades, the need for trauma-informed services has gained significant traction through the work of organisations like WHO, SAMHSA, and the United Nations Office on Drugs and Crime (UNODC). A trauma-informed service should, according to SAMHSA, be provided within a framework that:

• Realises the widespread impact of trauma and understands potential paths to recovery;
• Recognises the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
• Responds by fully integrating knowledge about trauma into policies, procedures, and practice;
• Resists re-traumatisation actively

A trauma-informed approach reflects an organisation’s observance of principles rather than operating to a set of specified rules or practices. These principles may be universally applicable and customisable depending on the setting or sector. This approach should be employed from the ground up where people with experiences of trauma are engaged in designing the service. Research suggests that a trauma-informed service should be designed around a set of underlying principles:

Safety

According to Lisa Najavits, the physical environment must feel safe both in a physical and psychological sense as defined by the people who attend the service, not the service providers (28).

Trustworthiness and Transparency

The service should operate in a totally transparent way with the goal of building trust with the services users, their families and the staff within the organisation.

Peer Support

Peer refers to “trauma survivors”, individuals with lived experiences of trauma who provide support. This support should offer mutual self-help for establishing safety and hope while building trust to promote recovery and healing.

Collaboration and Mutuality

This principle recognises that everyone in the organisation has a role to play in the trauma-informed approach. Emphasis and importance are placed on a levelling of power between administration staff, professional staff and service users within the organisation, recognising that healing happens when there’s a meaningful sharing of power.

Empowerment, Voice, and Choice

The core objective of the organisation should be to meet the needs of the clients through a collaborative approach. This approach should foster a belief in the primacy of the people served and the ability of all stakeholders be they, service users, service providers or communities to heal and promote recovery. With this principle at the centre of the operation, staff and services are developed and organised to foster empowerment with shared decision making. Staff become facilitators rather than controllers, guiding choice and goal setting within the healing plan.

Cultural, Historical, and Gender Issues

The organisation must actively move past all cultural, religious or sexual orientation stereotyping offering access without prejudice to services which are actively supported by policies, protocols and processes that are responsive to the needs of all individuals served, (22).

In conclusion, traumatic experiences complicate a person’s capacity to make sense of their lives and to create meaningful consistent relationships with their families and community, (27). The desired goal of a trauma-informed approach is to better understand people with lived experience of trauma and build a treatment environment that supports and empowers people in their recovery from addiction and associated health problems.

References

<sup>22. Poon K. TRAUMA-INFORMED PRACTICE: OVERARCHING THEMES AND PATTERNS IN BECOMING TRAUMA-INFORMED. Prince George, Canada: University Of Northern British Columbia; 2017.
27. SAMHSA. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Maryland: SAMHSA; 2014 July.
28. Najavits L. Seeking safety: A treatment manual for PTSD and substance abuse. New York: Guilford Publications; 2002.</sup>