Trauma occurs when an event is so frightening, overwhelming, or emotionally painful that it overwhelms a person’s ability to cope. Providing trauma-informed care means recognizing that trauma is extremely common, that anyone could be a trauma survivor, and that there are ways to minimize a person’s risk of being retriggered or retraumatized in the course of services. Palms Behavioral Health in Harlingen, Texas uses trauma-informed and evidence-based practices to support our patients.
Prevalence and Consequences of Trauma
It is estimated that nearly 90 percent of Americans have experienced at least one potentially traumatic event in their lives, with many people experiencing multiple such events before reaching adulthood. Potentially traumatic events a person survived in childhood are sometimes referred to as Adverse Childhood Experiences (ACEs). ACEs are linked to several poor outcomes in later life, including increased:
- Risky behaviors
- Chronic diseases
- Cancer
- Depression
- Post-traumatic stress disorder (PTSD)
- Premature death
Examples of Trauma
Trauma is unique to each person. What one person finds very traumatic, another might find only moderately distressing. If you think about the worst and most difficult experiences you’ve survived, some of them might have been traumatic for you. Some traumas are unavoidable, but many can be prevented. Events that are typically considered traumatic include:
- Losing a loved one suddenly and/or violently
- Abuse – sexual, physical, or emotional
- Entering foster care
- Incarceration of a parent
- Warfare
- Natural disasters
Guiding Principles Behind Trauma-Informed Care
There are six core principles behind trauma-informed care. These are:
- Safety
- Trustworthiness/transparency
- Peer support
- Collaboration/mutuality
- Empowerment and choice
- Sensitivity to cultural, historical, and gender issues
Examples of Trauma-Informed Care
To avoid causing additional harm, medical and mental health practitioners often follow similar best practices related to trauma-informed care. Some examples of this include:
- Creating a physical environment that is and feels safe
- Ensuring common areas, parking lots, bathrooms, entrances and exits are well-lit
- Providing security personnel inside and outside the building if appropriate
- Preventing people who are not receiving care from loitering near entrances and exits
- Monitoring who is in the building at all times
- Allowing patients to bring support people with them to appointments
- Keeping noise levels low
- Making modifications to how paperwork is handled
- Routinely screening for trauma
- Wording questions in sensitive ways
- Allowing patients to complete paperwork with sensitive or painful questions in advance and submit electronically
- Giving control to patients
- Letting patients know what to expect, such as verbally explaining if the provider will be touching them, and where and why this contact is needed
- Ensuring patients know that they have the right to refuse procedures
- Providing adequate information so that patients can make informed decisions
- Involving patients in organizational planning
- Allowing patients access to exits at all times and clearly stating their right to end sessions early if needed
Trauma Versus Post-Traumatic Stress Disorder
As mentioned above, PTSD can be an outcome of trauma, but that does not mean that every person who experiences a traumatic event will develop PTSD. Studies have shown that having a strong support system and utilizing cognitive behavioral therapy (CBT) and medications can help reduce the development of trauma for certain people. Some of the signs of PTSD include:
- Intrusive memories
- Reliving the event as if it were happening all over again (flashbacks)
- Nightmares
- Strong reactions to anything that brings the trauma to mind
- Avoidance
- Trying not to think about the traumatic event
- Avoiding anything that could be a reminder of what happened
- Negative changes to mood and thoughts
- Thinking poorly of themselves or others
- Hopelessness
- Memory issues
- Feeling detached from loved ones
- Loss of interest in previously enjoyable activities
- Difficulty feeling pleasant emotions
- Difficult physical and emotional reactions
- Jumpiness
- Always watching for danger
- Self-destructive behaviors
- Difficulty sleeping
- Poor concentration
- Feeling a lot of guilt, shame, anger or irritability
How to Help
If someone you love has experienced trauma, it is not necessary to know if they have PTSD. The ways you can support them do not change with or without the presence of a diagnosis:
- Offer to listen, but don’t force them to talk before they are ready. Your reassurance that you are willing to listen is all that is required.
- Set aside time when you will not be distracted. When you are both ready to talk, choose a time and place where you will have privacy and not be interrupted.
- Do not make assumptions, guesses, or give advice.
- Be ready to take a break. If the conversation is too much for your loved one, offer to pause the conversation and come back later. Be sure that you do come back later to complete the discussion.
- Watch for indications that your friend or family member may need professional support. If your loved one becomes suicidal, respond calmly but immediately.
- Do not allow them to be left alone.
- If possible, discreetly remove pills, firearms, or anything else they might use to make an attempt on their life.
- Contact a crisis line like 988 for support if they are struggling but not in immediate danger.
- Call 911 or take them to the nearest emergency room if they seem intent on ending their life.
At Palms Behavioral Health, we help adolescents, adults, seniors, and families to navigate their mental health struggles, which often includes providing support for people who are trauma survivors. If you or a loved one is struggling, we encourage you to reach out for help right away.
