Trauma-Informed Care Principles and Self-Care for Prevention Professionals
By Fabricia Prado, LCSW
“Be kind, for everyone you meet is fighting a hard battle.”
This quote of debatable authorship is some widespread popular advice about the kindness needed in our actions, taking into consideration the hard battles of others. When we translate “hard battle” into experiences of trauma, this means that whatever someone is fighting against is often manifested as “maladaptive” coping patterns. The neurological, physiological, behavioral, and health-wise consequences of trauma are pervasive and can be passed from generation to generation (Felitti et al.,1998).
When communities and individuals impacted by trauma are under preventive or treatment services, they may not feel safe initially and will be interacting with people and systems under the effect of their traumatized brains and bodies. Without recognition that these responses are signs of trauma, they may be mislabeled by providers and systems as resistant to treatment, lacking engagement, guarded, aggressive, or confrontational and be shamed or punished from a trauma-uninformed approach. They can be re-traumatized when attempting to seek help or never establish a trusting and healing relationship with community workers or health providers in general.
Trauma-informed care provides guiding principles to effectively put kindness into action when responding to the psychosocial effects of trauma by creating ways to deliver appropriately sensitive services to those affected by trauma and to nurture their resilience (SAMHSA, 2014). The principles of safety, trust, collaboration, empowerment and choice, as well as cultural, historical and gender issues, applied to communities and organizations in a culturally responsive framework are prescribed to create environments and relationships aimed at facilitating engagement, creating a sense of personal control and respect. Equally important is that organizations and systems that are trauma-informed will also proactively develop the workforce, implement training, wellness incentives and supporting supervision to protect their staff, students, interns, and peer support from burnout and secondary traumatic stress (Menschner & Maul, 2016).
While rewarding, the work of prevention professionals can potentially include exposure to narratives or direct experiences with individuals and groups with complex histories of abuse, violence and systemic oppression. Prevention professionals need to be aware of their own individual vulnerabilities, triggers, risks and exposure to secondary traumatic stress and be committed to maintaining their own wellness.
Self-care practices remind us to take care of the fundamental tool for the work we do: ourselves. Engaging in self-care practices is an opportunity to role-model the self-respect, healthy boundaries, and social-emotional skills we are trying to teach the people and communities we serve. Moreover, this can be an ethical obligation, as stated in regulatory boards, to prevent the professional impairment that will harm others. A variety of strategies for self-care can be used to encompass the domains of awareness, balance, physical health, social support, and spirituality. (Posluns & Gall, 2019).
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Huckshorn, K., & LeBel, J. L. (2013). Trauma-informed care. In K. R. Yeager, D. L. Cutler, D. Svendsen, & G. M. Sills (Eds.), Modern community mental health: An interdisciplinary approach (p. 62–83). Oxford University Press.
Menschner, C. & Maul, A. (2016). Key Ingredients for Successful Trauma-Informed Care Implementation, Advanced
Posluns, K., & Gall, T. L. (2019). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International Journal for the Advancement of Counselling. Advance online publication. https://doi.org/10.1007/s10447-019-09382-w
Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.