How to Provide Trauma-Informed Care
Providing trauma-informed care involves applying the 3 key themes and 6 key principles into all aspects of the support you offer – not just how you behave and interact, but also organisational aspects including strategies, policies, procedures.
Our course focuses on applying these principles as you help someone – achieving the best outcome through trauma-informed communication.
Before each interaction with a client, to provide trauma-informed care that builds a trusting relationship, ask yourself 3 key questions:
1. Who will my client will view as a “safe” person?
From a logical perspective, it should be fairly obvious that you’re a safe person. You’ve chosen work that is dedicated to helping others, have great experience in the sector and probably go over and above for your all clients.
But as we’ve seen in the previous sections, the trauma affected brain is often in a state of arousal that prevents logical thinking – the midbrain and brain stem take over and in these regions of the brain there is less language, logic and/or reasoning ability. With the parts of the brain being used by the person, sensations, feelings and their survival responses are often triggered by reminders of their traumatic experiences.
To help someone see you as a safe person, consider:
- How you present yourself
- Mannerisms and movements
- Physical appearance
- Body language and vocal tones
What if after applying all the techniques in the trauma-informed care course my client still doesn’t feel safe?
Well, the unfortunate reality is that even though you might be able to offer the best support on the planet, if part of your appearance, voice or mannerisms act as a trigger, it’s unlikely you’ll make much progress. The solution is to realise it’s not a personal issue, it’s not a choice by the person and you shouldn’t take it personally.
Chalk it up to the reality that it’s beyond your control and enlist the help of another colleague to take over. Someone who won’t activate the default trauma response. With on-going care and healing the default trauma response can be changed, however this will be much harder to do in the early stages.
2. What can I do to present myself as a “safe” person?
Many of the people you help are naturally sceptical about your involvement – after all, you’re probably one of many people and services being thrust into their lives.
What you say, and how you say it, can also make a difference. During the initial meetings, notice their behaviours and give them time to move from a heightened arousal state to one that is relatively calmer. As you wait for them to return to a more normal state, for children you could undertake types of play or distraction that take the focus away from your interaction and meeting purpose, to instead focus initially on the drawing, puzzle or other activity you’re doing.
When you notice they are calming down and are more open to listening, such that their verbal and reasoning skills are more present, you should talk openly and honestly about the situation.
Bruce Perry explained how he introduces himself by saying:
“Listen, you don’t know me, you don’t know anything about me, and you shouldn’t trust me until you get to know me. So I’m going to say a few things. After I leave, you will have a chance to think about whether or not you want to spend any more time talking with me. Whatever you decide is final. It’s your choice. You are in control”
You probably won’t use this exact phrasing which is for a clinical setting and you might not be able to give them the final choice in what’s going to happen, but it provides a good example of the principle.
You can change the concept or key message for your own situation, recognising there are two important things about this introduction:
Firstly, it’s honest. It doesn’t shy away from what everyone involved is already thinking.
Secondly, it introduces the important concepts of choice and control. Both are being given to the child, who because of the traumatic experience and previous helplessness, now craves both. For a sense of safety to exist, the person must be able to say no, stop or be empowered to ask to a change.
As you interact, it’s important that you begin to learn what tactile, sounds or smells upset your clients and begin the process of helping them to feel better through self-soothing experiences and activities. Even things you consider minor – knocking something over for instance – may produce a near instantaneous response. In those moments, portray calmness, safety and understanding.
3. What are the characteristics of a safe interaction?
Structuring your interaction is a key part of the planning to ensure the person is comfortable continuing to work with you, and they learn the important skill of moving from unpleasant emotions to the pleasant, thereby learning self-regulation skills in the process.
Another thing to keep in mind is that your interaction with the trauma survivor should always begin in a safe place, and end in a safe place. Try and ensure the trauma informed work part of the interaction takes place in the middle.
Adjust your pace and style of interaction accordingly. As the arousal starts, slow your interactions, giving them time to settle. Adjust your body language to demonstrate calmness and minimise movements. Give them back their sense of safety.
Feel free to check in with the person during the initial and end stages to find out if they still feel comfortable and for children, if they are enjoying the activity . Each person is different and you can’t assume what works for one will work for another, so in the first interactions make a point of noting what works and what doesn’t for your client.
Here are 10 things to keep in mind:
- Give choice and control where possible
- Ensure your approach is structured and consistent
- Act as a witness rather than an analyst seeking to question every detail
- Ask open-ended questions that show curiosity, not judgement
- Help them understand the physical sensations associated with being triggered
- Let the person know they can stop or change something that is too activating
Be guided by the person’s pace
Ensure the interaction starts and ends in a safe space
- Guide the person through the pleasant and unpleasant sensations they experience as they move from aroused to calm states
- If required to intervene and calm the person, use a consistent approach when doing this, so they learn a pattern they can use themselves
