According to SAMHSA, individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional,or spiritual well-being.
In the U.S., 61% of men and 51% of women report exposure to at least one lifetime traumatic event, and in public behavioral health settings, 90% of clients have experienced trauma. Data suggests that many people with mental illnesses and addictions will have poor physical health outcomes if trauma goes unaddressed, and ignoring trauma can hinder recovery. All care — in all health settings — must address trauma in a safe and sensitive way in order to ensure the best possible health outcomes.
Providing care in a trauma informed manner will promote positive health outcomes. A trauma informed approach is defined by SAMHSA as a program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization.
The American Academy of Pediatrics Trauma Toolbox for Primary Care is a 6-part series designed to assist primary care practices increase understanding of adverse childhood experiences (ACEs) and their impact on health. It provides suggestions for talking with families, identifying ways to prepare the medical home to address ACEs and other traumatic events, and more. The content focuses strongly on trauma during childhood and its impact on health.
SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach introduces a concept of trauma and offers a framework for how an organization, system, service sector can become trauma-informed. This document includes a definition of trauma (the three "E's"), a definition of a trauma-informed approach (the four "R's"), 6 key principles, and 10 implementation domains.
SAMHSA's TIP on Trauma-Informed Care in Behavioral Health Services assists behavioral health professionals in understanding the impact and consequences for those who experience trauma. It includes patient assessments, treatment planning strategies that support recovery, and information on building a trauma-informed care workforce.
The Adverse Childhood Experiences Study is ongoing collaborative research between the Centers for Disease Control and Prevention in Atlanta, GA, and Kaiser Permanente in San Diego, CA.
The National Council for Behavioral Health is a national leader in the areas of Trauma Informed Care and Integration of Behavioral Health and Primary Care Services. Experts in these fields are dedicated to assisting these and other providers and systems of care with effectively implementing Trauma-Informed principles and practices through learning communities, consultation, and training and technical assistance.
The Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse presents material that will help health care practitioners practice in a manner that is sensitive to the needs of adult survivors of childhood sexual abuse and other types of interpersonal violence. The handbook also includes information on examinations and procedures that health care providers might consider innocuous or routine but can be distressing for survivors, because they may be reminiscent of the original trauma.
The National Child Traumatic Stress Network strives to improve access to care, treatment, and services for traumatized children and adolescents exposed to traumatic events.
Developed by the Western Massachusetts Training Consortium, the Trauma Survivors in Medical and Dental Settings pamphlet alerts readers to the issues trauma survivors may have in medical and dental settings. This pamphlet also gives concrete suggestions that help avoid common problems and promote emotional well-being.
The Leaving The Door Open: Alternatives to Seclusion and Restraint DVD trains mental health services direct care staff, administrators, and consumers on alternative approaches to seclusion and restraint in the treatment of people with serious mental illness. An entire section of the video is devoted to addressing the trauma informed approach and explains how people with trauma backgrounds are especially triggered by the use of seclusion and restraint and an atmosphere that promotes it.
SAMHSA’s Disaster Technical Assistance Center (DTAC) supports SAMHSA's efforts to prepare States, Territories, Tribes, and local entities to deliver an effective mental health and substance abuse (behavioral health) response to disasters. Their brochure provides clear and concise resource information about SAMHSA DTAC, its mission, and its services.
The Anna Institute is a resource, research, and informational website developed by Ann Jennings, PhD, and named for her daughter Anna who was a victim of child sexual abuse and spent her last years of life in a psychiatric institution.
Addressing trauma helps organizations improve the quality and impact of behavioral health services, increase safety for all, reduce no-shows, enhance client engagement, and avoid staff burnout and turnover. The National Council for Behavioral Health's trauma-informed care checklist allows organizations to determine their commitment to providing trauma-informed services.
Adverse Childhood Experiences Survey provides data on the relationships between trauma and later health and social outcomes.
The National Council for Behavioral Healthcare lists numerous articles and resources relative to organizations changing their cultures into ones that embrace trauma-informed care, including a National Council magazine focused exclusively on trauma.
PTSD Coach is a mobile app created by Department of Veterans Affairs’ National Center for PTSD and the Department of Defense’s National Center for Telehealth and Technology to help individuals learn about and manage trauma symptoms.
SAMHSA National GAINS Center helps expand access to community-based services for adults diagnosed with co-occurring mental and substance use disorders at all points of contact with the justice system, as well as promotes communities’ integrated systems of behavioral healthcare for people in contact with the justice system.
SAMHSA Promoting Alternatives to Seclusion and Restraint through Trauma-Informed Practices & National Center for Trauma Informed Care (NCTIC) promotes trauma-informed practices in services delivery for people who have experienced violence and trauma and seek support for recovery and healing.
Trauma screening tools can be used to screen for the presence of adverse or traumatic life experiences. Once a person reveals that they are experiencing or have had adverse or traumatic life experiences, it would be appropriate to use an assessment tool that could uncover signs of related stress, functional difficulties and or PTSD. Two factors are very important when screening for trauma: one, in order to reveal such experiences, the person must be engaged in a sensitive and caring process that allows them to feel safe and comfortable and two, screening for trauma is a process that may not be revealed during intake; therefore a system should be in place to screen for trauma post intake and following the development of a trusting relationship with the clinician.
It's Just Good Medicine: Trauma-Informed Primary Care
August 6, 2013
Presented by Larke Huang, Cheryl Sharp, and Tara Gunther