What is a trauma-informed practice?

Trauma-informed practice is rooted in the knowledge that experiences of trauma are more common than not, and some basic principles should be followed to ensure the client’s safety within sessions. If you’d like more information on what trauma is before reading this, please click here for our post on this. Recent research demonstrates that when talking about traumatic content the experiential parts of our brains light up, rather than our language centres when we recall a sad story. This provides evidence that talking about our trauma is re-traumatizing. We are re-experiencing the event as if it is happening to us in this moment, and our brain floods our body with neurochemicals like cortisol. This means that when working on your trauma in session you do not need to tell the story about the event to be able to process it, it can be more harmful than helpful. As trauma has likely been inflicted on us, issues of power imbalances within the therapeutic space are particularly important and these principles all relate to ensuring the power remains with the client. 

Trauma-informed principles include safety, trustworthiness, choice, collaboration, empowerment, and respect for diversity. All five principles relate to ensuring the client’s agency, the freedom to act autonomously, and to make decisions about your life. Individuals who experience trauma have, in some way or another, had their agency impacted – no one chooses to experience traumatic events – and the impacts of that can be lifelong if left unaddressed. 

The five principles of trauma-informed care

Safety

Safety is co-created in several ways. Interpersonally, your clinician should make their best efforts to build a relationship with you, meeting you emotionally where you currently are without judgement, and listen to you in whatever ways you best feel heard. They should provide clear boundaries around their obligations in the relationship and respect any wishes you have around treatment within their ethical responsibilities. Environmentally, the clinician should make their best effort to make the space safe through accessibility, both physically and sensorily, and in privacy.  

Trustworthiness

This is the clinician’s ability to demonstrate their worthiness for your trust. Upholding your confidentiality, providing a non-judgmental space for your self-expression, and following through with what they say they will do, builds trust. For people with trauma, this process can take time, your clinician understands this and is along for the ride (even if it takes years or, you never fully trust them). 

Choice

This is the choice to say no to anything the clinician asks of you, whether that be no (or yes!) to participating in a therapeutic modality you don’t gel with, no to having a session that day, or even no to continuing a session halfway through one. While your clinician might follow up with some questions to make sure they are supporting you in the right ways, you are always entitled to make your own decisions. Your clinician must respect your boundaries around what you are comfortable engaging in and meet you where you are in that moment. 

Collaboration

This stems from choice – clinicians can hold a lot of the power as they may be perceived as the “expert”, holding a lot of the knowledge around treatment. This does not mean that the clinician “does” therapy and you are a passive participant. Just as you have the choice to say no, you also hold the power to co-create treatment that meets your needs. Nothing will make your clinician more excited than you manoeuvring a modality to create the right environment to express yourself! 

Empowerment

This could be argued to be the most important part of trauma-informed practice. Experiencing trauma demands that you have the resilience to survive it, and those strengths and skills can also help you to move forward. Empowerment is the clinician highlighting these and helping you to use these to resolve the challenges in your life. 

Respect for diversity

Your diversity is what makes you the unique human being that you are. Diversity can be the intersecting identities you hold – race, gender, sexuality, disability, etc., – but it also relates to diversity in opinions, reactions, thought patterns, world view, political beliefs, religious affiliation… the list could go on and on. Trauma-informed approaches recognise that diversity is valuable and respect human beings for who they are, whilst also holding space for the fact that this world can be oppressive and cruel to some intersections of identity.  

These five principles and an understanding of how the body responds to telling traumatic stories will inform how your clinician works with you. This is foundational for all practitioners working with trauma, but considering the statistics around trauma prevalence, can be viewed more as a standard of care in the mental health.