Trauma-Informed Practice or Care

Everyone Brings Some Trauma With Them

Written by and for people with Lived Experience - Port Alberni Community Action Team - Families Helping Families

Today’s Learning Moment – 02 01 21 Issue: Trauma-Informed Practice/Care

What the heck is Trauma-Informed Practice TIP, ⁽¹⁾ (also known as Trauma-Informed Care)? You might have overheard the phrase used if you or your family have received treatment in BC Health Care Facilities in recent years.

The idea behind the concept is fairly new. In BC it got off the ground approx. 2011. It wasn’t until approx. 2013 that it gain wide distribution through all Regional Health Authorities.

TIPs can be divided into Trauma-Informed Services and Trauma-Specific Services. In this article, we’re going to mostly concentrate on the TIS part of TIPs. However, in practical terms, TIPS and TSS are all often lumped together and called Trauma-Informed Care.

Enough of all that official jargon stuff. Let's talk specifically about what TIPs or Trauma-Informed Care is and what it means for you and your family. From here on in, we’ll refer to the concept as TIP/TIC.

It all started with evidence-based care in mental health and substance use (MHSU) care settings. Today in 2020, TIC practices have worked their way through most of the Heath Care Departments including ERs — not just MHSU

In the beginning, MHSU Health professionals began to realize that the majority of their patients arrived at their doorstep displaying significant evidence of childhood trauma symptoms. Of course, trauma can happen anytime in a person’s life and if it’s significant enough, it will seriously impact an adult as much as a child. The point here is that patients bring their trauma with them no matter when they experience it. It became obvious that Health Care Professionals needed to deal with the entire patient, including their illnesses and their past/present trauma to help them on the recovery journey.

TIP/TIC acknowledges this and sets up a partnership with the patient in which the care team not only treats their illness but recognizes that the patient’s trauma defines the relationship between the care team and the patient.

We’ll explore what that means for the patient and family in a minute, but first, let's take a short detour here and describe what trauma looks like. Trauma^(1)(2)+ is any experience that overwhelms a person’s ability to cope. We can appreciate that children can be easily impacted by trauma. After all, their brains are developing and it’s much harder to cope with trauma with a brain that is still growing. Events that occur in childhood can also impact a person for their entire life.

Trauma can be a single event or repetitive. It can be neglect, physical or mental violence, the loss of someone, the breakup of a family, natural disaster, or war. It can be historical, as an example, residential schools or intergenerational. Again residential schools come to mind as the generation that lived in those schools passed the trauma onto following generations.

Did you know that 76% of Canadians report some sort of trauma exposure throughout their lifetime?⁽¹⁾ Let's get real here. If ¾’s of us report trauma in our lives, the other 25% probably have too. Maybe the rest of us aren't traumatized or maybe we just push it to a dark corner of our minds and ignore it. What ever the case the important part of TIC is the idea that Care Teams should assume EVERYONE comes through the doors with trauma and act accordingly.

When Health Care Teams embrace the concept of TIC, the first thing they change is the way the view every patient. You start knowing that they have trauma. Every last one of them to some extent or level.

That idea frames how we see the patient’s behaviour and how we respond to that behaviour. Often in a health care setting, people act in strange ways. They can be aggressive, sullen, or withdrawn. The can act normally, yet not be completely aware of what they’re being told.

I personally can relate to this. I can remember going in for minor surgery. Nurses and doctors went out of their way to fill me in on what was going to happen. Outwardly I was nodding my head up and down and acknowledging what they said. Inside my brain, 98% of what they told me went right through one ear and out the other.

Was I responding to a past trauma? I don’t believe so. I was, however responding to my current situation, concerning enough for me that my brain was processing it as trauma.

So for patients and families, TIC is a big deal. It means that your health care team takes into account the idea that you have been traumatized. That your behaviour might not be who you are but reflects your trauma life experience including the present interactions delivering care to you. This is a key first step. TIC creates a treatment culture of nonviolence, learning, and partnership between the patient, the care team and the institution. ⁽¹⁾ The result is compassion.

It plays out in some of the following ways. Aggression might be attention-seeking, Being unable to respond to request might be the best a patient is capable of at that moment, manipulative behaviour might be the only way they know how to ask for help, demands might be their way of trying to gaining control over their environment – something they may never have had before. You can see in these examples, that it can make all the difference in the world to a patient if the Care Team perceives their behaviour through the lens of TIC.

For families and people advocating, you need to be aware of TIC, so that you can make Care Teams aware of trauma for your family member. You can refer to Trauma-Informed Care in your interactions. Reminding everyone involved that some of the behaviours of your loved one are probably driven by trauma.

Remember, marginalized people, due to culture or due to mental/substance illness, homelessness all bring past and current trauma to the table including the stigma of their situation. TIC is crucially important in their care plan and treatment.

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Author: Ron Merk — Ron is a person with family-lived experience. He advocates for people with substance or mental illness.

Families Helping Families is an initiative of the Port Alberni Community Action Team. We send out “Learning Moment” articles regularly to help folks understand substance illness. Knowledge is vital in understanding the illness of our family members. You may copy, distribute or share our articles as long as you retain the attribution. You can be added to our distribution list by dropping us a note to - albernihelp@gmail.com

This article was written from information sources below:

Reference Material

(1) 2013 BC Trauma-Informed Practice Guide — retrieved from - https://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf

(2) 2000 CAMH Trauma Explained in Simple Language — retrieved from https://www.camh.ca/-/media/files/guides-and-publications/trauma.pdf

(3) C Knight 2015 Trauma-Informed Social Practices — retrieved from:https://link.springer.com/content/pdf/10.1007/s10615-014-0481-6.pdf

(4) G. R. Hodas MD 2006 The Promise and Practice of Trauma-Informed Care — retrieved from:
http://www.childrescuebill.org/VictimsOfAbuse/RespondingHodas.pdf