What is Trauma?
Trauma refers to an event that threatens the life or integrity of the individual or a loved one, such as physical abuse, death of a parent, witnessing domestic violence, abandonment, natural disasters, war, community violence, or medical issues. Types of trauma include: single, complex, developmental, historical and intergenerational.
Trauma affects brain development, causing structural and hormonal changes that manifest in adverse physical and mental outcomes. If exposure to stress and trauma is unrelenting, the brain adapts in ways that can make learning and socialization difficult. Persistent exposure to toxic stress during childhood can have serious developmental consequences that may last well past the time of stress exposure. [1]
What is Trauma Informed Care?
At its core, the trauma-informed model replaces the labelling of clients or patients as being “sick,” resistant or uncooperative with that of being affected by an “injury.” Viewing trauma as an injury shifts the conversation from asking “What is wrong with you?” to “What has happened to you?” [2]
Utilizing a trauma-informed approach does not necessarily require disclosure of trauma. Rather, services are provided in ways that recognize the need for physical and emotional safety, as well as choice and control in decisions affecting one’s treatment. Trauma-informed practice is more about the overall essence of the approach, or way of being in the relationship, than a specific treatment strategy or method.
A key aspect of trauma- informed services is to create an environment where service users do not experience further traumatization or re-traumatization (events that reflect earlier experiences of powerlessness and loss of control) and where they can make decisions about their treatment needs at a pace that feels safe to them. [3]
Facts and Stats
- 76% of Canadian adults report some form of trauma exposure in their lifetime, 9.2% meet the criteria for PTSD
- An estimated 50% of all Canadian women and 33% of Canadian men have survived at least one incidence of sexual or physical violence
- Among Canadians with mental health and substance use concerns:
- 90% of women in treatment for alcohol problems at 5 Canadian treatment centres indicated abuse-related trauma as a child or adult; 60% indicated other forms of trauma
- 90% of females and 62% of male youths in co-occurring disorders treatment in one treatment centre endorsed concerns with traumatic distress [4]
Why is it Important?
Psychological trauma is a major public health issue affecting the health of people, families and communities across Canada. Trauma places an enormous burden on every health care and human service system. Trauma is not only a mental health issue, but it also belongs to every health sector, including primary/ physical, mental and spiritual health. Given the enormous influence that trauma has on health outcomes, it is important that every health care and human services provider has a basic understanding of trauma, can recognize the symptoms of trauma, and appreciates the role they play in supporting recovery. Health care, human services and, most importantly, the people who receive these services benefit from trauma- informed approaches. [5]
What Does it Look Like?
Reactions to trauma vary from person to person, from minor disruptions in an individual’s life, to debilitating responses. Across the continuum, people may experience anxiety, terror, shock, shame, emotional numbness, disconnection, intrusive thoughts, helplessness and powerlessness . Trauma responses can interfere with an individual’s sense of safety, self, and self-efficacy, as well as the ability to regulate emotions and navigate relationships.
Physiological adaptations can create an underlying state of dysregulation – difficulty controlling or regulating emotional reactions or behaviours, and/or an imbalance in the body, which often results in hyperarousal and hypervigilance (in which an individual seems to overreact to every situation) or listlessness and dissociation (in which an individual seems numb and disconnected in stressful or dangerous situations). This dysregulation of the brain and body systems perpetuates mental, emotional, and physical distress. [6]
See Trauma-Informed Care in the Mental Health Training Framework document
Mental Health Training Framework
Resources
Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma
This paper explores trauma at the population level and how it impacts efforts to prevent violence and improve other aspects of community health. It also presents a framework for addressing and preventing trauma at the community level.
PolicyWise for Children and Families
This website contains a range of resources on a wide variety of topics relating to generating knowledge to influence positive changes for children and families, including Aboriginal Children, Youth and Families.
The Trauma-Informed Practice (TIP) Guide and TIP Organizational Checklist
This Guide was developed on behalf of British Columbia's Centre for Women's Health in consultation with researchers, practitioners, and health system planners across British Columbia.
Trauma Informed Care Newsletter
This AHS Newsletter includes articles on various topics related to trauma-informed care.
Trauma Informed Community Initiative of WNY
The website contains resource repository related to trauma informed care for families, providers, organizations and communities
Toolkits
Trauma Informed Care: Perspectives and Resources
A Comprehensive Web-based, Video-enhanced Resource Tool series of modules with videos, briefs and resources. This information is offered through Georgetown University's Centre for Child and Human Development. (30 minutes to 90 minutes each)
Trauma-Informed: A Trauma Toolkit
This toolkit from Klinic Community Health Centre aims to provide knowledge to service providers working with adults who have experienced or been affected by trauma. It will also help service providers and organizations to work from a trauma-informed perspective and develop trauma-informed relationships that cultivate safety, trust and compassion.
Videos
Alberta Family Wellness Initiative
The website contains a videos and podcasts on a wide range of topics including brain architecture, ACEs, Resilience, Stress.
Home Fire: Ending the Cycle of Family Violence
Presented by the Native Counselling Services of Alberta, this video explores family violence and restorative justice from an Aboriginal Perspective. Includes guide. (37 minutes) https://www.youtube.com/watch?v=lmstyXc6FnI&index=1&list=PLMG2IaX_R_oAiSEoVWIIlDQEzq7nZfF3V
Paper Tigers
This documentary is available on Tugg Educational. Information can be viewed by trailer from Amazon $28 USD. Free Facilitator's Guide is also available on this website. (1 hour 42 minutes)
In-Person Training
CRI Trauma Informed Certification
Offered locally through ECDSS Community Resilience Initiative (CRI) course highlights CRI’s capacity-building framework for building resilience, that describes community’s learning and movement from theory to practice and how to implement evidence-based strategies into action. The training includes three groups of topics: the NEAR sciences, a cluster of emerging scientific findings
Trauma Informed Care: Translating Trauma Informed Principles into Practice
This introductory training acknowledges the prevalence and significant impact of trauma in an individual’s life and aims to inform service providers how to apply a trauma-informed lens to their current practice. This workshop will define and describe the six main trauma-informed principles outlined in the literature and will focus on
Online Training
Calgary & Area Child Advocacy Centre
Online training includes topics related to childhood maltreatment and trauma, trauma and brain development, impacts of trauma, trauma-informed practice, and building resilience. Competency: Knowledge Audience: Children / Youth Cost: Free; must create account
Community Resilience Initiative
Website offers live webcasts of Trauma Informed Courses at various times during the year. Competency: Knowledge Audience: All Cost: $150 USD
Developmental Pathways of Addiction and Mental Health
This AHS Mental Health and Addictions Learning Series offers a web-based interactive e-Learning curriculum designed to support healthcare providers to enhance their practice working with children, youth and their families experiencing addiction and mental health issues. The focus of these modules is to help health providers recognize and reduce significant
Trauma Informed Care
The purpose of this AHS series is to increase knowledge about trauma and the impact it has by creating connection, sharing knowledge and resources. TIC offers resources for individuals who help those impacted by trauma provide patient centred care. (6 modules; 3.5 hours) Competency: Knowledge, Behavioural Audience: All Cost: Free
References
- Trauma Informed Perspectives and Resources. Understanding the Impact of Trauma. Retrieved from https://gucchdtacenter.georgetown.edu/TraumaInformedCare/issueBrief1_UnderstandingImpactTrauma.pdf
- Klinic Community Health Centre. (2013). The Trauma-Informed Toolkit. Retrieved from https://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf
- 4. BC Centre of Excellence for Women’s Health. (2013). Trauma Informed Practice Guide. Retrieved from http://bccewh.bc.ca/wp-content/uploads/2012/05/2013_TIP-Guide.pdf
- Klinic Community Health Centre. (2013). The Trauma-Informed Toolkit. Retrieved from https://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf