Trauma-informed Care . . . for most of your clients

On February 24, 2011 I received an email letter from Linda Rosenberg, National Council President and CEO. The letter was entitled Trauma-informed Care: A Call to Arms. I was delighted to read it.

In my previous life, when I worked as a psychologist, I practice Feminist Therapy. Somehow, my practice had developed into one in which I saw mostly women. By the time I retired from practice in 1993, some 90% of my clientele were the survivors of some form of abuse. After 18 years out of direct service delivery, it has become obvious that women and girls do not begin to be the only people who are abused during their lives. Boys and men also suffer physical, emotional and sexual abuse. And every person who is abused experiences an impact on their lives from that abuse. Those who are abused repeatedly feel the greatest impact.

Linda’s letter presents a simple challenge: rather than ask clients what is wrong with them, she suggests that we ask what happened to them. This formulation was presented by a survivor named Tonier Cain who, after 83 arrests and 66 convictions, is now a team leader with SAMHSA’s National Center for Trauma Informed Care. She shares her story in speeches around the country and is the subject of the documentary “Healing Neen.”

The Adverse Childhood Experiences study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente reports the outcome of interviews with more than 17,000 individuals undergoing a comprehensive physical exam who chose to provide detailed information about their childhood experiences of abuse and family dysfunction. Almost two-thirds of the participants reported at least one experience; 20% reported three or more. The greater the number of adverse experiences, the greater the risk for health problems like alcoholism and alcohol abuse, chronic obstructive pulmonary disease, depression, fetal death, illicit drug use, ischemic heart disease, liver disease, intimate partner violence, suicide attempts, and unintended pregnancies, with risk increasing directly based on experiences. Trauma-related difficulties take a huge toll on individuals and our society.

Ms. Cain is one of many survivors of abuse who have recovered from their trauma and continue to progress by helping others. . .a standard part of the “recovery” model of care. But the recovery model is not enough. It is essential that providers become informed about trauma and learn the most effective ways of intervening. A good resource to start down this path is the report Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services.

Is it time for you and your organization to focus on “what happened to you” rather than “what’s wrong with you?”

Please share your organization’s approach to trauma. This old feminist would love to hear some inspiring stories. And, if you do not use trauma-informed methods, please let us know the bases for that decision. Just enter your comments below.

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