What is trauma-informed care?
The trauma informed care model is based on the fact that it’s highly likely that patients have experienced a traumatic experience at some point during their life.
Trauma-informed care is a patient-centric medical approach to dealing with trauma history and avoiding traumatic relapses. The trauma-informed care does not treat only one type of trauma but all types.
6 Core Principles of Trauma-Informed Care
Trauma-informed care principles:
Safety is of paramount importance, both physically and psychologically. It is important to create a safe physical environment as well as a feeling of security amongst staff and patients. You can also include friends or family members if requested.
Communication between healthcare providers and patients must be honest and transparent. It is also important to foster trust between staff and patients’ families.
This collaboration focuses specifically on communication among all members of the diagnosis team. Every member of the organization is considered part of the diagnostic team. This allows for easy information exchange, reducing the time it takes to arrive at a correct diagnosis. It also reduces the power gaps between levels in the organization.
The peer principle is a way to encourage a therapeutic element in which a patient can be exposed to others who share a similar trauma history. This can reduce feelings of isolation and give the patient a greater sense of security.
Empowerment revolves around the positive reinforcement of achievements, values, remarks, and patient interests. In order to achieve empowerment, healthcare providers need to understand the impact that listening to patients and colleagues at any level in the organization can have. Medical professionals should also seek to validate and understand valid patient suggestions regarding their trauma triggers. All staff interactions must adhere to this principle.
This principle means that medical professionals should take into account a patient’s gender or culture when determining the treatment they will provide and their receptivity to it. This can include traumas from the past, traumas that are personal, and cultivating an environment where patients feel safe. This principle suggests that the healthcare provider should also consider their biases and perceptions.
Each of the six principles of trauma-informed care shares a common viewpoint: the patient comes first. To achieve and maintain the principles, the organization should also apply them at all levels. I.E., Staff must be treated with respect for their safety, empowerment, etc.
A number of different factors causes trauma. Here are some of the most common traumatizing events
Adverse Childhood Experiences
A childhood adverse experience (ACE) can be defined as any type of physical or psychological harm, abuse, or loss. One in six adults has had multiple ACEs. The experiences and perceptions of ACEs can be vastly different. Allowing the patient to speak about their trauma is important.
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It is well known that violent or combative experiences can profoundly affect the brain. This category is often applied to veterans who have returned from combat. The same symptoms and triggers can be caused by an abusive childhood.
Death or loss
Everyone will experience death or loss at some point in their lives. These events can trigger severe trauma and cause relapses depending on the mental state, the emotional connection and the length of time the patient has been living. These effects are exacerbated when they occur during adolescence or through violent means.
Domestic violence can seriously disrupt the ability to build healthy relationships. Domestic violence survivors may have problems with their feelings of trustworthiness and empowerment. The victim and those affected by the emotional effects of abuse can be included.
Emotional abuse can be very subtle. This includes gas-lighting or guilt-tripping and other forms of emotional manipulation. Some survivors of emotional abuse have difficulty trusting their instincts and may even have a negative view of themselves.
Trauma-Informed Care Is Transforming Addiction Treatment
Trauma and substance abuse disorder often occur simultaneously. These two elements combine and cause havoc in the mind and body.
The relationship between trauma and substance abuse disorder
The average person with PTSD is 5 times more likely than the average person to require treatment for substance abuse disorder. There is enough evidence between the two to include trauma treatment and treatment in most substance abuse recovery programs.
A PTSD diagnosis increases the risk of drinking alcohol more frequently and at a higher rate than those who do not have PTSD. This can lead to a vicious cycle whereby drinking alcohol is used to suppress PTSD-affected feelings and thoughts, and this in turn, leads both tolerance and dependence.
Therapy to teach healthy coping skills is often used in conjunction with the treatment of PTSD and alcoholism.
Evidence-based treatment is used in trauma-informed care. PE, or prolonged exposure therapy, is a time-proven and effective option for recovery. Studies have proven prolonged exposure treatment effective, safe, and acceptable.
Exposure therapy can be considered a type of CBT or cognitive behavioral therapy. The documented use of exposure therapy has been for the treatment of PTSD and other traumatic experiences.
PE is a method of visualizing traumas in a therapeutic, controlled environment. It involves replicating triggers and slowly increasing the intensity. You can then look at the trauma in a different light and hopefully better deal with it.
Non-exposure treatment is any type of treatment that does not fall under the category of exposure therapy. This includes therapy for emotional processing, developing a better understanding of the effects of trauma and managing self-image.
Medical professionals may use non-exposure therapy if they are unwilling to expose patients or if the patient does not show improvement in symptoms after exposure therapy. In most cases, non-exposure therapy can be equally effective and is also considered CBT.
At the moment, there is no medication that treats both trauma and SUD. It is partly due to the low chances of SUD patients being admitted into pharmacological testing groups.
Focus on Empowerment
The success of recovery depends on empowerment. This can lead to a low self-esteem, both in terms of trauma and SUD. To prevent relapse, it is important to reverse and prevent this negative self-view. In order to empower people, it is important that they feel heard and validated in a supportive recovery environment.
How should addiction treatment address trauma?
Due to the high level of comorbidity between trauma and SUD it is recommended that treatment overlaps. In a group, it can be difficult to treat multiple conditions.
The nature of recovery groups makes it more likely that multiple traumas will be re-traumatized. It is also difficult to replicate previous tactics, as no universally applicable treatment options exist. The healthcare system must be careful and consider the trauma of each patient.
Policies and Procedures
A trauma-informed care organization needs policies and procedures that support this. It allows for an integrated and seamless recovery environment where all members of diagnostic teams share a common focus and understanding about trauma-informed care. It is important to refresh these procedures periodically in order to maintain a fresh understanding.
Focuses and aspirations
Trauma informed healthcare focuses on changing the way we practice and view healthcare. This holistic approach allows for more effective and deeper treatment options. In order to be successful, a recovery environment or organization must focus on the patient’s health and betterment while also nurturing a staff who adheres to the principles of trauma informed care.
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