Trauma-informed therapy is a form of therapy in which the therapist takes the client’s traumatic experiences into account and assesses how it impacts their mental health, presenting complaints, and their ability to participate in treatment. Trauma-informed therapists take proactive steps to avoid triggering the patients unless it is necessary to proceed therapeutically. To begin with, it is essential to understand what trauma is before we get into understanding trauma-informed therapy.
What is trauma?
Trauma can mean different things to different people, and many people use it quite loosely. However, every bad experience in life is not traumatic, and it is essential to remember that what we think is trauma is probably not.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition or the DSM 5, explains trauma as
“An exposure to actual or threatened events involving death, serious injury, or sexual violation in one or more of the following ways: directly experiencing traumatic events, witnessing them in person when these traumatic incidents happen to someone else, learning that trauma took place to someone we love, or being exposed to such incidents on a repeated basis.”
In this article, we look at the principles of trauma-informed therapy, its techniques, and how it benefits you.
Principles of Trauma-Informed Therapy
The Substance Abuse and Mental Health Service Association (SAMHSA) has laid out six critical principles. These include:
- Safety – The idea behind safety is to ensure the client feels physically and emotionally safe while working with the therapist. As traumatized individuals often feel unsafe and at risk of threatening events and situations, a trauma-focused therapist ensures that they create a safe space for the client.
- Trustworthiness and transparency – One of the hallmarks of being traumatized is not being able to trust and feel open about things. Clients may not disclose their genuine emotions or suspect the therapists’ intentions. Hence, the second core principle is to build trust and be transparent as much as possible.
- Collaboration and mutuality – Trauma is a subjective experience that the therapists may not have personally experienced. Hence, the therapist collaborates with the client and learns from their experience to provide inputs that may help them heal. This is why a trauma-informed approach focuses on mutuality.
- Empowerment, voice, and choice – Traumatised individuals often feel like they do not have agency and that they have lost control over their individual choices. The therapist’s goal is to help clients feel empowered enough to voice out their difficulties and make choices that help them make therapeutic progress.
- Cultural, historical, and gender issues – It is important to note that therapists cannot always represent the client’s demographic attributes. Hence, it is necessary for a trauma-informed therapist to be aware of different cultural, historical, and gender issues that the client may experience. An example is a heterosexual therapist trying to help a homosexual man come to terms with rape.
- Peer support – Although the therapist may provide professional assistance, it is always good for the client to seek peer support. The therapist may actively help the client to find peer support as long as it is in their therapeutic interest.
Who Can Benefit from Trauma-Informed Therapy
Anybody who has been exposed to trauma can benefit from trauma-informed therapy. It is important to remember that post-traumatic stress disorder (PTSD) and complex PTSD are not the only traumatogenic conditions. Many personality disorders like borderline personality disorder (BPD), anxiety, depression, and even schizophrenia can be traumatogenic. Hence, anybody with a psychological condition can benefit from trauma-informed therapy if they have experienced trauma in their lives.
Trauma-Informed Therapy Pros and Cons
| Pros of Trauma-Informed Therapy | Cons of Trauma-Informed Therapy |
| Trauma-informed therapy places the onus on the therapist to learn more about the client’s traumatic experiences. | Focusing too much on trauma may distract the therapist from maladaptive behaviors that maintain certain psychological conditions. |
| Provides comfort, solace, and understanding to the client | The therapist may not always provide genuinely and may instead do it as part of their job |
| Therapists who have experienced trauma themselves may be able to provide better trauma-informed care. | Trauma-informed therapy requires great empathy, which many therapists may lack if they have not walked in their client’s shoes. |
| Traumatizing memories can be processed in a safe environment. | Focusing too much on trauma may exacerbate the effects of traumatizing memories. |
| Connecting with traumatized peers may help to learn from and share each others’ experiences. | Sharing traumatic experiences may trigger one another, leading to exacerbation of symptoms. |
Common Trauma-Informed Therapy Techniques
Here are some common trauma-informed therapy techniques.
- Creating safe spaces – The first and foremost technique of trauma-informed therapy is to develop physically and emotionally safe spaces. In these spaces, the clients can freely process their trauma and move towards healing.
- Collaboration – Although all therapeutic modalities are collaborative, trauma-informed therapy focuses explicitly on therapists learning from their clients and helping them along the way. Hence, it is a collaborative approach that benefits both.
- Transparency – As traumatized individuals find it difficult to trust people, one of the essential techniques is to build rapport and trust so that clients feel comfortable enough to share their innermost struggles.
- Competency – This refers to not only professional competency but also cultural competency. This means that a therapist must understand what it means to be a homosexual man or a lesbian woman, especially when they experience different kinds of traumatic situations from multiple directions.
Trauma-Informed Therapy Examples
Here are two examples of trauma-informed therapy:
- AZ is a 16-year-old boy who was deprived of food and water as a child by his parents, who suffered from substance use disorders. His therapist first ensured that his physical well-being was taken care of by a social worker and worked with him to process his trauma and regain trust in adults. He was also encouraged to speak to his peers his age and focus on his schoolwork.
- ML is a 42-year-old woman whom her boyfriend repeatedly raped. As she was not financially independent, she had to endure the assault until she finally managed to complain to the authorities. Her psychologist worked with her to process her sexual assault with the help of Eye Movement Desensitization and Reprocessing (EMDR) while using CBT and DBT to help process her thoughts and emotions.
Effectiveness of Trauma-Informed Therapy
Trauma-informed therapy is an emerging treatment modality that shows promise in helping treat different traumatogenic conditions. Usually, clinical psychologists use it as an approach rather than a standalone treatment. It is often used alongside CBT, DBT, psychodynamic therapy, and others to help traumatized individuals get better mentally. Trauma-informed therapy can be highly effective when performed by experienced clinical psychologists who understand the context and prognostic considerations.
Considerations for treatment planning
The therapist usually does treatment planning, and you do not have to worry much about it as a client. However, it makes sense to make a list of triggering events and memories so that your therapist knows what to avoid and when to tackle each of these issues. You may also make a note of how traumatic events have changed your life and what exactly you expect from therapy. Having an honest conversation with your therapist before beginning trauma-informed treatment can help you achieve your goals sooner rather than later.
Trauma-informed therapy is an approach more than a therapeutic model
Most people experience some trauma in their lives. While most of us have the tools to deal with them and continue to live healthy and well-adjusted lives, others find it difficult. Trauma cannot be measured or compared, and each person processes pain differently. Hence, trauma-informed therapy takes every traumatic incident seriously regardless of how serious the event objectively was.
If you think you have been traumatized, or if you have been diagnosed with PTSD or C-PTSD, help is available. Speak to the nearest clinical psychologist or mental health worker to find out if they offer trauma-informed care so that you can begin your healing journey today.
