Continuing our exploration on trauma informed care

Welcome back to part II of our Trauma Blog series, last week we began by identifying trauma as ‘an injury or an event that was found highly distressing or overwhelming’. Reinforcing that the perception of distressing and overwhelming may differ from person to person and can be based on a myriad of elements. We started tiptoeing into the concepts of trauma informed care by identifying how this may look around the holidays for both those who have found this to be a trauma trigger as well as the loved ones working to support them.

What is trauma informed care and why does it matter?

This week’s blog will look more deeply into these terms of ‘trauma informed care’ and how this can be best demonstrated or needed in a counseling environment. Over the last several years there has been a needed shift in the medical & mental health world towards the importance of providing ‘trauma informed care’. The shift comes with a push towards ensuring that we are clinically seeing the whole picture of a person’s experiences and being cognizant of their journey and healing process. This has been an essential transition that is bringing greater recognition to the stories under the present symptoms and how our past experiences can impact so many aspects of our current lives. Rather then keeping the focus solely on what is happening in the moment, it encourages us to assume that a person is more likely than not to have had some traumatic events/ elements at play in their lives that may be impacting them at the present time.

This forces a shift in the atmosphere, approaches, and assumptions at play in providing clinical care at all levels. Although trauma informed care is an active model of approach in most medical and mental health settings it is something that necessitates an ongoing area of focus and expansion. Being able to identify the signs and symptoms of a traumatic response can save an infinite amount of grief and ongoing traumatization. Trauma informed care can also dramatically help those suffering more easily move through periods of feeling ‘stuck or trapped’ in symptoms that enhance feelings of shame and blame. Moving towards more of a radical acceptance model of seeing current struggles as a result of past traumatization that can be worked through, rather than as a character flaw or dysfunction related to their own value.

Safety:

Establishing safety in therapy starts with the very basic question of if a person can feel physically and emotionally safe within the therapeutic space and with the therapist. Often, this can mean being able to go to a counseling office that is free from any influence of past traumatic experiences, perpetrators, or shame/ blame elements. However, in the new world of telehealth this has become slightly more complicated.

During the initial lock down periods many individuals living in abusive situations were ‘trapped’ in spaces where they could not feel safe. With in-person offices closed down for health and safety reasons it took away that safe space element for many, as well as their choice in how/where they could seek counseling.

Asking a person to engage in virtual therapy while at home has multiple levels to consider.

• Do they feel safe at home?
• Do they have a private and secure space that they can meet in?
• Is the person they are sharing with going to be with them through the whole process?
• Do they have reliable internet coverage? Losing a signal at a vulnerable part of counseling can be a significant safety and trust issue.

On the other side of this is that the new expansion of telehealth has also been a HUGE asset for many. With past traumatic experiences many people were never able to feel safe to physically walk into a counseling office, and consequently never started very necessary treatment and healing. With the option of telehealth in addition to in person sessions this has dramatically expanded access for many. Not only with increasing their comfort in engaging in sessions but this also dramatically increases the freedom of choice with expanding their options of therapist to a greater geographic area.

Trustworthiness & Transparency

When seeking out a therapist to start working on past issues of trauma it is ok and important to ask any and all questions that you have up front. Having an outline of the therapy process and the rules/ boundaries between therapist and client can help shape realistic expectations and increase comfort in addressing rather difficult life experiences. Every interaction element, from scheduling ease, communication methods, and billing issues can enhance or negatively impact the effectiveness of the clinical process. If the scheduling process feels very cloak and dagger and unclear it may not be the best choice of your treatment and it is ok to move on to options you may feel more comfortable with.

Collaboration & Mutuality

The treatment journey is a joint venture that the therapist and client are working on together. This means an ability to explore what is and isn’t working, past struggles and engaging in future planning. Together! Having frequent check ins within the counseling process can help ensure that things are on the right path and allow for recalculating and mapping new routes when necessary.

Empowerment, Voice & Choice

One of the first things we often tell our clients is that ‘this is your treatment, and you should ALWAYS be a part of the treatment planning process and have an active voice in the strategies and approaches that are used. The therapist is there to help guide teach but they are not there to decide what a person needs. If you are working with a therapist who dismisses your views, fears, and goals that is probably not going to be the right therapist for you. It is ok to move on. Part of the journey towards healing is deciding what does or does not work for you now.

Cultural, Historical and Gender issues

This should be a very self-explanatory element, but it often is not. Having a therapist who can be open to the uniqueness of your life circumstances without bringing in their own views and values is a big deal. Where a person has grown up, their economic level, their race, and even their gender can have a large impact on how traumatic events may have shaped their life, and consequently their ability to respond to and gain from treatment. All aspects of you matter. Make sure you are connecting with a therapist who can recognize and build on that.

What next? 

As we continue our trauma blog series in the coming weeks we will be exploring how to identify signs/ symptoms of traumatic reactions, treatment approaches, and the importance of self care as you work through your journey. If you would like to start trauma therapy at Angelus we have several great trauma informed therapists specializing in trauma treatment. Reach out to us today by calling 724-654-9555 or by completing our treatment request form online and we can contact you at your convenience.

Blog Credit: Nessa L Smith, LCSW MBA