Studies show that 51% of the general North American population have experienced trauma in childhood and that 98% of users of services in the public mental health system have trauma histories (e.g., car accidents, deaths, abuse, etc.).
Unresolved or untreated trauma leads to symptoms such as depression, anxiety, panic attacks, alcohol and drug dependency, reliance upon social support, missed work and unemployment, relationship dysfunction, and the increased risk for serious and chronic circulatory, digestive, musculoskeletal, respiratory and infectious diseases.
Social services (e.g., housing, medical, employment, criminal justice, etc.) workers see symptoms (e.g., missed work, mood issues, addiction, etc.) in their clients, yet need to understand them as possible adaptive responses to past trauma. For example, children who experience child abuse/neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult, and 30% more likely to commit a violent crime.
Presuming that many clients seeking services do have a history of traumatic childhood experiences shifts systems to one that is trauma-informed. However, for what purpose?
One reason is to direct clients to trauma resources and treatment. Many people go through the system without being asked about the possibility of any past trauma/abuse. Unnamed and untreated, the person is caught in the unbeknown and bewildering cycle of traumatic adaptation.
Professor Richard Bentall suggested that “it is even more vital that services routinely question patients about their life experience.” This recommendation can be addressed by screening and assessing for past or current trauma(s) during intakes in a timely and respectful manner. For example, “How do you and your partner solve disagreements” or “Were you ever treated harshly as a child?”
Another reason is that there is a real possibility that workers unintentionally cause harm by using practices, policies and activities that are insensitive to the needs, the vulnerabilities and the triggers of traumatized clients which leads to further re-traumatization and the likelihood that people will not seek support in the future.
If trauma is the ultimate lack of relationship and void of protection, then the basis of trauma-informed practices must be the importance of relationship, and emotional and physical safety. Thus, interactions need to be based upon support, patience, reassurance, honesty and acceptance. Environments should be welcoming, calm and safe.
If trauma takes away a person’s sense of power, then rebuilding personal control and empowerment is also a key factor. People receiving services would be encouraged and given opportunities to use their voice, make choices and to self-advocate.
Understanding trauma also means recognizing that our personal traumatic experiences or the stress associated with working in human services may impact our well-being as well as our work success and satisfaction, which further impacts the people we service.
On a societal level, we can be curious about the circumstance a person is in rather than judging the circumstance. What hurts is thinking “What is wrong with this person?” versus wondering “What harmful events may have contributed to the current problems and to the way the person is coping?” And, what can we do about the prevention of such events?