Trauma has a way of clinging to us, lingering long after its initial sting. This reality becomes starkly apparent in healthcare settings, where traditional patient encounters can unintentionally reopen old wounds. However, embracing trauma-informed care within these spaces promises a more compassionate and healing approach, ensuring patients leave feeling genuinely nurtured and understood. It's a crucial step towards addressing the holistic needs of those we aim to help.
Chris Spearn, AFMC’s Trauma-Informed Resiliency Coordinator, discusses the importance of Trauma-Informed Care, its connection with ACEs, and its impact on patients’ mental health.
What is Trauma-Informed Care?
Trauma-informed care, at its most basic definition, is an approach that considers trauma’s effect on people’s daily functions. “Trauma-informed care, or TIC, focuses on creating a safe and empowering environment,” Chris says. “Healthcare providers who follow the TIC approach know how common trauma is, can identify its signs, and value safety, trust, choice, teamwork, and empowerment when working with patients.” By using a TIC approach, healthcare professionals can offer better support to individuals on their path to healing, helping them feel more secure, even in vulnerable situations.
Trauma’s Effect on Other Health Factors
Adverse Childhood Experiences (ACEs) and Social Determinants of Health (SDOH) play crucial roles in shaping an individual’s mental and physical well-being. “ACEs, such as abuse, neglect, or household dysfunction, can have long-lasting effects on a person’s health and behavior. These experiences often intersect with social determinants of health,” Chris says. “Things like healthcare access, housing stability, and economic development all influence an individual’s risk of trauma.”
Trauma-informed care approaches recognize the effects of ACEs and SDOH, emphasizing empathy, safety, and resilience to support individuals affected by trauma. Through addressing the factors that contribute to trauma, TIC promotes healing and holistic well-being for those who have experienced adversity.
ACEs Screening Tools
Because ACEs and SDOH have such a heavy influence on a person’s trauma response and well-being, it’s important to use screening tools that identify the root of the trauma. “To determine a person’s ACE score and identify the underlying issues beyond what a clinician might initially observe, it’s best to use various screening tools and resources available,” Chris says.
According to the National Child Traumatic Stress Network (NCTSN), there are a number of trauma screening tools providers can administer depending on the age and developmental state of the child and the child’s relationship with the caregivers and adults in their life. For example, it can be difficult to screen very young children specifically for “trauma symptoms.” Instead, providers may find it more effective to screen for exposure to traumatic events and social and emotional difficulties, like attachment issues and mood dysregulation. “Once the child gets older, it may be more appropriate to screen specifically for trauma symptoms,” Chris says.
Most of the trauma screening tools available are developed by professionals with a wide array of training and experience. Any provider using a trauma screening tool should consider factors that may affect the tool’s effectiveness and appropriateness, such as the child’s age, language skills, and cognitive abilities; their involvement in populations for which the tool has been validated; and other factors that may affect the tool’s validity for that particular child.
NCTSN outlines three main types of screening tools providers can use, keeping in mind the three factors mentioned above:
- Child-Completed Tool (Self-Report) – appropriate for children ages eight and above who can read and complete the questions. This tool allows the child an opportunity to vocalize his or her responses aloud or in writing.
- Caregiver-Completed Tool – designed for infants, toddlers, young children (ages 0-8), or children with developmental delays. This tool will require a caregiver or provider to complete the screening by writing out the responses or conducting an interview.
- Provider-Completed – most effective for providers or other professionals to administer while reviewing information about a child from court reports, interviews with caregivers and teachers, behavioral observations, and other media. Provider-completed tools may be useful in consolidating several complex pieces of information in one place for easy access.
Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) provides guidelines for healthcare professionals to dive deeper into a patient’s past struggles and traumatic experiences, leading to a more comprehensive study of a patient’s overall well-being. All of these screening tools help uncover hidden traumas that may not be apparent during a standard clinical assessment.
Looking at Patients through a Trauma-Informed Lens
Now that we’ve explored various screening tools and resources for identifying and assessing a patient’s traumas, it’s time to look into ways to employ these strategies into your practice to enhance sensitivity and awareness into your care.
“One approach is active listening, where professionals create a safe space for patients to share their experiences without judgment,” Chris says. “Offering support and validation throughout the treatment process, even by just verbally responding to your patients while they’re expressing their traumas, builds trust and rapport.”
Creating a safe physical, social, and emotional environment in clinical settings is crucial for ensuring patients’ comfort. “To achieve this it’s important to make changes to the clinical environment that improve patients’ feeling of safety and reduce re-traumatization,” Chris explains.
“Areas like parking lots, common spaces, bathrooms, and entrances/exits should be well-lit to enhance visibility and security. Maintaining low noise levels in waiting rooms can help create a calm atmosphere, while decorations with warm colors and community-representative artwork can provide a sense of familiarity and comfort.”
Socially and emotionally, using positive and welcoming language on signage, encouraging staff to communicate warmly, and understanding how culture influences perceptions of trauma and safety are essential. “Additionally, respecting patients’ preferences regarding privacy, such as asking about door closure during exams, can further contribute to a supportive environment,” Chris adds.
Verbalizing the Steps of the Appointment Goes a Long Way
Taking the time to talk about how a medical appointment should go before starting any tests or treatment will build trust and comfort between the patient and the provider. It also gives the patient a chance to express any worries or preferences they have. “When patients know what to expect during their visit, they can be ready mentally, which can help them feel less anxious and more willing to cooperate during their check-ups or procedures,” Chris says.
Going over the visit plan helps ensure that patients are well-informed and involved in their own healthcare journey. This promotes a team effort and puts the patient at the center of their own care. By following TIC principles, healthcare professionals can promote a sense of safety, trust, and well-being for all individuals seeking care.
TIC is Always Changing, So Stay Informed
Ongoing training and education on trauma-informed practices are crucial to providing ongoing effective care and support for individuals. By incorporating trauma-informed principles into practice, providers can better meet the needs of their patients and contribute to their healing and recovery.
Learn more about trauma-informed care at AFMC’s 8th annual ACEs and Resilience Summit on August 8. This year’s theme is “Living in a House of Cards: Dealing with the ACEs in Our Lives.” Each session will feature strategies and tools to prevent ACEs presented by subject matter experts working in various community sectors. Two of this year’s break-out sessions, “Strategies for a Trauma-Informed Classroom” and “Quality Improvement Principles for Building a Trauma-Informed Healthcare Practice,” will provide great insight into TIC strategies you can begin to incorporate into your practice.
Read more about the sessions and speakers at this year’s summit. We hope to see you there!
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Meet Chris Spearn
Christine Spearn is a highly accomplished professional in the field of education, holding a Master of Education degree with a specialization in Curriculum and Instruction. She also possesses a Bachelor of Science degree in Education Pk-6, with a specialization in Special Education PK-12. In addition to her educational background, Christine has undergone training as an instructor of Mental Health First Aid, further enhancing her expertise in supporting individuals' well-being.
With an impressive career spanning over 29 years, Christine has excelled in various roles and specialties within the education sector. Her extensive experience includes serving as an Instructional Specialist for students with behavioral challenges, a District Behavior Consultant, a District Special Education Consultant, and a 504 Coordinator. She has developed a deep understanding of the unique needs and challenges faced by students and has actively worked to address them.
Christine's knowledge and expertise extend beyond her professional roles. She frequently engages with local stakeholders and parents, sharing insights on important topics such as Adverse Childhood Experiences (ACEs), Positive and Compensatory Experiences (PACEs), Trauma-Informed Care, and Resilience. Her dedication to educating and empowering others in these areas is evident in her contributions to the community as Board Member of the Distinguished Young Women of Arkansas and volunteer for Special Olympics.
With her exceptional qualifications, extensive experience, and commitment to sharing knowledge, Christine Spearn is a highly respected professional in the field of education.
