Trauma-informed care (TIC) is reshaping perinatal mental health support. It focuses on understanding past experiences rather than just treating symptoms.
The 5 core principles of TIC are:
- Safety and Trust
- Patient Choice
- Respect for All Backgrounds
- Working Together
- Getting Started with Implementation
Here's a quick comparison of how these principles change care:
| Traditional Approach | Trauma-Informed Approach |
|---|---|
| "What's wrong with you?" | "What happened to you?" |
| Provider-led decisions | Shared decision-making |
| One-size-fits-all care | Culturally sensitive care |
| Provider as expert | Collaboration with patients |
| Focus on symptoms | Address underlying trauma |
TIC matters because:
- 6 in 10 men and 5 in 10 women experience trauma
- Up to 44% of women see childbirth as traumatic
- About 8% of pregnant patients have PTSD
By applying these principles, healthcare providers can create safer, more supportive environments for healing and recovery during the perinatal period.
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What is Trauma-Informed Care?
Trauma-Informed Care (TIC) isn't a specific treatment. It's a way of thinking about healthcare that puts trauma front and center.
The big idea? Instead of asking "What's wrong with you?", TIC asks "What happened to you?"
This shift in thinking can make a huge difference, especially for new and expecting parents.
Key Elements of TIC
TIC is built on a few important ideas:
- Everyone might have trauma: TIC treats everyone with care, just in case.
- Safety comes first: Both patients and providers need to feel safe.
- Patients have power: TIC gives patients choices about their care.
- We're in this together: Patients and providers work as a team.
- Culture matters: TIC respects different backgrounds and experiences.
Why TIC Matters for New Parents
TIC can be a game-changer during pregnancy and after birth. Here's how:
- It helps prevent old traumas from popping up during childbirth.
- It builds trust between parents and their healthcare team.
- It gives parents tools to handle stress and worry.
- It can lead to better mental health for both parents and babies.
Dr. Michele Reali-Sorrell, a nursing expert, puts it this way:
"The goal of trauma-informed care is shifting the lens of how we care for people. Instead of saying, 'What's wrong with you?' we change that into 'What happened to you?'"
This matters a lot when you consider that almost half of women see their childbirth as traumatic. And about 1 in 12 pregnant patients have PTSD.
TIC isn't just a nice idea. It's a powerful tool for supporting new parents through one of life's biggest changes.
1. Safety and Trust
Safety and trust are key in trauma-informed care (TIC), especially for perinatal mental health. They're the foundation for healing.
Making Safe Spaces
At Moxie Psych and Wellness, we go beyond physical safety. We create an environment where patients feel emotionally secure and respected.
Our approach includes:
- Well-lit, accessible clinic with private rooms
- Staff trained to handle triggers and stay calm
- Clear routines to help patients feel at ease
Dr. Regina Koepp, a Clinical Psychologist, puts it this way:
"Establishing safety and trust is paramount when forming a therapeutic connection."
This is crucial for perinatal patients who may have trauma from pregnancy, childbirth, or past events.
Clear Communication
We build trust through open, honest communication. Here's how:
| Strategy | Purpose |
|---|---|
| Active Listening | Value patient input |
| Empathetic Responses | Validate experiences |
| Transparent Policies | Clarify care process |
| Consent-Based Approach | Empower decision-making |
We're upfront about confidentiality and privacy. This reassures patients their information is safe.
When discussing postpartum depression treatment, we always:
- Explain options in detail
- Cover benefits and risks
- Welcome questions
- Respect the patient's choice
This approach builds trust and gets patients involved in their care.
2. Patient Choice
At Moxie Psych and Wellness, we put patient choice front and center. It's a big deal in trauma-informed care, especially for perinatal mental health.
Making Decisions Together
We're all about teamwork when it comes to planning care. Here's why it matters:
- You know yourself best
- We bring the medical know-how
- Together, we make a plan that works
Here's how we do it:
1. Share info
We give you the full scoop on your options. No jargon, just clear facts.
2. Talk it out
We listen to what matters to you. Your worries, your hopes - it all counts.
3. Choose together
You're in the driver's seat, but we're right there with you.
4. Back you up
Once we've made a plan, we're with you every step of the way.
Dr. L. Elizabeth Lincoln, a Primary Care Physician, puts it well:
"Patients can advocate for themselves by explaining to physicians their anxiety about medical visits, why this is so, and what they have found helpful or harmful in prior healthcare encounters."
Speaking Up
We want to hear from you. Your voice matters, especially if you've had tough experiences in the past.
To make it easier to speak up, we:
- Ask what you need to feel comfortable
- Explain why we're asking certain questions
- Welcome a friend or family member to join you
- Do our best to accommodate your requests
During exams, we offer choices to help you feel at ease:
- We ask before we touch
- We explain what we're doing, step by step
- You can keep some clothes on if you prefer
- You can say "stop" anytime, and we will
Dr. Anita Ravi, CEO of the PurplEHealth Foundation, talks about how important words are:
"Now I change the language in how I talk about it with people. I say, 'Okay, and if you just want to undress from the waist down, and you can put everything on the side.' I don't want to imply societal pressures anymore. I'm trying to be as respectful or sensitive as possible, and you just have to learn and do better each time."
Your comfort and trust are our top priorities. We're here to work with you, not just for you.
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3. Respect for All Backgrounds
At Moxie Psych and Wellness, we get it: trauma isn't one-size-fits-all. That's why we put respect for all backgrounds front and center in our trauma-informed care.
Care for Everyone
We tailor our care to fit people from all walks of life. How? By:
- Asking about your cultural beliefs on trauma and healing
- Using language that clicks with you
- Welcoming family or friends you trust into your care
- Being open to traditional healing practices you find helpful
Dr. Allison Briscoe-Smith, a Child Clinical Psychologist, nails it:
"I have never really worked with people where trauma wasn't housed in some sort of cultural context - poverty, mass incarceration, etc."
This insight shapes our approach. We don't just treat symptoms; we look at the whole picture of your life and experiences.
Past Trauma Effects
Different groups face different challenges. We keep this in mind:
| Group | Potential Trauma Factors |
|---|---|
| People of Color | Systemic racism, discrimination |
| LGBTQ+ Individuals | Social stigma, family rejection |
| Immigrants | Displacement, language barriers |
| Low-Income Families | Financial stress, limited access to care |
Understanding these factors helps us provide better care. We know that some cultures see illness as a test or special message. Others might feel uneasy talking about emotional distress. Many have had bad experiences with healthcare systems in the past.
We take all of this into account when working with you.
The Stephen and Sandra Sheller 11th Street Family Health Center in Philadelphia shows how this approach makes a difference. They serve mostly Black patients, offering not just medical care, but also health promotion and mind-body wellness services.
4. Working Together
At Moxie Psych and Wellness, we put collaboration at the heart of trauma-informed care. We're all about building strong partnerships between providers and patients.
Team Approach
In our world, patients aren't just recipients of care - they're partners. Here's how we make it happen:
We involve you in setting goals and making treatment plans. Your voice? It matters. We explain things clearly and welcome your questions. And we get it - you're the expert on your own experiences.
Dr. Regina Koepp, a Clinical Psychologist, puts it this way:
"By integrating trauma-informed care and cultural humility in healthcare systems, we create an environment that promotes healing, empowerment and cultural responsiveness."
This team approach isn't just feel-good stuff. It gets results:
| Patients | Providers |
|---|---|
| Trust healthcare more | Understand patient needs better |
| Get more involved in treatment | Enjoy their jobs more |
| See better health outcomes | Experience less burnout |
Support Networks
Healing isn't a solo act. That's why we're big on support networks:
1. Peer Support
There's power in connecting with others who've walked in your shoes. We offer:
- Support groups for new parents
- Moderated online forums
- Peer mentorship programs
2. Family Involvement
With your okay, we bring trusted family members into the loop. This might mean:
- Teaching them about trauma and its effects
- Family therapy sessions
- Tips on supporting a loved one with trauma
3. Community Resources
We don't just treat you in our office. We connect you with community resources like:
- Local parenting groups
- Trauma-informed yoga classes
- Volunteer opportunities
Working together isn't just about you and your healthcare provider. It's about building a network that supports your healing journey.
One of our case managers puts it perfectly:
"I tell my clients that I do not have the answers and will not solve or 'fix' their problems. They have all the answers within and everything they need to heal themselves."
We're here to guide, support, and empower you. By teaming up - provider, patient, and support network - we create a solid foundation for trauma-informed care and lasting healing.
5. Getting Started
Implementing trauma-informed care (TIC) isn't a quick fix. It's a journey that takes time, effort, and dedication. Here's how to kick things off and keep the ball rolling.
Measuring Progress
You need to track your TIC implementation progress. Here's how:
1. Use assessment tools
The National Center on Domestic Violence, Trauma, and Mental Health offers a self-reflection tool. It helps pinpoint strengths and areas to improve in handling trauma for both clients and staff.
2. Track key indicators
Keep an eye on changes in patient engagement, treatment adherence, and health outcomes. Montefiore Medical Group, for example, created a measurement model for trauma-informed primary care.
3. Get feedback
Regularly ask patients and staff for input. Use surveys, focus groups, or one-on-one chats.
Here's a simple framework to measure TIC implementation:
| Area | What to Track |
|---|---|
| Organizational Culture | Staff turnover, employee satisfaction |
| Patient Experience | Patient satisfaction, treatment adherence |
| Clinical Outcomes | Health improvements, reduced trauma symptoms |
| Staff Competence | TIC training completion, use of TIC principles |
Fixing Problems
You'll hit some bumps along the way. Here are common issues and how to tackle them:
1. Change resistance
Some staff might drag their feet. To fix this:
- Show them why TIC matters
- Share success stories from other places
- Get staff involved in decisions
2. Resource shortage
TIC can stretch your resources thin. To manage:
- Start small with pilot programs
- Team up with other organizations
- Look for TIC-specific grants or funding
3. Staff secondary trauma
Healthcare providers can get secondhand trauma from patients. To prevent this:
- Set up staff wellness programs
- Provide regular support and supervision
- Push for self-care practices
4. Inconsistent TIC application
To keep things consistent:
- Write clear policies and procedures
- Do regular training refreshers
- Set up a peer review system
Remember, becoming trauma-informed is an ongoing process. As Lee Frost, IHI Marketing Operations Manager and patient advocate, puts it:
"Provide an atmosphere of safety. This is the essence of trauma-informed care."
Keep at it, and you'll see the positive impact of TIC on both patients and staff.
Next Steps
Let's recap the key principles of trauma-informed care (TIC) and discuss how to put these practices into action.
Main Points
Here's a quick rundown of the five core TIC principles:
| Principle | What It Means |
|---|---|
| Safety and Trust | Make patients feel secure and build trust |
| Patient Choice | Let patients have a say in their care |
| Respect for All Backgrounds | Value different cultural experiences |
| Working Together | Team up with patients and their support networks |
| Getting Started | Put TIC into practice and track results |
These principles are the backbone of trauma-informed healthcare, especially in perinatal mental health.
Moving Forward
Implementing TIC isn't a one-and-done deal. Here's how to keep the ball rolling:
1. Form a TIC Workgroup
Put together a team to lead your TIC efforts. They should:
- Figure out what you're already doing right
- Suggest what to change first
- Keep an eye on how your TIC initiatives are doing
2. Check Your Progress
Use tools like the self-reflection assessment from the National Center on Domestic Violence, Trauma, and Mental Health. Keep tabs on things like:
- How happy patients are with their care
- How often staff quit and how satisfied they are
- Whether patients' health is improving
3. Keep Training
Make sure everyone on your team knows the basics of TIC. As Dr. Diane K. Yatchmenoff, former Director of Trauma Informed Oregon, puts it:
"The importance of trauma-informed care is now recognized across most health and human service systems."
Don't forget to do refresher courses to keep everyone on the same page.
4. Screen for Trauma
Start checking for trauma-related issues in your patients. Just remember to do it in a way that doesn't make things worse.
5. Team Up with Your Community
TIC isn't just about what happens in your office. Dr. Shannon Thyne, Professor of Pediatrics at UCLA, says:
"What we really want to do is screen in a setting where we can have the capacity to support – through training and through educating yourself about the resources available in your community."
Find local organizations that can help you support your patients.
6. Take Care of Your Staff
Help your team avoid burnout. Try things like:
- Regular check-ins and support sessions
- Encouraging self-care
- Creating chances for staff to connect and work together
7. Always Improve
Use the Plan-Do-Study-Act (PDSA) model to guide your TIC journey:
- Make changes
- Build teams
- Set goals
- Measure results
- Look at what's working (and what's not)
- Tweak your approach as needed
FAQs
What are the 5 principles of trauma-informed care?
Trauma-informed care is built on 5 key principles. These principles, developed by Drs. Maxine Harris and Roger Fallot, shift the focus from "What's wrong with you?" to "What happened to you?"
Here's a breakdown of these principles:
1. Safety
This means creating a physically and emotionally secure environment for both patients and staff.
2. Trustworthiness
It's all about being transparent in decision-making to build and maintain trust.
3. Choice
This principle focuses on giving patients options and control over their care.
4. Collaboration
The goal here is to level out power differences and encourage shared decision-making.
5. Empowerment
This involves recognizing and validating the strengths and resilience of both patients and staff.
These principles aren't just nice ideas. They're the backbone of trauma-informed care. They help create a healing-oriented environment that acknowledges the widespread impact of trauma.
The Substance Abuse and Mental Health Services Administration (SAMHSA) puts it this way:
"A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization."
In other words, trauma-informed care isn't just about treating trauma. It's about creating an entire system that understands and responds to trauma in all its forms.
