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What does “trauma-informed” therapy/practice mean?

I hope to offer a clear and concise definition of "trauma-informed", even though there may not be total agreement (is there ever literally total agreement about anything?) about it.

In a nutshell, and in my view, trauma-informed therapy or practice generally entails an evidence-based framework to safely address and process people’s traumatic experiences in order to help them lead the lives their want considering their circumstances. The longer answer includes some specialist understanding of how to conceptualise what trauma is (see my article “What is Trauma?”) and the implementation of methods used to process the trauma, which I will go into more detail about below.

  • Trauma-informed therapists generally understand how trauma operates in the mind and body. This means they recognise trauma problems on the cognitive/thought level, emotional level, behavioural level, physiological level, and sociological level.

  • Trauma-informed therapists attempt to increase awareness of trauma and advocate for its wider implementation in society.

  • Trauma-informed therapists think it is important that clients feel empowered and in control of trauma work, and so a collaborative working relationship is established.

  • Trauma-informed therapists generally have a plan for how to work with trauma that typically works in several stages.

    • Assessing the client’s problems, their history, and risk concerns.

    • Ensuring that clients are ready to engage in trauma processing. This means that client’s need to be adequately internally and externally resourced to begin the journey. In other words, therapists help clients to learn strategies to manage and increase their tolerance of distressing emotions.

    • Helping clients to process their trauma. I’m being overly simplistic for the sake of brevity here, but some approaches, like Trauma-Focused CBT require clients to explicitly describe in detail the narrative of the trauma to process it, while other approaches like EMDR Therapy mainly require clients to think about aspects of the traumatic memory and let their minds naturally take them where they need to go.

    • To review the processing has been adequately addressed and, in some cases, ensure clients can continue to manage in case of relapse.

Fundamentally, and not least, when undertaking work with trauma, the therapist—and I also speak for myself here—intends to build and maintain rapport with their clients. If trust is not earned, then it doesn’t matter how informed one is, clients are very unlikely to feel safe enough to do the work. Safety is paramount since trauma or traumatic experiences are in many ways a threat to safety. If you would like to know more or to have a chat about whether a trauma-informed approach may help you, please get in contact and I would be happy to listen.

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