A trauma-informed approach to care acknowledges that healthcare organizations and care teams need a complete picture of a patient’s life situation—past and present—to provide effective healthcare services with a healing orientation.
Physician’s Weekly Editorial Board member and columnist Alex McDonald, MD, spoke with Erika Roshanravan, MD, about traumainformed care and the need to shift the focus in patient conversations from “What’s wrong with you?” to “What happened to you?”
Dr. McDonald: What is trauma-informed care?
Dr. Roshanravan: Trauma-informed care takes into consideration that trauma and toxic stress are highly common among our patients, our staff, and ourselves. The Substance Abuse and Mental Health Services Administration developed a set of principles to describe traumainformed care. They include safety; transparency and trustworthiness; peer support; empowerment; collaboration; and cultural, historical, and gender issues.
This approach is not reserved for a few unique patients who may be severely traumatized. This is an approach to care that we apply to everyone who walks through the door. We always assume there could be a history of trauma or toxic stress, and we treat patients accordingly. Creating safety and trust is core to traumainformed approaches.
How does a trauma-informed approach translate into care?
Trauma-informed care can include little things such as not slamming doors, asking for permission to talk about certain topics, being mindful during physical exams, and empowering patients to say something if they want exams to stop. As part of an organizational approach, we hold collective care near and dear to our hearts. There is a lot of cynicism among US physicians around how to spend time on self-care when it feels like there is no time or energy. In collective care, we create an environment where we help each other create space to take care of ourselves.
What advice do you have for implementing this approach?
Whether we acknowledge it or not, the influence of trauma is extremely common. Sometimes, it can save us time to name what is important for the patient. We can also help patients make connections with the stressors in their lives and understand how trauma may contribute to other health struggles. Naming trauma and stress is powerful.
