Category: Trauma-Informed Care

6 Myths About Trauma-Informed Care

Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP

Trauma-Informed Care has become increasingly recognized as an essential approach in both therapeutic settings and broader organizational contexts. Despite its growing acceptance, several myths persist about what trauma-informed care is and how it should be applied. Let’s debunk some of the most common misconceptions.

Myth 1: Trauma-Informed Care Is Only for People with Trauma

Reality: Trauma-Informed Care Is for Everyone

One of the most widespread myths is that trauma-informed care is relevant only for individuals who have experienced trauma. While it is indeed designed to support those affected by trauma, its principles benefit everyone. Trauma-informed care emphasizes safety, trust, and empowerment—universal needs that improve interactions and outcomes in all settings, whether or not trauma is involved. By creating environments where everyone feels respected and valued, trauma-informed care fosters positive outcomes across all interactions.

If you are working with humans, you are working with trauma survivors. Trauma-informed care is useful in any industry, organization, and system.

Myth 2: Trauma-Informed Care Is a Specific Therapy

Reality: Trauma-Informed Care Is a Philosophy That Can Be Incorporated into Any Therapy or System

Another misconception is that trauma-informed care is a specific type of therapy or intervention. In reality, it is a broader philosophy or framework that can be integrated into any therapeutic approach or organizational system. It involves shifting the focus from “What’s wrong with you?” to “What happened to you?” This change in perspective can be applied across various settings, from healthcare to education, ensuring that all services are delivered with an understanding of how trauma impacts individuals.

Myth 3: Trauma-Informed Care Is Only for Therapists and Mental Health Providers

Reality: Trauma-Informed Care Was Created for Organizations and Systems

While trauma-informed care is vital in therapeutic settings, it was originally designed with an emphasis on organizational culture and structures. The principles of trauma-informed care can and should be integrated into any system, including schools, hospitals, criminal justice systems, and workplaces. By implementing trauma-informed practices at an organizational level, systems can create environments that are sensitive to the needs of all individuals, especially those who have experienced trauma.

Myth 4: There Is No Accountability in Trauma-Informed Care

Reality: Trauma-Informed Care Offers Flexibility While Still Holding People Accountable

Some believe that trauma-informed care allows people to avoid responsibility for their actions due to its focus on understanding and empathy. However, trauma-informed care does not eliminate accountability; instead, it balances flexibility with clear expectations. Trauma-informed care values control and choice, allowing individuals to make decisions about their care and actions. At the same time, it includes predictable and thoughtful consequences. By understanding the underlying reasons behind someone’s behavior, trauma-informed care enables providers to address issues in a compassionate yet effective manner.

Myth 5: Trauma-Informed Care Avoids Catharsis

Reality: Trauma-Informed Care Values Catharsis but Not as the Primary Source of Change

There is a misconception that trauma-informed care avoids emotional catharsis altogether. In truth, trauma-informed practitioners do value catharsis, but it is not seen as the primary driver of change. Instead, trauma-informed care focuses first on building strengths and ensuring safety. Only when a stable foundation is established does catharsis become a tool for deeper emotional processing, ultimately leading to growth. This careful approach helps prevent retraumatization and ensures that emotional release happens in a controlled, supportive environment and within a trusting relationship.

Myth 6: Trauma-Informed Care Either Avoids Trauma Processing or Requires One to Talk About Trauma

Reality: Trauma-Informed Care Emphasizes Client Choice and Autonomy

A final myth is that trauma-informed care either forces clients to talk about their trauma or avoids it entirely. In reality, trauma-informed care prioritizes the client’s choice and autonomy. It provides structure and support, allowing clients to decide if and when they want to discuss their trauma. Practitioners understand the importance of not reprocessing trauma too quickly and work to create an environment where the client feels safe and in control of their healing journey.

Trauma-informed care is a versatile, compassionate approach that goes beyond specific therapies to influence entire systems. By debunking these myths, we can better understand the true value of trauma-informed care and its potential to transform how we support individuals and communities in healing and growth. Whether you’re a therapist, a teacher, or part of a larger organization, integrating trauma-informed principles can make a meaningful difference in the lives of those you serve.

To learn more about trauma-informed care, consider downloading SAMHSA’s resources, following us on YouTube, or purchasing Dr. Scott Giacomucci’s new book on the topic.

Trauma-Informed Care: The Basics

Dr. Scott Giacomucci, DSW, LCSW, BCD, CGP, FAAETS, TEP

“Trying to implement trauma specific practices without first implementing trauma informed organisational culture change is like throwing seeds on dry land” – Dr. Sandra Bloom

Trauma-Informed Care

There are many different aspects and nuances within a trauma-informed approach. SAMHSA (2014) describes four “R”s  as key assumptions within a trauma-informed approach. A provider that operates from a trauma-informed framework, implements the following four “R”s:

  1. Realizes that trauma has extensive impacts on individuals and understands that there are multiple paths to recovering from trauma.
  2. Recognizes the unique symptoms and manifestations of trauma or traumatic stress for individuals, groups, families, communities, and staff members.
  3. Responds by implementing policies, procedures, and practices which are guided by trauma-informed principles.
  4. Resists Retraumatization in all aspects of the work

Six Trauma-Informed Principles

SAMHSA (2014) outlines six core principles of trauma-informed practice which guide practitioners and organizations in embodying a trauma-informed care that prevents retraumatization and supports healing. SAMHSA defines trauma-informed care through these key principles (2014):

  1. Safety: Providers promote physical and emotional safety through the design of their facility, social interactions, and the provision of services. Providers seek to understand what safety means through the perspective and experience of those they serve.
  2. Trustworthiness and Transparency: Decision-making at all levels is done with transparency for staff, clients, and the community in the spirit of establishing and maintaining trust.
  3. Peer Support: Trauma survivors are incorporated as essential members of one’s recovery process using their lived experiences to promote healing.
  4. Collaboration and Mutuality: Power dynamics between various staff members and with clients are managed in a way that values each person, emphasizes each role as important, and distributes power and decision-making.
  5. Empowerment, Voice, and Choice: Providers emphasize the resilience and autonomy of clients, communities, and staff. Everyone is empowered in decision-making, goal-setting, and self-advocacy. “Staff are facilitators of recovery rather than controllers of recovery” (Brown, Baker, & Wilcox, 2012, as cited by SAMHSA, 2014, p. 11).
  6. Cultural, Historical, and Gender Issues: Providers actively address their own biases while developing practices/policies that are conducive to the needs and values related to the race, ethnicity, culture, religion, gender, sexuality, and age of those they serve and employ. The impact of historic/collective trauma or discrimination is acknowledged while mitigating the potential for reenactments of oppression and microaggressions. The healing potential of cultural and identity values are leveraged and emphasized for clients when appropriate.

Trauma-Informed Organization Areas

Building upon the work of others (Bloom & Farragher, 2011; Harris & Fallot, 2001), SAMHSA (2014) has also outlined ten organizational domains for consideration when developing a trauma-informed system. These ten domains are meant to help guide providers and practitioners implement trauma-informed principles into their work. The articulation of these ten domains also illuminates how trauma-informed practice informs not only the ways in which treatment is provided, but every aspect of organizational structure and operations.

  1. Governance and Leadership
  2. Policy
  3. Physical Environment
  4. Engagement and Involvement
  5. Cross Sector Collaboration
  6. Screening, Assessment, Treatment Services
  7. Training and Workforce Development
  8. Progress Monitoring & Quality Assurance
  9. Financing
  10. Evaluation

Being trauma-informed requires critical examination and reflection by individuals and organizations. It isn’t simply a buzzword to be thrown around, but a comprehensive philosophy that guides and informs policy, organizational structure, work culture, community engagement, and how services are provided.

Trauma-Informed vs Trauma-Focused

In discussions about trauma-informed care, it is essential that we also differentiate “trauma-informed services” and “trauma-focused services”. Many mistakenly use the terms interchangeably but there is an important difference (Giacomucci, 2021). “Trauma-focused services” refer to practices that are directly provided for trauma survivors to address and/or treat post-traumatic stress disorder. The trauma-Informed philosophy describes the processes by which services are provided and the larger context in which they are offered. Whereas Trauma-focused services are dedicated to trauma-related content. One of the major differences then is that trauma-informed care highlights “process” while trauma-focused care centralizes trauma “content”.

Ideally, trauma-focused services are also offered within a trauma-informed framework. Unfortunately, this is not always the case as there are a multitude of examples of trauma treatment programs, practices, and providers that have been known to retraumatize participants without regard to the six trauma-informed principles. It should be emphasized that learning to integrate and offer trauma-informed and trauma-focused services requires education, training, self-awareness, and commitment. Most trauma-focused approaches or treatments for PTSD demand extensive training and should not be offered by professionals outside the scope of their competency. Practitioners who are not aware of the limits of their practice risk retraumatizing participants, especially when attempting to implement more complex interventions. This is one of the problems that has negatively impacted the reputation of psychodrama and other trauma treatments.

Excerpts from Chapter 1 of:   Giacomucci, S. (under contract for 2023). Trauma-Informed Group Work, Psychodrama, and Leadership: A Guide for Therapists, Facilitators, & Leaders

 

The 4 ‘R’s of Trauma-Informed Care: What it Means to Really Be Trauma-Informed

This video presents an introduction to the 4 ‘R’s of Trauma-Informed Care:
-Realize
-Recognize
-Respond
-Resist Retraumatization

Each of the 4 are described in detail by Dr. Scott Giacomucci, a Fellow of the American Academy of Experts in Traumatic Stress (FAAETS). These four ‘R’s are essential knowledge for all trauma-informed practitioners, providers, and organizational leaders. The four ‘R’s provide a simplified framework for applying trauma-informed principles from the SAMHSA. See other videos on this channel for additional context including:


SAMHSA’s 6 trauma-informed principles

https://www.youtube.com/watch?v=R4Js6VTu9yw&t= What is PTSD? – https://www.youtube.com/watch?v=LbpdG2tiX8c&t= Post-Traumatic Growth – https://www.youtube.com/watch?v=uFGJI1o-ciQ&t=



Visit our website to learn more about how we can help your organization implement trauma-informed principles and trauma-focused group work – https://www.phoenixtraumacenter.com/training-for-your-team-in-experiential-trauma-therapy/

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