Category: Trauma-Informed Care

Written by: Chris Klem, MS (he/him)

As we age, our chances of experiencing some form of trauma increase. By the time we reach retirement, we may have lived for six to nine decades, leaving ample opportunity for hardship and trauma. Given this reality, one might expect that professionals who work with older adults are well-trained in Trauma-Informed Care. However, this assumption is often not true. When we examine programs specifically designed for older adults who are experiencing harm, Trauma-Informed Care is seldom addressed or taught to staff in the aging field. In fact, the term “trauma” is rarely mentioned.

Why is Trauma-Informed Care Lacking in this Field?

Many would agree that abuse and neglect of older adults can lead to significant trauma. Unfortunately, professionals who are responsible for supporting older adult victims often lack training in Trauma-Informed Care. Here are three ideas that illustrate why these concepts may be absent in the aging field:

1. Trauma is frequently associated with experiences from earlier in life, such as childhood trauma, bullying, sexual assault, and domestic violence. There is a common misconception that once individuals reach their sixties or seventies, childhood trauma is in the rear-view mirror, out of sight, out of mind.

2. Another damaging belief is that older adults do not experience trauma from events like domestic violence or sexual assault. In reality, older adults, particularly those with mental health issues or cognitive decline, are at a significantly higher risk of harm. According to the National Council on Aging, one in ten older adults report experiencing abuse, neglect, or exploitation, but only one in twenty-four cases are reported. Furthermore, older adults are rarely referred for therapy, and emotional support is often not prioritized in their care planning.

3. Many professionals working in this field are over-worked and experience daily vicarious trauma or intense feelings of burnout.  The combination of these two things can decrease one’s capacity to empathize as a form of self-preservation. Often these programs are stretched thin, and training concepts like “Trauma-Informed Care” are labeled as non-essential and too time-consuming for the front-line staff.

Why Childhood Trauma Matters for Older Adults

The ACE Study (Adverse Childhood Experiences) was a large-scale research project that investigated the effects of childhood abuse, neglect, and other adverse experiences on individuals in adulthood. This study is well-known among professionals in the mental health field who work with both children and adults; however, it often does not reach those who work with older adults. It is important for professionals engaging with older adults to understand post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), as these conditions can significantly impact an older adult’s life. Additionally, the ACE Study highlighted significant correlations between childhood trauma and physical health issues later in life.

Working with clients who have multiple health conditions, low socioeconomic status, limited education, or unmanaged mental health symptoms requires a deep understanding of how their challenges may be rooted in childhood trauma or complex trauma. Recognizing the impact of ACE scores, Complex PTSD, and an individual’s history of adversity is essential for building strong relationships with our clients. Additionally, the six principles of Trauma-Informed Care offer a framework for professionals to provide high-quality, person-centered care, ultimately leading to improved outcomes for the organization.

Vicarious Trauma and Burnout

When professionals work with victims of abuse and neglect, whether they are children, adults, or older adults, they often experience a high rate of vicarious trauma. This trauma arises from indirect exposure to the victims’ firsthand narratives. These professionals frequently encounter poor living conditions and visible signs of abuse and neglect, and they may even face threats of physical violence themselves.

Working in underfunded programs can also lead workers to develop survival instincts, which can diminish a person’s capacity to hold space for empathy. This unrecognized, and often unsupported form of trauma, can have significant consequences that negatively impact not only the clients, but also the workers and the organizations they are part of. Ongoing, unsupported vicarious trauma can lead to harmful practices, liabilities, and staff turnover.

Why Should Trauma-Informed Care be taught to those working with older adults:

Many professionals in this field are motivated by a genuine desire to help others, often inspired by personal experiences of caring for family members. While their intentions are typically well-meaning, these efforts may not always yield positive outcomes for the clients. Actions perceived as beneficial might not align with what is truly in the client’s best interest and could even lead to significant emotional harm.

Professionals require accessible tools to guide their decision-making, assess risks, and foster supportive environments that prioritize both physical safety and emotional well-being. It is also essential to provide ongoing support to address issues such as vicarious trauma, burnout, and compassion fatigue. Adopting Trauma-Informed Care principles and practices can address these needs, especially when these principles are integrated throughout all levels of an organization and included in annual continuing education.

How do we begin to integrate Trauma-Informed Care?

While we may not be able to resolve issues related to funding and caseload sizes, many organizations can improve the training, education, and support they provide to their staff. The six principles of Trauma-Informed Care should be integrated into the onboarding and training of all staff who work with trauma survivors, regardless of their clients’ ages. There have been programs that have made progress over the years and have started incorporating Trauma-Informed Care into their practices, however, these training practices should be the standard across all organizations.

The Phoenix Center offers tailored Trauma-Informed Care training specifically designed to meet the needs of organizations serving older adults. We have trained numerous trauma-focused organizations in the Philadelphia area, including Women Organized Against Rape, the Delaware Coalition Against Domestic Violence, and the Chester County Department of Human Services, among others.

In addition to Trauma-Informed Care training, we also collaborate with teams to develop trauma-informed leadership, foster group cohesion, and enhance workplace wellness. We can assist organizations in recognizing signs of burnout and promoting healthy relationships between leadership and frontline staff. Contact us today to learn more about our workshops and training opportunities.

Written by: Chris Klem, MS (he/him)

Contact: chris@phoenixtraumacenter.com

Learn More About Chris

Bring Training to Your Organization

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.

Reach out to us to bring trauma-informed care training to your organization or team! Support@PhoenixTraumaCenter.com

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.

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

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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