We all have the ability to help survivors and victims of crime. While the specific services or assistance you can offer may vary depending on your role, knowledge, expertise, and organization, the basic principles of trauma-informed care can be implemented by anyone. The key is to be not only trauma-informed, but trauma-responsive.
In keeping with this year’s National Crime Victims’ Rights Week theme, which “asks all of us—friends, family members, neighbors, colleagues, community leaders, victim service providers, criminal justice practitioners, and health professionals—how we can help crime victims”, for this guide we use the term “victim services” broadly, to mean any efforts an individual or organization takes to assist and support survivors and victims of crime, including child sexual abuse, exploitation, and trafficking.
A Trauma-Responsive Approach
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are multiple definitions of “trauma”, generated through decades of work by field experts. After developing and reviewing an inventory of these definitions, SAMHSA found subtle nuances and differences between them, and, assisted by a panel of experts, generated the following to define trauma:
“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
Trauma-informed care recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in lives. Its goal is to infuse knowledge of the impact of trauma on survivors into all aspects of a program to not only recognize the impact of trauma, but also be responsive to trauma and ensure that survivors are not re-victimized in the process of seeking help.
More specifically, a trauma-informed and -responsive approach, as defined by SAMHSA, is rooted in a set of four assumptions and six key principles. The four assumptions at the heart of a trauma-informed approach are also known as “The Four Rs”:
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.
First, a trauma-informed approach requires that all people at all levels of the organization or system realize that trauma can affect individuals, families, groups, organizations, and communities. Experiences and behaviors of those impacted by trauma should be understood in the context of coping strategies in the face of adversity and overwhelming circumstances, whether past or current. A trauma-informed approach also realizes that clinicians, victim services professionals, and others who work with individuals who have experienced trauma may themselves experience indirect trauma, such as secondary trauma or vicarious trauma. It is important to have awareness of the symptoms of vicarious trauma and burnout, and be on the lookout for these symptoms in yourself, your colleagues, friends, and family members.
A trauma-informed approach requires that all people in the organization or system recognize the signs and symptoms of trauma. There are many symptoms of trauma, and one important thing to remember is that everyone is different – not everyone will have the same symptoms, and there is no “right” or “wrong” response to trauma. Symptoms of trauma may vary depending on age, gender, culture, setting, and other factors. Trauma screenings and other assessment tools can help you recognize the signs of trauma in yourself and others.
Next, the program, organization, or system cannot truly call itself trauma-informed unless it then responds by applying the principles of a trauma-informed approach to all areas of functioning. The behavior, language, and policies of all staff should reflect an integrated understanding that experiencing traumatic events affects all people involved. Mission statements, staff handbooks, manuals, and other written materials should promote a culture based on beliefs about resilience, recovery, and healing from trauma. The program, organization, or system should be committed to an environment which promotes trust, fairness and transparency, and is both physically and psychologically safe. It is advisable to err on the side of caution, and expect the presence of trauma in lives of individuals being served.
Finally, a trauma-informed and -responsive approach resists re-traumatization of individuals being served, as well as staff. In a trauma-informed environment, staff recognize the ways in which organizational practices may trigger painful memories and re-traumatize individuals with a history of trauma. There should be an understanding that creating a stressful or toxic environment, even unintentionally, interferes with client recovery; staff well-being; and the fulfillment of the organization’s mission.
Specific practices and procedures for trauma-informed care will depend on the organization, program, or system; however, a trauma-informed approach incorporates the following six key principles into not only in written policies, but also its practices:
1. Safety
All individuals, including staff as well as the people they serve, should feel physically and psychologically safe. Interpersonal interactions should promote a sense of safety, and the physical setting should be safe. It is important to understand “safety” as defined by those served.
2. Trustworthiness and Transparency
There should be transparency in organizational operations and decisions, with the goal of building and maintaining trust with clients, family members, staff, and others involved.
3. Peer Support
Establish safety and hope, build trust, and enhance collaboration through peer support and mutual self-help. “Peers” may be individuals with lived experiences of trauma, or family members of children who have experienced traumatic events and are key caregivers in their recovery.
4. Collaboration and Mutuality
Demonstrate that healing happens in relationships and in the meaningful sharing of power and decision-making. Recognize and emphasize that everyone has a role to play in taking a trauma-informed approach. Place importance on partnering and leveling power differences between staff and clients, and among organizational staff.
5. Empowerment, Voice and Choice
Empower staff and those you serve by recognizing their individual strengths and experiences. Understand power differentials and the ways in which, historically, the voices of trauma survivors have been diminished. Believe in the primacy of those you serve, as well as their resilience and ability to heal. Support clients in shared decision-making, choices, and goals; encourage clients to determine the plan of action which they need for their own healing. Cultivate self-advocacy skills, and encourage clients to speak up about their needs.
6. Cultural, Historical, and Gender Issues
Move past cultural stereotypes and biases (including, but not limited to, those based on race; ethnicity; sexual orientation; age; religion; gender identity; geography; and more). Incorporate practices and policies which are responsive to the racial, ethnic, and cultural needs of those you serve. Offer access to gender-responsive services. Recognize and address historical trauma.
ADDITIONAL RESOURCES AND READINGS:
Substance Abuse and Mental Health Services Administration. 2014. SAMHSA’S Concept of Trauma and Guidance for a Trauma-Informed Approach.
Office for Victims of Crime Training & Technical Assistance Center. Back to Basics: Trauma-Informed and Victim-Centered Approaches.
Office for Victims of Crime Training & Technical Assistance Center Human Trafficking Task Force e-Guide. Using a Trauma-Informed Approach.
Center on Trauma and Adversity. Symptom Domains of Indirect Trauma.
Center on Child Wellbeing & Trauma. Signs of Trauma.
Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
The George Washington University. Common Reactions to Trauma.
National Center on Safe Supportive Learning Environments. Secondary Traumatic Stress and Self-Care Packet.