The Four Rs of Trauma Informed Care

 

September is Suicide Prevention Awareness Month. Studies have shown that there may be an increased risk of attempted or completed suicide when an individual has experienced a traumatic event. This event could be something that happened one time, or something that occurred repeatedly. These events don’t necessarily need to happen to an individual directly, and may be something that happened to someone close to them. Unfortunately, experiencing trauma is something that many people experience and is more common than many people realize.

According to the Centers for Disease Control and Prevention, 1 out of 6 adults surveyed across 25 states reported having experienced four or more Adverse Childhood Experiences, events that are likely to cause lasting traumatic effects into adulthood. It’s important to note that trauma can occur at any age, demographic, or lifestyle. Here are some examples of the most common events in which a trauma may occur:

• ·         Experienced a serious accident (e.g. car crash, injury).
• ·         Experienced life-threatening illness.
• ·         Miscarriage or pregnancy complications.
• ·         Witnessed violence (e.g. family violence, robbery, mugging).
• ·         Experienced a natural disaster such as a hurricane, tornado, fire, or earthquake.
• ·         Physical or sexual abuse.
• ·         Military combat.
• ·         Repeatedly exposed to death due to your job (e.g. first responder, nurse).
• ·         Lost someone unexpectedly to suicide.
• ·         Sudden loss of a family member, friend, spouse, or pet.

Knowing that so many individuals have experienced, or will experience trauma at some point, it’s important that we take the time to understand how to address trauma to better help people recover. This blog will provide an overview of the Four Rs of Trauma Informed Care as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA), and why they are important for helping people heal.

The Four Rs of Trauma Informed Care

1.       Realize – the impact of trauma and understand how it impacts individuals, families, groups and communities.

When in doubt, assume that all people that you are working with have experienced some kind of trauma in their lives and have employed coping skills to help them manage it. The impact of the trauma and how well a group or individual handles it will vary widely. It’s important to make sure that you take the time to fully understand what the people you are working with have experienced and understand that the trauma may be layered. It is also important to reflect on your own traumas and how you may be triggered by certain responses or behaviors.

2.       Recognize – the signs and symptoms of trauma in the individual or group you are working with.

Although trauma affects everyone differently, some of the more common signs and symptoms include shock, denial, disbelief, mood swings, anxiety, fear, withdrawing from others, feeling sad or hopeless, feeling disconnected, and/or feeling numb. These can vary drastically between children and adults and may have both short and long-term physical, behavioral, and emotional consequences.

3.       Respond – by fully integrating knowledge about trauma into policies, procedures, and practices.

Focus on what you can do individually to understand the impact of trauma. Best practices are constantly changing as we learn more, and it is important to stay up to date with the current recommendations from reputable behavioral health authorities. In addition, take a look at the environment you are working in and challenge yourself to make it a safe place for those addressing their trauma.

4.       Re-Traumatization – actively seek to resist re-traumatizing the individual you are working with.

Re-traumatization can happen consciously or subconsciously. Due to each person’s specific experience with trauma, it is important to be vigilant in our efforts to avoid doing harm while we are trying to help.

 

• ·         Creating a safe and trustworthy environment
• ·         Collaboration with individuals and loved ones about their treatment options
• ·         Empowerment
• ·         Being conscious of how historical or current bias may play a role in each person’s experience.

Regardless of your role, trauma can show up anywhere; Whether in a professional capacity, or in your personal life, keeping these principles in mind will help you facilitate recovery and find support for those who have experienced trauma.