A Healthcare Practitioner’s Guide to Trauma-Informed Language
The words we choose and the manner in which we communicate with our patients can have a profound impact on their experience. For trauma-exposed individuals specifically, certain phrases, tones, touch, settings, or images can inadvertently activate distressing memories or emotional responses. As healthcare professionals, using trauma-informed language helps us avoid re-traumatization by creating a safe, respectful, and supportive environment for all patients. This guide aims to provide practical tips and examples to help you integrate this language into your practice.
Practical Tips for Trauma-Informed Communication
1. Address the Person First: A key component of offering person-centered care is placing the individual before their condition. This applies both in conversation with a patient and when speaking about a patient with colleagues/other practitioners. For example:
Avoid
“A diabetic”
“Mr. Thompson is a 48-year-old homeless man with a history of medical noncompliance and alcoholism who is here with poorly controlled diabetes.”
Replace With
“A person with diabetes”
“Mr. Thompson is a 48-year-old man with a history of housing instability, alcohol use disorder, and diabetes with an A1c of 15.”
2. Use Simple Language: A trauma-informed approach to communication supports transparency and collaboration. To ensure patients understand their conditions and treatments, it’s important to remember your audience and avoid using medical jargon. In addition to speaking in accessible terms, keep your words clear, your speed slow, and your volume appropriate, while paying attention to cues from the patient that show understanding — you can and should pause if there are any signs of distress or confusion.
Avoid
“Palpate”
“Auscultate”
“Percuss”
“Myocardial infarction”
“Can you tell me your past surgical history?”
Replace With
“Press”
“Listen”
“Tap”
“Heart attack”
“Have you had any surgeries?”
3. Be Mindful of Non-Verbal Cues: Remember that non-verbal communication is as important as spoken words. The undivided attention you provide and the pleasant and calm demeanor you maintain will help to instill trust and provide comfort to your patients, reinforcing that their health is a priority to you. This is true whether you are seeing them once in the ER or longitudinally in primary care. Maintaining open body language, making appropriate eye contact, and sitting/standing at eye level with the patient are also ways to demonstrate non-verbal support.
4. Adopt a Professional Over Personal Approach: While the care we deliver is person-centered, the language used — especially during an exam — should remain somewhat neutral and formal. Some examples of this include:
Avoid
“Your breast”
“Butt”
“Bed”, “Sheets”
“Put up your arms like you’re going to fight”
“Don’t let me do this”
“Feel”, “Touch”
Replace With
“The breast”
“Bottom”, “Buttocks”
“Exam table”, “Drape”
“Bend the elbows”
“Keep the arms up”
“Examine”, “Evaluate”, “Check”
Remember, we cannot make assumptions around where, when and how someone’s past negative experiences took place. Even something as seemingly calming as “pretend you’re at the beach” can be presumptive (even triggering). This example can be easily replaced with something like “some find it helpful to take a relaxing breath.”
During an exam, provide information in advance of your actions (“I’m going to listen to the lungs”), what they will expect (“The speculum/stethoscope may feel cold”), and why you’re doing it (“This is important, because we need to see if you have pneumonia, which is an infection of the lungs.") And of course, always ask for permission before physical contact, even during routine procedures. This respects personal boundaries and reduces the risk of causing a trauma response.
5. Provide Choice: Whenever possible, give the patient options. This can be as simple as asking, "Would you like to discuss your test results now, or after you’ve had some time to think?" If you’re conducting an exam that’s more sensitive in nature (ex. breast, genital, or rectal) offer the individual an option to include a chaperone, loved one, or other support person. If providing choice seems overwhelming for the patient, ask them something more open-ended, such as “How can I support you today?"
6. Practice Inclusivity: Be mindful of language that respects diverse identities and experiences, including those related to race, gender, sexuality, and ability. In some instances, it may be necessary to make accommodations for patients (ex. those who speak other languages, have large body sizes, or those facing challenges with social determinants of health). Find some examples of inclusive language below:
Avoid
“Mr. Jackson! Nice to meet you. I’m Dr. Elisseou.”
“Are you married? Do you have a husband/wife?”
“Do you understand?”
“Everything on your exam looks normal.”
Replace With
“Nice to meet you! I’m Dr. Elisseou. How would you like to be addressed?”
“Are you in a relationship? Do you have a partner?”
"Would you like an interpreter to help us communicate?"
“Everything appears healthy.”
Adopting trauma-informed language in healthcare extends beyond what I’ve shared here. For a deeper dive into best practices, check out this presentation I gave during the 2022 Gold Executive Session of the Planetree International Conference, entitled “Trauma-Informed Care as Person-Centered Care.”
By educating ourselves and being mindful and deliberate with our communication, we can better support the healing journey of individuals who have experienced trauma, ultimately enhancing their quality of care and promoting engagement for better health outcomes.