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: 

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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.”

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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. 

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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?”

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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:

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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”

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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: 

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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.”

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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.

Offering Trauma-Informed Support to Loved Ones

Supporting a loved one through trauma can be a delicate and challenging endeavor. Acknowledge that you have already taken a first step by finding yourself on this page. Educating yourself on what trauma is and how to best offer support is integral to being able responding more effectively to your loved one’s needs. You can help to create a safe, supportive environment that facilitates their healing. In the following sections, we’ll explore practical strategies and insights to help you navigate this challenging, yet profoundly important role.

Understanding Trauma

You don’t have to have endured the same adverse experiences as someone else to understand or offer support, but it is important to know what trauma is. The Substance Abuse and Mental Health Services Association (SAMHSA) describes trauma as “an event or circumstance resulting in: physical harm; emotional harm; and/or life-threatening harm.” It can stem from various experiences, such as abuse, accidents, war, natural disasters, medical illness, or loss, and can be acute (a single incident), chronic (repeated and prolonged), or complex (the result of multiple stressors, particularly early in life). Symptoms may include anxiety, depression, flashbacks, and difficulty trusting others, though there can be a wide range of effects depending on the person and the nature of the trauma. 

While it is true that human responses to stress are well studied, biological, and generally predictable, an individual’s interpretation of an event as traumatic is quite personal. What might be traumatic for one person might not be for another. In other words, it’s not so much what happened that matters—it’s how it impacts us. 

Every instance of trauma impacts individuals uniquely, affecting their emotional, physical, and psychological well-being, and can alter how individuals perceive the world, their relationships, and themselves. Offering trauma-informed support means approaching your loved one with sensitivity, understanding, and empathy. Here are some practical steps to provide effective trauma-informed support that align with SAMHSA’s 6 guiding principles of a trauma-informed approach.

Principles of Trauma-Informed Support

1. Safety: Create an environment where your loved one feels physically and emotionally safe.

2. Trustworthiness and Transparency: Be reliable and consistent in your actions. Building trust is crucial for someone who may feel vulnerable or betrayed.

3. Peer Support: Peer support can offer validation, empathy, and understanding from those who have shared similar experiences.

4. Collaboration and Mutuality: Work together with your loved one in their healing process.

5. Empowerment, Voice, and Choice: Empower your loved one by respecting their autonomy, highlighting their strengths, and validating their feelings.

6. Cultural, Historical, and Gender Issues: Be aware of your loved one’s intersectional identities (ex. age, gender, race, ethnicity, occupation), which may shape their trauma and healing process. Listen rather than assuming, and remain humble in your desire to learn. 

Practical Steps for Providing Support to a Trauma-Impacted Individual

1. Educate Yourself: This cannot be overstated--Understanding trauma and its effects can help you respond more effectively. Read about trauma and consider seeking guidance from professionals or support groups, whether in your area or virtually.

2. Listen Actively: When they are ready and/or ask to talk, offer a non-judgmental, empathetic ear. Let them share their story at their own pace without pressing for details. Oftentimes, just being there and listening can be profoundly healing. If it makes sense, you can acknowledge their emotions without minimizing or dismissing them. Phrases like “It’s okay to feel this way” or “Your feelings are valid” can provide comfort.

3. Be Patient: Healing from trauma is a long and non-linear process. Be patient with your loved one and understand that progress may come in small steps, with ups and downs along the way. Understand that your loved one’s behaviors are coping mechanisms they’ve developed and are not aimed to hurt, offend, or push you away. Trauma survivors often need to establish and maintain boundaries to feel safe. Respect these boundaries, even if you don’t fully understand them.

4. Encourage Professional Help: Gently suggest professional help if they are open to it. Therapists and other professionals specializing in trauma can provide tools and strategies that friends and family are likely not equipped to offer. If 1:1 support doesn’t appeal to them, peer support groups are an alternative that can offer a sense of belonging and community and help reduce feelings of isolation and shame.

5. Promote Self-Care: Self-care is crucial in the healing process and can consist of physical, mental, emotional, social, and spiritual well-being practices. Encourage your loved one to start/restart/continue activities they enjoy, such as exercise, mindfulness, journaling, playing music, or other positive hobbies. Eating nutritious foods and prioritizing a healthy amount of sleep are also important for overall wellness and help to establish a routine.

6. Take Care of Yourself: Supporting someone through trauma can be emotionally taxing, but remember, you are not alone in this process; professional resources and support networks are available for both you and your loved one. Ensure you’re also taking care of your own mental and emotional health and seek support for yourself if needed. As the saying goes, ‘you can’t pour from an empty cup.’ 

Above all, compassion is the cornerstone of trauma-informed support, and being there for someone you love is a profound act of empathy and care. Your continued presence and unwavering understanding can make a significant difference in their path to recovery.

Introducing a Trauma-Informed Approach in the Workplace

In today’s fast-paced world, we are exposed to various stressors every day that can impact our mental and emotional well-being—those caused by personal relationships and obligations, exposure to social media, financial uncertainties, the constant bombardment of information via the news, and work pressures. Given the sheer amount of time most people spend at their job (whether in-person or from home), in addition to their limited ability to control workload, one might argue that workplace anxieties can be the biggest stress source of all. 

While employees can learn to utilize different coping mechanisms to manage stress and create a better work/life balance, I believe there is a growing responsibility on organizations to actively cultivate a workplace that prioritizes employee well-being, resilience, and support. Fortunately, there is a growing interest in creating trauma-informed workplaces that will meet those needs.  

What is a Trauma-Informed Workplace? 

A trauma-informed workplace is one where the organization realizes the prevalence and impact of trauma, recognizes the signs and symptoms, responds by integrating knowledge about trauma into policies, procedures, and practices, and actively resists re-traumatization. It prioritizes creating a safe, supportive, and empowering environment for all employees, acknowledging that trauma can affect anyone, and tailoring approaches accordingly. 

Benefits of a Trauma-Informed Workplace 

As with any type of change management, introducing trauma-informed policies and procedures in your workplace may seem daunting, but the benefits far outweigh the effort. These include: 

● Enhanced Employee Well-being: Employees who feel supported by their employer are more likely to thrive and contribute effectively. 

● Increased Productivity: When employees are mentally and emotionally healthy, their productivity and engagement levels increase. 

● Reduced Absenteeism: A supportive environment can reduce the likelihood of burnout and absenteeism, leading to a more stable workforce. 

● Positive Workplace Culture: Fostering empathy and understanding enhances overall workplace culture, making it more inclusive and collaborative. 

● Attracting and Retaining Talent: Organizations known for their supportive culture are more attractive to top talent and can retain their employees more effectively. 

Steps to Implement a Trauma-Informed Workplace 

To successfully create a trauma-informed workplace, organizations should focus on several key areas, including: 

● Leadership Commitment: Change can only be effective if it’s consistently demonstrated from the top down. Organizations should invest in training that ensures all people leaders not only understand trauma and its effects, but also places a focus on empathy, active listening, and compassionate responses to employees' needs. Leaders must be committed to modeling trauma-informed behavior, as their actions set the tone for the entire workforce. 

● Training and Education: Training is also beneficial for the entire employee base, so that peer-to-peer interactions and client-facing services are also conducted through a trauma-informed lens. Providing comprehensive educational sessions, inviting guest speakers for ‘lunch and learns’, and developing onboarding learning modules are a few ways to engage employees around recognizing the signs of trauma and responding appropriately. As with any other policies, education should be ongoing and integrated into organizational culture.

● Policy Review and Development: In partnership with senior leadership, Human Resources personnel should review existing policies regularly to ensure they align with trauma-informed language and principles. If there are gaps, seek guidance from stakeholders (including employees) on adopting new policies that prioritize staff safety and well-being. If no policies currently exist, consider creating them with the help of a subject matter expert.  

● Creating a Safe Environment: Both physical and psychological safety are critically important in a trauma-informed setting. Whether the workplace is small or large, physical design and functionality matter. Consider factors like lighting, space, and accessibility. Offer adequate health and hygiene resources (eg. sanitizing stations) and ensure that emergency preparedness measures are in place. When managers and leaders foster a psychologically safe environment, employees feel that they can present authentically and openly share ideas without fear of judgment or reproach. This facilitates job satisfaction, healthy team performance, and creative problem solving.  

● Support Services: Though fairly commonplace today, it remains important to offer Employee Assistance Programs (EAPs) and counseling services. Providing readily available (often 24/7 online) resources for stress management and self-care for both employees and their families could help them manage personal and work-related problems that impact well-being and performance. Offering access to professional, individual or group counseling services—including trauma-specific treatment—is another crucial element in a trauma-informed workplace. 

● Fostering a Supportive Culture: Creating a trauma-informed culture involves normalizing conversations about stress, burnout, mental health, and trauma. Leaders should encourage open discussions and provide platforms for employees to share their experiences and seek help without fear of stigma or judgment. Similarly to a weekly town hall or a recurring meeting for project updates, managers should consider regular check-ins and surveys to gauge employee well-being and gather feedback on trauma-informed practices. Flexibility in work arrangements and reasonable accommodations can also help employees manage their mental health more effectively, particularly in today’s hybrid landscape. 

Further information about fostering trauma-informed cultural change is described in an article I wrote with colleagues about leading organizations from burnout to trauma-informed resilience. 

Adopting a trauma-informed culture in the workplace is a significant step towards creating a supportive, inclusive, and productive work environment—but this is not achieved in one day; it is an ongoing, evolving process. Those who lead trauma-informed efforts should regularly seek feedback, assess the impact of their initiatives, and be willing to adapt and improve. By continuously refining their approach, organizations can ensure that the workplace remains a supportive, empathetic and resilient environment for all employees—their most valuable asset.

Looking to the Future of Trauma-Informed Care: Innovations and Trends

The concept of trauma-informed care is steadily evolving within the healthcare industry, ushering in a new era of understanding and support for trauma-exposed individuals. As we look towards the future, I’m encouraged to see innovations and trends in trauma-informed healthcare that will help shape the way professionals approach, diagnose, and treat (and possibly prevent) trauma-related conditions. In this blog, we'll explore some of these promising developments that are paving the way for more compassionate and effective approaches to trauma-related care. 

Innovations Driving Change 

1. Technology Integration: One of the most significant advancements in trauma-informed healthcare is the integration of technology to improve access to care and enhance treatment outcomes. Largely prompted by the onset of COVID-19, we’ve seen telehealth platforms, mobile applications, and virtual reality therapies more frequently leveraged, providing remote support and interventions for individuals who may face barriers to traditional, in-person care. 

2. Personalized Treatment Approaches: As our collective understanding of trauma deepens, there is a growing emphasis on personalized treatment tailored to individuals’ unique needs and experiences. Instead of focusing on one modality, mental health treatment plans reflect a keener understanding of the role of trauma in health and may involve a combination of evidence-based therapies, such as Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), neurofeedback, and mindfulness practices, each customized to address a person’s specific symptoms and goals. 

3. Interdisciplinary Collaboration: collaboration across disciplines is increasingly common when determining appropriate treatment(s). Integrating insights from psychology, neuroscience, social work, and other fields allows for a more holistic understanding of trauma’s health impacts and facilitates comprehensive care plans to address both the physical and psychological aspects of healing. For example, a patient may opt to seek traditional talk therapy to address emotional wounds while also incorporating somatic techniques to work through bodily manifestations of trauma. A primary care physician may now work alongside a psychotherapist or social worker within the same healthcare practice and collaborate on a patient’s treatment plan to ensure optimal care outcomes. These professionals may also work with the patient’s gastroenterology team to address trauma-related stress leading up to a colonoscopy, and so on.  

4. Community-Based Initiatives: Recognizing the role of social determinants of health (SDOH)1 in trauma onset and recovery, there is a growing emphasis on community-based initiatives that provide support beyond the clinical setting. This includes partnerships with community organizations, peer support networks, advocacy groups, and outreach programs aimed at addressing social disparities and structural issues such as poverty, racism, education, and access to resources. 

Emerging Trends to Watch 

1. Mental Health Awareness: the world is an increasingly complex place, and the past several years have challenged society in unprecedented ways—a pandemic, war and displacement, climate change, racial injustice, and political divides. Amidst the tumult and collective uncertainty is a recognition that much of mental “illness” is a natural response to stressful circumstances beyond the average person’s control. While trauma experts have long understood the impact of structural factors on mental health, society at large is now promoting mental health awareness and demanding changes that promote peace, human rights, and agency. 

2. Culturally-Competent Care: As healthcare providers strive to deliver more inclusive and culturally-sensitive care, there is a renewed recognition of the importance of cultural competence in trauma-informed practice. Understanding the cultural background, beliefs, daily practices, and values of individuals seeking care and adapting treatment approaches accordingly helps to ensure the treatment is both effective and respectful of their unique identities and experiences. This approach not only enhances therapeutic outcomes, but also promotes trust, collaboration, and mutual respect between clinicians and patients, ultimately contributing to more equitable and compassionate healthcare. 

3. Preventive and Early Intervention Strategies: While trauma-informed care traditionally focuses on addressing the effects of past trauma, there is a growing emphasis on preventive and early intervention strategies, aimed at reducing the risk of future trauma exposure and mitigating its impact. For example, we’ve seen an increase in trauma-informed approaches to parenting, education, school-based interventions, and community-specific resilience-building initiatives for youth. By equipping individuals, families, and communities with the necessary skills and resources to navigate adversity, trauma-informed preventive measures have the potential to break cycles of trauma and promote well-being long-term.

4. Trauma-Informed Workforce Development: Building a trauma-informed workplace environment is essential for ensuring that healthcare professionals (and employers in non-healthcare settings) have the knowledge, skills, and compassion needed to provide effective care and/or support. Training programs, continuing education initiatives, and organizational policies that prioritize trauma-informed principles are becoming increasingly prevalent across healthcare settings, as well as in various other industries and sectors. This proactive approach can not only enhance job satisfaction and retention among staff, but also foster a culture of wellness and resilience. 

5. Research and Development: The field of trauma-informed healthcare is continually evolving, thanks to ongoing research and development. From advances in neurobiology and genetics, to novel therapeutic modalities and treatment protocols, researchers and clinicians are continuously uncovering new insights and interventions that have the potential to transform the way we understand and respond to trauma. 

As we look into the future and promise of a trauma- and resilience-informed society, it is clear that innovation, collaboration, and a commitment to compassion will be the driving forces behind meaningful progress. By encouraging innovation, embracing emerging trends, and prioritizing the needs of individuals and communities affected by trauma, we can create transformative change on both individual and societal levels and make trauma-informed care accessible to all.

Trauma-Informed Approach to Physical Exams: Ensuring Patient Comfort and Trust

In healthcare settings, a trauma-informed approach isn't just a “nice-to-have,” it's an essential framework for providing effective and sensitive care to individuals who have experienced trauma. Having a trauma-informed medical visit, rather than a standard one,  can deeply influence a patient's experience and outcomes. This holds especially true during physical examinations, where any patient may feel vulnerable and exposed, and for trauma-exposed individuals, these feelings can be even more pronounced.

In April 2024, the U.S. Department of Health and Human Services (HHS) made a significant — and necessary — step in the right direction as it relates to patient privacy and protection, by announcing that hospitals are required to obtain written informed consent from patients before conducting sensitive examinations, such as pelvic, breast and prostate exams.1 This mandate is particularly emphasized when patients are scheduled to undergo these exams while under anesthesia. Though it begs the question, “Why wasn’t this a mandate before now?,” it underscores a long overdue recognition of the profound impact of personal and historical trauma on health, as well as the potential for medical encounters to be distressing, re-traumatizing, or even newly traumatizing. Most of all, it highlights the need for greater sensitivity and respect for patient autonomy.

Outside of mandates and other requirements, there are other ways that healthcare providers can create an atmosphere of safety and understanding that promotes trauma-informed care. Whether you’re a practitioner or a patient, below are some strategies that foster a supportive environment, specifically for physical exams:

1. Ensuring Clear, Two-Way Communication: In an effort to alleviate anxiety and build trust, clinicians should explain each step of the physical exam beforehand, including what they'll be doing and why it's necessary. This transparent approach should continue throughout the exam by checking-in with the patient to ensure their comfort and addressing any issues that arise. This includes taking note of non-verbal cues, such as body language or facial expressions that may indicate distress or discomfort. Keep in mind that communication goes both ways; providers must allow space for patients to express their concerns or ask questions from the onset and encourage open, ongoing communication.

2. Respecting Patient Autonomy: Help patients feel respected and in charge of their own healthcare journey by empowering them with choices and control over the exam process. Informed consent isn’t something we should obtain only for surgeries—it’s relevant for physical exams, too. Informed consent must be freely given and can be revoked at any time. When and where appropriate, practitioners can invite the patient to specify alternatives or preferences for the examination environment, such as inviting a support person or loved one to be present, adjusting the lighting, holding or inserting devices on their own (ex. speculum), listening to music or other distractions, and shifting body positioning. By taking the patient's feedback into account, clinicians show that they value their input and are committed to providing care that is tailored to their individual needs.

3. Trauma-Sensitivity Training: In a “perfect world,” all healthcare providers should receive regular training in trauma-informed care, especially given the widespread occurrence of traumatic life events in our global population. Knowing that this “perfect world” isn’t reality (at least, not yet), the onus is on organizations to start implementing training programs on trauma-informed care for their healthcare staff. This training should include education on the prevalence and impact of trauma, as well as strategies for creating a safe, supportive, and healing environment for both patients and employees. 

4. Trauma-Informed Language: In addition to standard communication techniques, such as limiting the amount of medical jargon used, being mindful of word choice during the exam is crucial to avoiding triggering or retraumatizing patients. This means using terms that are factual, descriptive and nonjudgmental, without adding unnecessary connotations. For instance, instead of asking patients to sit on the “bed” and place a “sheet” over their lap, which can frame the exam in an intimate manner, consider calling it an “exam table” with a “drape”. Rather than informing a patient that their body “looks great”, perhaps note that everything appears “healthy”. 

5. Follow-Up Support: Extending contact beyond the actual appointment time can speak volumes about a practitioner’s level of care and leave a lasting impression for patients. This could include providing information on local support groups, referrals to specialized practitioners, counseling services, or follow-up from a team member. Individuals who struggle with physical exams or procedures (ex. dissociation during a pelvic exam) may benefit from a follow-up phone call or clinic visit, whether by the examiner or an allied team member. By offering resources and support services to individuals who may benefit from additional assistance, healthcare professionals can demonstrate that they are invested in that person’s continued health. 

Ultimately, trauma-informed approaches to physical exams are not only about improving the patient experience in the moment, but also about supporting long-term healing and well-being. We all stand to benefit from collaborative healthcare settings. By prioritizing empathy, safety, and dignity, healthcare professionals can create environments where patients feel respected, empowered, and more likely to engage in their care.

Explaining the 6 Guiding Principles of Trauma-Informed Care

In all settings, but especially the healthcare industry, understanding and acknowledging the profound impact of trauma on individuals and communities is vital for a system’s flourishing. Trauma, whether experienced firsthand or indirectly, can leave lasting effects on a person's physical, emotional, and psychological well-being, and can lead to resistance in seeking care at all. When we hear that 70% of adults worldwide have reported experiencing some form of trauma, we are dealing with the vast majority, and must acknowledge and prioritize compassionate and effective support systems to address their needs.

So imagine for a moment if all healthcare professionals approached patient care in a similar way, acknowledging a person’s lived experience, without having to overtly call it out. Similar to visiting your favorite department store or restaurant or hotel chain, where you grow to naturally expect a certain standard of service from that provider, regardless of location. Or showing up to work feeling able to rely on your coworkers for support consistently, no matter what.

In an effort to provide a core framework that health organizations can adopt, the Substance Abuse and Mental Health Services Administration (SAMHSA) developed six guiding principles for trauma-informed care. The intention is for institutions to train their staff on this methodology and integrate it into their practices, ultimately creating more environments that are sensitive to the needs of trauma survivors and able to promote healing and recovery.

SAMHSA’s 6 Guiding Principles To A Trauma-Informed Approach

1. Safety: The first principle of trauma-informed care emphasizes the importance of ensuring physical and emotional safety for all individuals. This involves creating environments where people feel secure and protected from harm both in the physical sense — evaluating their journey from the parking lot, all the way through to the office — and emotional sense — through a warm and friendly environment with approachable staff.

2. Trustworthiness and Transparency: Building trust is essential in any therapeutic relationship, as prior betrayal or abuse can lead to struggle with feelings of mistrust. Practitioners must be transparent in their actions and communications, maintaining consistency and reliability. An example of this is explaining in advance, and in detail, a procedure or process, and allowing time for individuals to ask questions.

3. Peer Support: Peer support plays a vital role in trauma recovery, providing individuals with validation, empathy, and understanding from those who have shared similar experiences. Peer support groups offer a sense of belonging and community, reducing feelings of isolation and shame, and (where appropriate) can even be part of a trauma treatment plan.

4. Collaboration and Mutuality: Trauma-informed care emphasizes collaboration between practitioners and individuals receiving services, and can translate to collaboration in any professional environment. Rather than adopting a hierarchical approach, we should strive for mutual respect and partnership. By involving individuals in decision-making processes and respecting their autonomy, practitioners can empower survivors to reclaim control over their own choices by building customized plans that support their daily lives.

5. Empowerment, Voice, and Choice: Empowerment lies at the heart of trauma recovery, enabling individuals to regain a sense of agency and self-assurance. Trauma-informed care seeks to amplify survivors' voices and choices, honoring their preferences and values, and allowing them to feel seen and heard. Practitioners should seek to provide opportunities for individuals to make informed decisions about their experience, so that they remain at the center of their own healing journey.

6. Cultural, Historical, and Gender Issues: Recognizing the intersectionality of trauma is essential in providing culturally-competent care. Trauma-informed practitioners must consider the cultural, historical, and gender-specific factors that influence individuals' experiences of trauma and healing, including age, race, ability, sexual orientation and religion/beliefs, to name a few. By adopting the proper approach, practitioners can move past biases and tailor interactions to meet the diverse needs of individuals and communities.

Though founded by behavioral health organizations, implementing these principles doesn’t have to be limited to healthcare; they can be applied across various sectors and settings — including education, social services, and workplaces of all forms and sizes — to support individuals who have dealt with severe stress. Acknowledging that training and integrating these principles into action will take time and resources, it’s encouraging that a universal framework has been developed to reinforce the need for trauma- and resilience-informed communities. As organizations commit to this ethos and invest in ongoing education and structural changes, we will find ourselves closer to a workplace culture that prioritizes healing and well-being for all.