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.