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.