Improving Behavioral Health with Trauma-Informed Care

Trauma can impact anyone, and often, a person experiences the effects of trauma for years after the event occurs. Ongoing symptoms of trauma can include a general lack of trust with others, trouble forming relationships, and aversion to particular places or interactions that make the person recall the traumatic episode. Trauma can also impact a person's behavioral health and ability to receive treatment for behavioral health issues.

In this article, we focus on the relationship between trauma-informed care and behavioral health. We define trauma-informed care, and we discuss the importance of a trauma-informed care approach in behavioral health treatment programs. We also detail how behavioral health hospitals can implement trauma-informed care and establish a trauma-informed care culture throughout their facilities.

What is trauma-informed care, and why is it important?

With a trauma-informed care approach, clinicians recognize the impact of trauma and work to avoid instances of retraumatization. Retraumatization occurs when an individual recalls past trauma and re-experiences the painful feelings associated with that trauma. When a person experiences retraumatization, he may become anxious, distracted, and unable to continue with the task at hand.

Trauma-informed care is important for behavioral health treatment for multiple reasons. First, when a person experiences retraumatization, he often becomes unable and unwilling to continue treatment. In some cases, the retraumatized person may stop treatment altogether, and his behavioral health condition may worsen as a result. Accordingly, a trauma-informed care approach helps ensure that patients with a history of trauma can achieve their behavioral health goals.

A second reason trauma-informed care is important for behavioral health is that some components of treatment may be particularly reminiscent of traumatic episodes. Without trauma-informed care and clinicians being sensitive to those similarities, patients may be at risk of retraumatization. Components of behavioral health treatments that may be reminiscent of trauma include:

• Periods of seclusion
• Invasive clinical procedures
• Disciplinary practices
• Use of restraints

Lastly, trauma-informed health care is important because experiencing trauma is, unfortunately, quite common. Often, people do not discuss or share their traumatic experiences due to the stigma surrounding the issue. Since experiences of trauma are quite common, many patients are at risk of facing retraumatization and its harmful effects on treatment progress. Findings on the prevalence of trauma compiled by the CDC include:

• About one in five women and one in 71 men are victims of trauma from rape.
• About one in four children experiences trauma from physical, sexual, or emotional abuse.
• About one in four women is a victim of trauma from domestic abuse.

Additionally, trauma can occur from sources other than physical, sexual, and emotional abuse. People can experience trauma from the sudden loss of a loved one or a near-death experience from illness or injury. People can also experience trauma from the stress of natural disasters or the realities of historical trauma surrounding race.

Ways that behavioral health hospitals implement trauma-informed care

Behavioral health treatment hospitals can take actionable steps to implement trauma-informed care. Each step helps patients avoid retraumatization and continue making progress on their behavioral health treatment plans. Ways that behavioral health hospitals implement trauma-informed care include:

• Allowing a patient's trusted family member or friend to be present during treatment sessions. In some cases, a patient may feel uncomfortable being alone with a stranger, and having a loved one closeby can provide the comfort and sense of safety that the patient needs.
• Explaining the reasons and needs behind each step of an exam. This step is particularly relevant to exams involving the patient's sexual health and exams that require the patient to disrobe. In many cases of trauma, a person experiences a violation of trust, and explaining each step of the treatment process to a patient may help build trust between the patient and clinician.
• Regularly asking the patient if there is anything he needs or anything the facility can do to make his stay more comfortable. Trauma often involves power-imbalances, and patients who have been victims of trauma may struggle with speaking up for themselves and self-advocacy. Actively working to improve the patient's experience can help ensure the patient feels safe and welcomed throughout the treatment process.

The above steps are just a few ways that behavioral health hospitals can combine a trauma-informed approach with their existing treatment methods. When a patient avoids retraumatization and feels safe during his treatment program, the patient has the best chance of achieving his behavioral health goals.

Guiding principles for trauma-informed care

A trauma-informed care approach includes more than a set of predetermined actions and protocols for each patient-clinician interaction. A trauma-informed care approach is a guiding philosophy towards treatment that extends to all aspects of patient care. To implement trauma-informed care best practices throughout an organization, behavioral health hospitals can follow five guiding principles of trauma-informed care. The five guiding principles of trauma-informed care include:

• Safety - Behavioral health hospitals must ensure both the physical and emotional safety of each patient. A lack of safety is a common characteristic of traumatic experiences, and maintaining patient safety during treatment programs is key to avoiding retraumatization.
• Choice - Clinicians and staff must ensure that patients know they have a choice when it comes to behavioral health treatment. During an episode of trauma, a person typically does not have a choice or control over the situation's outcome. Ensuring that a patient knows they have options during treatment is important for avoiding retraumatization.
• Collaboration - Traumatic experiences often involve power-imbalances between an abuser and a victim. When practicing trauma-informed care, clinicians can include patients in the treatment planning and review process to build a collaborative relationship and avoid retraumatization.
• Trustworthiness - Many cases of trauma involve a violation and breakdown of trust. To avoid retraumatization, clinicians must foster a relationship of trust with each patient. One method for building trust is by setting clear roles and expectations for each person and keeping the relationship defined within strict interpersonal boundaries.
• Empowerment - When people experience trauma, they may be stripped of their agency and feel unable to enact change. To avoid retraumatization, clinicians can build and encourage patients' strengths, thereby empowering patients to take control of their behavioral health.

It is important to highlight that both clinical and non-clinical staff at behavioral health treatment facilities can use the above guiding principles. A trauma-informed care approach is most effective at ensuring optimal treatment outcomes when it becomes part of an organization's culture.

How Las Encinas Hospital Can Help

Las Encinas Hospital is a behavioral health hospital serving Pasadena, CA, and the surrounding communities. We are sensitive to the impact of trauma on each patient, and our team implements trauma-informed care at each step of the patient journey. At our behavioral health hospital, we implement a trauma-informed care approach across our inpatient behavioral health programs and outpatient treatment programs.

To get started with a trauma-informed treatment program at Las Encinas Hospital, your first step is to contact our team. You can call our team any time at (877) 579-8140, and a member of our staff can help answer any questions you may have. We can also help schedule you or a loved one for a free mental health assessment. The mental health assessment will help our team better understand the individual's behavioral health needs, and with the mental health assessment results, we can start building a personalized treatment program.