Trauma-informed care

Domain V · Systemic, relational, group & community · Harris, Fallot · 2001 · Washington DC

What it is

Trauma-informed care (TIC) is not a single therapy. It is an organisational and practice framework that any service (mental health, substance use, primary care, child welfare, justice, housing, schools) adopts so that everything it does takes account of how common trauma is and avoids repeating its…

Format

• TIC has no fixed session count or protocol. It runs on two levels at once.
• First contact and orientation (session 1): explain how the service works, what will happen and why, rights and choices; offer contact and naming preferences.

Who practises it, and how they are trained or regulated

• The CCTIC protocol is organised as Part A, service level (procedures and settings reviewed against each core value; formal service policies such as coercion, crisis and grievance; trauma screening, assessment and service planning) and Part B, system level (administrative support; staff training; human resources).
• Trauma-informed care (TIC) is not a single therapy. It is an organisational and practice framework that any service (mental health, substance use, primary care, child welfare, justice, housing, schools) adopts so that everything it does takes account of how common trauma is and avoids repeating its dynamics. SAMHSA and TIP 57 explicitly separate it from trauma-specific services (e.g. CPT, PE, EMDR, NET, Seeking…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Entries drifting into trauma detail; redirect.
• Complicated grief needing specialist referral.
• Drop-off at hand-over; a warm introduction helps.
• Logging that becomes rumination; keep entries brief.
• Numbing leading family and staff to underrate severity.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.