Addressing trauma is not a one-size fits all approach (Machodi, 2020). Trauma-informed practice seeks to ensure individuals and communities are empowered and informed about trauma and facilitated to be collaborators to formulate treatment. Judith Herman writes that trauma destroys the bond between the person and the community. The solidarity of the group, say Herman, provides the strongest protection ‘against terror and despair, and the strongest antidote to traumatic experience’ (p.214).
Van Der Kolk’s model for approaching developmental trauma focuses on young people, beginning with establishing a sense of safety and competence in which they can focus on pleasurable experiences without becoming dysregulated. This involves directing attention to activities that do not remind them of trauma and create a sense of mastery. The second step involves dealing with traumatic re-enactments in which children replay their trauma through fear, aggression, sexual acting out, lack of control, impulsivity and avoidance. This includes perceive helping adults as perpetrators that want to harm them. In this step, it is important to help children recognise and begin to change their responses to trauma. Finally, the third part paying attention to the body which emphasises the sense of mastery, feeling calm and in charge and focusing on goals. Children need to experience curiosity and safely explore their environment while developing confidence through play and physical games.
Trauma-informed practice or trauma-informed care is based on the fact that people who seek care have experienced trauma at least once. Providing trauma-informed care means linking past experience to present health and reframing behaviours and reactions as efforts to cope. It is about helping practitioners understand how trauma impacts throughout the lifespan and how this contributes to problems in functioning and how to reduce these reactions through best practices.
Five principles are essential when designing interventions and programmes for children, families and groups:
- Firstly, is the recognition that trauma is part of many disorders and challenges for people of all ages. This means there is a link between trauma and potential outcomes like addiction eating disorders, depression, anxiety etc.
- Secondly, there is an understanding that trauma is a mind-body experience that effects physiology and neurobiology as well as the mind. Symptoms and reactions are reframed not as pathology but adaptive coping that helped the person survive. Psychoeducation is central here.
- Another principle is that the person, family, community etc. is empowered to collaborate in treatment and the intervention fits with the culture and worldview. The person is a participant, not a patient. Choice, sharing of power and decision-making are essential.
- Finally, those effected are viewed not just as having the potential to survive but also to thrive and they are given hope about recovery.
Other important points in trauma-informed approaches include:
- Peer support and mutual self-help in trauma-informed approaches are seen as central to resilience-building and empowerment which plays a key role recovery.
- Strengths are validated and focused on rather than deficits. This, according to Sandra Bloom, creates resilient systems of care.
- Professionals should be knowledgeable about the types of traumatic experience and consider exposure to distress over the lifetime.
- Unresolved historical trauma needs to be addressed through healing processes that use cultural traditions to support reparation.
- When expressive arts are applied as group interventions, they support prosocial behaviour and connect the individual to the community.
- Expressive arts encourage mastery, therefore building resilience and strength with the goal of moving perception from victim to survivor to thriver.
- Trauma-informed practice, despite its benefits, can be limiting in that it still places on emphasis on what is wrong thus reinforcing the sense that symptoms can define us rather than strengths and capacities.
References
Malchiodi, C. A. (2020). Trauma and expressive arts therapy: Brain, body, and imagination in the healing process. Guilford Publications.