What is trauma-informed practice? How to best support survivors

‘I see the difference trauma-informed services make to the young people that I work with, some of the most vulnerable young people in Scotland, and I truly understand that because the professionals around them are thinking with a trauma-informed lens, they have trauma-informed practices, it really does make a difference to how they interact with other human beings […] I know first-hand what it can do.’ – Shumela Ahmed, Resilience Learning Partnership

Regular trips, appointments, conversations, and services take on a renewed significance and weight in the wake of traumatic experiences. Placing your trust in a stranger, being put into situations where you have limited control over your surroundings – such as being in a dentist’s chair, a doctor’s office, or a police station – can evoke more than just low-lying social anxiety for a survivor. The ability to relax in these situations is severely inhibited by post-traumatic flashbacks, as well as a defensive mistrust of others. Relinquishing control can be reminiscent of the traumatic event; normal situations feel threatening as survivors’ bodies and minds enter defence mode, even if there is no immediate danger. Without this context, survivors’ behaviour may seem “erratic”, “strange”, or “oversensitive”; people delivering these services often dismiss them outright, or even worse, callously probe deeper into their experiences without realising their own insensitivity. In reality, these are completely understandable reactions as survivors adjust to life after trauma. What seems like an overly defensive or sensitive reaction is in reality a physiological (as well as psychological) reaction by the survivor to try to ensure that they are not hurt in the same fashion again. ​ Unfortunately, survivors continue to be underrepresented in practice and policy when it comes to these routine services. The reason is simple: trauma-informed practice is yet to be implemented on a wide enough scale. But survivors need access to dentists, doctors, police, and emergency services just as much anyone else. Without sufficient support, it is easy for survivors to slip through the cracks and lose access to these vital services. Survivors sometimes even state that dealing with service providers can be just as traumatic as a past event, all due to a lack of understanding and sympathy. Where misunderstanding and miscommunication now take precedence, more needs to be done to give service providers the adequate context, information, and advice when delivering a service to a potential survivor. It is our aim at Thriving Survivors to open up the conversation about what it means for a service to carry out trauma-informed practices, and why it’s so vital.

What is trauma-informed practice, and why is it important? Shumela Ahmed, Education and Managing Director at the brilliant Resilience Learning Partnership, identifies five key principles to trauma-informed practice:

  1. Choice

  2. Collaboration

  3. Trust

  4. Empowerment

  5. Safety

She notes that an example of choice, for instance, would be giving service users the option for either male or female providers: especially (but not exclusively) important in relation to lived experiences of gender-based violence. Where choice has often been taken from survivors, it must be re-implemented in other areas of life. In turn, this builds an atmosphere of collaboration, helping survivors feel more in control and at ease. Collaboration also means making efforts to agree on a time and place together for the service, all the while being sensitive to the fact survivors may be evasive or late to appointments, or may even miss them entirely. It is important to understand this not as an act of rudeness or apathy but a consequence of anxiety. In order for the best communication possible, providers should allow and encourage survivors to be active participants in the service they are receiving. After their experiences, it is all the more important that they feel they are being respected and heard. Of course, this can take longer than simply imposing the service onto them, but it is precisely this time that is needed to build the next principle: trust. It may take survivors a while to fully trust service providers, especially if they have been let down by them in the past. This goes beyond one-to-one relationships; it is essential that survivors feel they can trust an organisation to meet their needs, and service providers need to ensure this. Trauma-informed practice is more than just an individual’s awareness and sensitivity; it must be built into the design of the organisation. This is why training and education are so key. ​ The aim is for survivors to feel empowered and safe. This is not because they are fragile and need sheltering, but because trauma provides to survivors a kind of knowledge about the world that most other people don’t have. As Resilience Learning Partnership notes on their website: ‘Lived experience refers to a representation of the experiences and choices of a given person, and the knowledge that they gain from these experiences and choices.’ Lived experience of trauma does not give survivors a skewed, mistrustful lens of the world that means they must be coaxed back into safety. Rather, their experience tells them that danger and abuse by trusted people is in fact possible. Trauma-informed practice is therefore not a call to cushion survivors from the world and patronise them, but to ensure they are supported and informed at every step of the way. Despite common misconceptions, survivors’ perspectives and actions are not irrational or warped. Lived experience is a powerful form of knowledge that must inform how providers shape their services. The alternative is letting people slip away from support systems who need and deserve care.

Where do we go from here? We hope we can be part of implementing trauma-informed practices so that survivors and non-survivors alike can live in a kinder, healthier society. If you are a service provider of any kind - be it medical care, police, receptionist, dentist, emergency operator, etc. – please do not hesitate to contact us about education and training. ​You can email us at info@thrivingsurvivors.co.uk or call us at either 0141 237 5776 or 07577632809. For more resources, you can visit https://resiliencelearningpartnership.co.uk/ as well. Your trauma-informed training could make a massive difference. Join us in reshaping these services for the better.

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