Trauma Informed Care

The science and information about trauma is growing rapidly[1]. Years of research has identified the dramatic impact that chronic trauma has on brain development and functioning, particularly in early childhood[2]. Trauma can impact not only our mental and physical health but it can also impact capacities as parents, friends, partners, and employees.

There are specific populations in which we know high rates of trauma exposure have occurred. These populations include those in the child welfare system, children and adults with mental illness, youth served in the juvenile justice system, homeless populations, domestic violence victims/survivors as well as adults in the criminal justice system.

Due to the high prevalence of trauma, especially in specific subpopulations along with the wide and diverse impact trauma exposure can have, more organizations and communities are becoming “trauma informed”. Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives[3]. This is a culture shift in which policies, practices and environments are viewed through the lens of trauma with a focus of doing no harm and building resilience. The core principles of trauma informed care include safety, trustworthiness, choice, collaboration and empowerment[3a].

Although we all hope that someday there will be no more child abuse, natural disasters, car accidents, or violent crime, that is not realistic. So how can we reduce the impact of being exposed to traumatic events or toxic stress? We know that trauma that occurs in early childhood can have the most disabling effect due to the vulnerable nature of the brain during this period. Infants and toddlers’ brains are particularly susceptible to their experiences both environmentally and through their relationships. Both positive and negative experiences shape the brain’s development. In the document Missouri’s Comprehensive Public Health Approach for Resilience to Mitigate the Impact of Trauma, a model shows the role communities, organizations, families and businesses can play in developing and supporting children with the resilience to face and overcome adversity. Everyone has a role and responsibility to support development of health communities, healthy families and healthy children.

The Department of Mental Health (DMH) offers support, training and consultation on trauma. Below are just a few of the many resources that now exist on trauma, including a document developed by DMH and its partner organizations which provides a roadmap and resources for becoming trauma informed.

1 "The Relationship of Adult Health Status to Childhood Abuse and Household Dysfunction", published in the American Journal of Preventive Medicine in 1998, Volume 14, pages 245–258

2 Understanding the Effects of Maltreatment on Brain Development, Child Welfare Information Gateway, Children’s Bureau, Issue Brief, April 2015.

3 Finkelhor, D., Ormrod, R.K., Turner, H.A., & Hamby, S.L. (2005). The victimization of children and youth: A comprehensive, national survey. Child Maltreatment, 10(1), 5-25. (CV73)

3a Creating Cultures of Trauma-Informed Care (CCTIC): A Self-Assessment and Planning Protocol
Roger D. Fallot, Ph.D. and Maxine Harris, Ph.D. Community Connections, July, 2009.