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Trauma Informed Care has been popularized in recent years as a central approach for helping patients in their trauma recovery. As we provide trauma therapy in Toronto, we are often providing education on what it means to be trauma-informed and how this approach can present in therapy. Many often are unclear about what this approach entails and how it represents a shift from more traditional treatment models. In this article, we outline what it means to provide trauma informed treatment, as well as answer the questions:
“What is trauma?”
“How is trauma informed care different from traditional treatment?” and
“How can trauma informed care help me heal?”
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a gold standard resource to guide clinicians in conceptualizing and diagnosing mental health difficulties. The DSM’s definition of trauma for the purpose of identifying post-traumatic psychological distress has been very specific to certain kinds of experiences. More specifically, its definition has focused on personal experiences of actual or threatened death, serious injury or sexual violence either through first hand or vicarious exposure. This narrow definition excludes a number of experiences that may also result in post-traumatic distress and this gap has been highlighted by a number of researchers and clinicians alike.
Gradus and Galea (2022) in their article, “Reconsidering the definition of trauma” have noted that there is a discrepancy between the definition of trauma in the DSM-5 and the experiences of the people with post-traumatic symptoms and related difficulties. They noted that the events “defined as traumatic do not capture all events reported by people who have post-traumatic psychological distress.”
According to a seminal document from the Substance Abuse and Mental Health Services Administration (SAMHSA) (2014) on trauma informed services in behavioural health systems, they noted that trauma is defined beyond physical harm and includes events or series of circumstances that are “emotionally harmful.” The International Classification of Disease 11 (ICD-11), which is an alternative classification system for mental disorders spearheaded by the World Health Organization, defines trauma more broadly as an “an extremely threatening or horrific event or series of events.” Theoretically, this definition allows for inclusion of a greater range of situations that can be viewed as “traumatic.”
The concept of trauma informed care seems to have arisen from several influential researchers, clinicians and findings from the 1990s. Specifically, the Adverse Childhood Experiences (ACE) study recognized the tangible physical and psychological impacts of adverse experiences in childhood and identified key risk factors for future morbidity. SAMHSA also influenced the conceptualization and particularly the popularization of trauma informed care as a treatment model. From the various influences on defining this concept, key areas of overlap emerged among these sources, which emphasized a more holistic and generalizable approach that expanded beyond the traditional medical model and was applicable to populations more broadly. This approach marked a shift from our traditional focus in understanding mental health which tended to focus on “what’s wrong with you?” to a more compassionate response centering curiosity which asked instead “what happened to you?”
In its current state, trauma informed care appears to be influenced by Maxine Harris and Roger Fallot’s five guiding principles, which included Safety, Trustworthiness, Choice, Collaboration and Empowerment. These are expanded on below.
Safety – Creating spaces that feel secure, confidential and thoughtful consideration of possible triggers that may retraumatize or otherwise adversely affect individuals. By creating a safe therapeutic space, it helps clients to feel secure enough to disclose and reach out for help.
Trustworthiness – Clearly outlining expectations and maintaining appropriate boundaries throughout a system that delivers car. Trust is achieved through consistency, clarity and interpersonal boundaries that aid in establishing rapport and maintaining a sound therapeutic relationship with a client.
Choice – Giving clients choices and control over treatment and restore autonomy should they have been disempowered or lost agency through traumatic and other adverse experiences. This approach sees the client as an active agency in their recovery.
Collaboration – An approach focusing on working with clients as partners in their healing. This approach can address the power differential that can occur in therapeutic relationships and work to see both client and clinician as a team to work together.
Empowerment – An emphasis on recognizing and mobilizing strengths and experiences of individuals. By affirming and validating client experiences, clients can work towards growth and assuming greater control and agency.
While different organizations and bodies may expand or somewhat alter these main principles, these core five guidelines can be seen as central principles influencing the conceptualization and approach of trauma informed care. These principles can be seen as ways to integrate concepts such as cultural humility, gender-affirming care and lived-experience into a treatment approach. As trauma-informed therapists in Toronto, we aim to provide services that are client-centered and trauma-informed, but recognize this is a continual process that requires ongoing reflection and review.
As noted traditional models of care, such as the medical model, emphasized the clinician as an authority figure, saw the client as a passive recipient and focused on identifying pathologies, particularly biological based explanations of illness to understand mental disorders. Trauma informed care aims to be more holistic in considering the physical, emotional, psychological, social, political factors that can influence one’s mental health as well as recognizing that an approach to care needs to be sufficiently generalizable so that it can be applied to a broad population. As noted in the guiding principles outlined above, emphasis on strengths, empowerment, safety and transparency are important ways that demonstrate a shift from traditional approaches to care.
When a clinician uses a trauma-informed approach to therapy, the client is centered. The strength of the therapeutic relationship is one of the biggest factors predictive of therapy success. When a client feels safe, empowered and has trust in the clinician and therapy, these can strengthen their therapeutic relationship with the clinician and thus, increase the likelihood of positive outcomes.
While more research is needed to review the specifics of Trauma Informed Care and its effectiveness and validity, some research has shown that training providers in TIC can help enhance their sense of competency and confidence, and such training appears associated with increases the use of trauma screening in vulnerable populations. These alone are benefits to using this approach and TIC is consistent with a client-centered approach, which has been known to be effective across problem types and populations.
At the Momenta Clinic, we pride ourselves on being at the forefront of offering trauma therapy for adults within Toronto. Our team strives to be the best trauma therapists in Toronto, specializing in trauma counseling therapy Toronto and are known as leading trauma informed practitioners in Toronto. We provide trauma informed care for adults, adolescents and children and work with diverse culture, gender identities and backgrounds. We understand the significance of a supportive and empowering therapeutic environment in facilitating trauma recovery.
Our trauma counselors in Toronto, Brampton and online counselors in Ontario are dedicated to providing personalized trauma therapy sessions Toronto, tailored to meet the unique recovery needs of our clients. Whether you are seeking support for the first time or looking to continue your journey of trauma healing, the Momenta Clinic offers a compassionate, understanding, and professional setting to explore trauma therapy in Toronto. We invite you to take the first step towards healing and empowerment. Contact us today to book a session with one of our trauma informed therapists and begin your journey towards recovery and wholeness.
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