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Using a Trauma-Informed Care Approach for Behavioral Health

News Release

Many people who face behavioral health issues also have a history of trauma. One can experience trauma in various ways, and trauma can affect an individual for years after a traumatic event occurs. One way that trauma can have an ongoing impact is by affecting a person's behavioral health.

A trauma-informed care approach takes into account the impact of trauma on each patient. The approach seeks to help patients avoid retraumatization, which refers to recalling and reliving a traumatic episode. Below, we discuss the relationship between trauma-informed care and behavioral health treatment. We first describe how patients experience trauma and how behavioral health treatments can have similarities to traumatic experiences. Next, we cover ways that trauma-informed care facilities can foster a trauma-informed culture and implement trauma-informed care best practices. We also detail how a person can access trauma-informed treatment for themself or a loved one.

Understanding trauma in the context of behavioral health treatment

Over the last two decades, the Substance Abuse and Mental Health Service Administration (SAMHSA) has researched the impact of trauma on patients. This research includes academic work, practice-generated learnings, and feedback from patients with a history of trauma. One useful tool for understanding trauma is via SAMHSA's "Three E's of Trauma" framework. When clinicians and staff at a behavioral health facility understand the Three E's of Trauma, they can better understand each patient's needs. The Three E's of Trauma framework includes:

  • Events - Trauma begins with a particular event. The event may include violence, emotional abuse, losing a loved one, or a natural disaster. Exposure to trauma can occur through one-off events or episodes that occur multiple times.
  • Experience - Next, clinicians must consider the patient's experience of each event, and it is important to note that each person processes trauma differently. The way a person experiences trauma depends heavily on his relationships and community at the time of the event.
  • Effects - Depending on how a patient experiences trauma, trauma can have different adverse effects. Ongoing effects of trauma can include the patient having difficulty forming trusting relationships and being unable to cope with stress. Trauma can also cause patients to have persistent anxiety or be in a constant state of vigilance when around other people.

In addition to understanding the timeline of trauma, it is important for clinicians to recognize how behavioral health treatment practices can have similarities to patients' traumatic experiences. Through SAMHSA's work, the organization has highlighted that parts of behavioral health treatment processes may cause patients to recall traumatic episodes. Those components of behavioral health treatment may include:

  • Invasive medical procedures
  • Moments of seclusion
  • Restraints
  • Disciplinary practices

Regarding patients who have been the victim of physical, sexual, or emotional trauma, one can understand how they may associate aspects of treatment with their past traumatic experiences. Depending on how a patient has processed his trauma, recalling trauma episodes may severely hinder the patient's progress on his behavioral health goals.

Key principles for implementing trauma-informed care

Trauma-informed care does not have a manual with set actions for each patient encounter. However, a trauma-informed approach is much more than behavioral health teams merely being aware of a patient's history. Trauma-informed care has several key principles that help clinicians and staff improve patient care in actionable ways. Those key principles include:

  • Safety - Behavioral health teams must make patients feel safe. Experiencing trauma almost always includes feeling unsafe, and feeling unsafe can lead to a person recalling his past trauma. Teams can make each person feel safe by ensuring privacy and allowing patients to have the support of friends and family during treatment.
  • Choice - Trauma often occurs in the context of a person not having a choice or control over his situation. When implementing a trauma-informed care approach, teams must ensure that each patient knows he has a choice regarding treatment. Patients must not only elect to enroll in a treatment program but also know that they can leave at any time.
  • Collaboration - Trauma often involves power differentials where one person has control over another individual. Behavioral health teams can remove similar power differentials in behavioral health treatment programs by involving patients at each step of planning and implementing treatment. A collaborative relationship can help motivate patients throughout a treatment program.
  • Trustworthiness - Many cases of trauma involve the abuse and breakdown of trust. Some people who have experienced trauma may have difficulty developing trusting relationships. Teams can foster a trustworthy environment by clearly communicating each step of the treatment process with each patient. For example, if a patient needs to undergo a physical exam, the physician must clearly explain the exam's purpose and steps.
  • Empowerment - Traumatic experiences can often lead to a person feeling helpless or unable to enact change. During behavioral health treatment programs, teams can work to identify and build on each patient's unique strengths. Building on each patient's strengths can help empower and encourage patients to reach their behavioral health goals.

A best practice is to apply the above principles of trauma-informed care to all patients, whether or not they have a history of trauma. Asking a patient to explain his history of trauma forces the patient to recall traumatic episodes, and that recall risks retraumatization. Additionally, experiences of trauma are quite common among patients who face behavioral health challenges. When teams apply trauma-informed care principles to all patients, they do not have to worry about retraumatization or failing to implement trauma-informed care practices to patients who need them.

Accessing trauma-informed care at Houston Behavioral Healthcare Hospital

Today, people who face behavioral health challenges and have a history of trauma can receive specialized treatment. Houston Behavioral Healthcare Hospital is an acute care psychiatric hospital, and we promote a culture of trauma-informed care in all that we do. Our clinical and non-clinical staff members receive trauma-informed care training, and our goal is to create a welcoming and supportive environment for all patients.

At Houston Behavioral Healthcare Hospital, we offer customizable treatment programs for a range of behavioral health needs. For adults, we offer both inpatient psychiatric services and outpatient treatment programs for adults. Our outpatient programs include partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). While IOPs have fewer treatment hours than PHPs, both outpatient programs allow adults to remain at home and keep up with family responsibilities during their treatment programs. In addition to our treatment programs for adults, we offer age-specific inpatient programs for adolescents.

Sometimes, people can turn to substance abuse as a result of experiencing trauma, and to help those individuals, we offer a dedicated chemical dependency treatment program. The program includes a 12-step component, a medical detox component, and family therapy sessions.

Get started at Houston Behavioral Healthcare Hospital

At Houston Behavioral Healthcare Hospital, we understand the impact that trauma can have on patients and their treatment programs. We believe that by being mindful of each patient's past, we can best help patients with recovery and best prepare them for the future.

To get started with a trauma-informed behavioral health program at our hospital, the first step is to schedule a free mental health assessment with our team. The assessment results help our team better understand the patient's unique needs and help us design a custom treatment program. To schedule a free mental health consultation for yourself or a loved one, you can contact our team 24/7 at (877) 489-4707.