Bridging Past and Present: Strategies for Compassionate Trauma-Informed Care
January 2025
In January 2025, the Center for Health Communication Think Tank gathered to address one of the key challenges in trauma-informed care. The group focused on an important issue: while treatments are designed to help, they can sometimes unintentionally bring up painful memories. For some communities, their sense that they are being judged or discriminated against (a reflection of past experiences or even current realities) can cause them to drop out of care or not return/seek it in the first place. A person who was removed from their home, or had their child taken, might delay or fail to seek care out of fear of similar outcome. A person who has experienced sexual assault or abuse may have a difficult time during physical examinations and may in fact experience a typical and routine exam as another violation or instance of assault. These realities underscore the need to build trust and develop clear strategies for recognizing and gently tending to the unique needs of those impacted by trauma.
Background
Trauma-informed care recognizing that many patients carry the weight of past emotional or psychological trauma, which can affect their ability to trust healthcare providers. Even routine treatments can sometimes trigger painful memories, causing patients to become overwhelmed or mentally disconnect without obvious signs. This can make it challenging for care teams to detect when additional support is needed, potentially hindering effective treatment.
The core challenge in trauma-informed care is to provide necessary, life-sustaining treatment while avoiding inadvertent re-traumatization. Healthcare providers must balance clear, honest communication with a sensitive approach that respects the patient's emotional state. For example, a patient with a history of trauma may experience heightened anxiety during a standard procedure, leading to sudden withdrawal or distress. When this happens, the clinical team may struggle to pinpoint the cause, resulting in a disconnect between the care being provided and the patient's emotional needs.
This scenario highlights the delicate balance required in trauma-informed care - ensuring that patients are fully informed and involved in their care decisions without feeling overwhelmed. Such sensitive communication is vital not only for the immediate success of treatment but also for fostering long-term trust and emotional safety.
How can healthcare providers improve communication to better support patients who may experience trauma-triggered responses during care?
Takeaways | Recommendations | Implementation/Examples |
|---|---|---|
Opening the conversation with patients Some people make it easy to see that they are experiencing feelings related to psychological trauma and others do not | Take the approach of assuming that all people have assumed some sort of psychological trauma | "I understand that many people have gone through challenging times. If there's anything from your past that might make today's visit tougher, please let me know so we can adjust things to help you feel more at ease." |
Recognizing when patients are feeling disconnected or overwhelmed Not all distress is obvious - some patients might seem compliant while actually feeling disconnected or overwhelmed | Use open-ended questions and observe nonverbal cues to detect subtle signs of emotional distress | "How are you feeling? What questions do you have? What can I do to help put you at ease?" |
Encourage patient-led sharing Patients benefit from sharing details about their pasts only on their own terms. A patient-led conversation helps them express what they need without feeling forced to relive their trauma | Empower patients by asking how they prefer to receive and share information, ensuring that the pace is set by them Make sure that you are prepared for any and all revelations or details. Try not to appear uncomfortable, but rather gracious in the face of any disclosures | "What information would you like us to share with you, and how would you prefer we share it?" "Thank you so much for sharing that with me. I know it's not always easy, but the more I know, the better I can care for you." |
Explain each step clearly Clear, simple explanations reduce anxiety and help patients know what to expect during their care | Use plain language to walk patients through each step of their care process Offer them the choice to have a friend or loved one with them. Or let them know they can have another nurse or patient advocate present, if it would make them feel more comfortable | "I'm going to start with the first part of your exam now. Please let me know if you have any questions or need to take a break." |
What strategies can be employed to set clear expectations for care delivery while maintaining a trauma-sensitive approach?
Takeaways | Recommendations | Implementation/Examples |
|---|---|---|
Provider self-awareness Providers' own experiences and biases can influence patient interactions; self-awareness is essential for compassionate care | It's important for clinicians to be aware of past difficult experiences and how they might affect interactions with patients A diverse staff, including individuals with histories of incarceration, drug use, and low-income status, can help counter biases and support your efforts to develop and provide effective care strategies | Encourage clinicians to reflect on their own trauma and its impact on their practice |
Maintaining a calm and confident demeanor A calm, and confident presence from providers reassures patients and contributes to a secure care environment | Balance urgent care with reassuring, steady communication to keep patients informed and comfortable | "We have a supportive team here to ensure you receive the best care possible," pared with efforts to maintain composure even under time pressures |