At Into The Light we offer a Trauma Informed Practice approach to our work with Survivors.
We thought you might like to know more about what Trauma Informed Practice actually means and as an approach to working with Survivors of Trauma and also as a Three Stage Process towards Trauma Recovery. Essentially Trauma-informed approaches encourage trained practitioners like counsellors to ask their clients, “What happened to you?” – not “What’s wrong with you?”.
We also offer training around Trauma Informed Practice for more information please see our Training On Trauma Informed Practice tab:
Six Principles Of A Trauma-Informed Approach
Trauma-informed practice refers to an approach which is grounded in the understanding that trauma exposure can impact an individual’s neurological, biological, psychological and social development. In 2022 NHS updated its working definition of trauma-informed practice, detailing six key principles to a trauma-informed approach.
Safety
The physical and emotional safety of clients is prioritised by:
- Service users knowing they are safe or requesting what they need in order to feel safe
- Ensuring adequate freedom from threat or harm
- The organisation making an effort to prevent re-traumatisation
- Putting robust policies and safeguarding practices in place
Trustworthiness
An organisation’s policies and procedures are both transparent and clearly communicated, with the intention of building trust among staff, service users and the surrounding community, by:
- the organisation explaining the measures it has taken and why
- the organisation and staff actioning what they have said they will do
- employing clear expectations and avoiding either the staff or the organisation overpromising and underdelivering
Choice
Service users are given sufficient choice and supported in shared decision-making goal setting to determine the infrastructure they need to heal by:
- ensuring service users and staff have a voice in the decision-making process of the organisation and its services
- listening to the needs of service users and staff
- clearly and transparently communicating choices
- acknowledging that those who have experienced or are experiencing trauma may feel a lack of safety or control which can cause difficulties in developing trusting relationships
Collaboration
Staff and service user experience is utilised to overcome challenges and improve the system as a whole by:
using peer support and mutual self-help
the organisation asking service users and staff what they need and working together to implement these changes where possible
focusing on working alongside and actively involving service users in the delivery of services
Empowerment
Efforts are made to share power and making service users and staff an integral part of decision-making, at both individual and organisational level by:
- validating concerns and feelings of staff and service users
- listening to what someone wants and/or needs
- supporting both staff and service users to make decisions and take action
- acknowledging that those who have experienced or are experiencing trauma may feel powerless to control what happens to them, isolated by their experiences and have feelings of low self-worth
Cultural consideration
Move past cultural stereotypes and biases based on, for example, gender, sexual orientation, age, religion, disability, geography, race or ethnicity by:
having access to gender responsive services
incorporating the healing value of traditional cultural connections
utilising policies, protocols and processes that are responsive to the needs of the individual served
(Source www.napac.org.uk/blog-what-are-the-six-key-principles-of-a-trauma-informed-approach)
The Phased Oriented Approach to Trauma Recovery
This model was first conceptualized by Judith Herman in 1992 and many therapists use this model to help people who have experienced sexual abuse and trauma.
There are Three Phases:
- Safety and Stabilisation
- Remembrance and Mourning and processing the past
- Reconnection or integration and meaning making
(Source “Trauma and Recovery: The Aftermath of Violence–From Domestic Abuse to Political Terror” Judith Herman Basic Books: First Published 1992)
This has now been adapted by other therapists including Christiane Sanderson who is an excellent resource for more detailed training on this model.
This approach ensures safety, identifies and cultivates resources, builds resilience, promotes self care, and a support network.
Stabilisation – psychoeducation, regulation of arousal, restore internal control,
mindfulness, grounding, affect regulation, window of tolerance ..
Processing of Trauma – realisation of the past, trauma experiences, split off feelings, recurring themes, mourning, develop a coherent narrative
Integration – restore meaning, integrate experiences, reconnection, post traumatic
Growth (Source Christiane Sanderson Trauma Informed Practice when Working with Complex PTSD April 2022)
Phase One: Safety and Stabilisation
People affected by trauma tend to feel unsafe in their bodies and in their relationships with others. For some this has always been their reality, so they are unaware they are living in a constant state of fear. It is important to regain a real sense of safety and stabilization before any processing of past memories can take place.
Stability Essentials Include:
- Access to the basics: somewhere stable to live, enough money for food, shelter
- Some support structures e.g. friendships and social structure
- Control over your memories and symptoms – the memories do not control you – you can calm yourself or stop a flashback
- Ability to manage life day to day for whatever is normal for you. For example looking after kids, going out to work
Basic Safety Includes:
- If you have been sexually abused – you are no longer in a close relationship or living with or near the abuser.
- If you are a victim of domestic violence you are no longer living with the abuser.
Regaining a sense of safety may take days to weeks with acutely traumatised individuals or months to years with individuals who have experienced ongoing/chronic abuse/ chronic trauma responses.
Figuring out what areas of life need to be stabilised and how that will be accomplished is helpful in moving toward recovery. The experience of emotional overwhelm is similar to that of a shaken bottle of coca-cola. Inside the bottle is a tremendous amount of pressure. The safest way to release the pressure is to open and close the cap in a slow, cautious and intentional manner so as to prevent an explosion. (Babette Rothschild, 2010) So, for example in the first phase the focus would be on support and psycho-education to gain tools to feel more emotionally regulated and restore inner control. This could include understanding triggers and flashbacks, receiving psycho-education on some of the key issues around abuse for example powerlessness and shame. Working on regulating emotions through breathing techniques and grounding. Looking at the window of tolerance.
Phase Two: Remembrance And Mourning
This task shifts to processing the trauma, putting words and emotions to it and making meaning of it. This process is usually undertaken with a counselor or therapist in group and/or individual therapy.
There are several issues to consider before starting to re-visit painful and traumatic memories:
- Do you want to revisit these memories
- When you pay attention to the past do you lose connection with present life:
- This means if you find you cannot live your daily life when you think about the past then consider putting memories aside until you are able to manage a better balance.
- Find things to occupy yourself and mind – eg hobbies etc because sometimes when you don’t have structure you are more vulnerable to past memories feeling overwhelmed.
During Phase Two it is necessary to be continuing to attend to safety and stability during this phase. Attending to safety allows us to move through this phase in a way that integrates the story of the trauma rather than reacts to it in a fight, flight or freeze response. Pacing and timing are crucial during this phase. If we become very quickly overwhelmed and emotionally flooded when talking about the trauma memories, safety and stability must be regained before moving further on with the story. This phase involves the important task of exploring and mourning the losses associated with the trauma. This will mean providing space to grieve and express emotions as we come to terms with what has been lost.
Phase Three: Reconnection And Integration
In this phase there must now be a creation a new sense of self and a new future. This is often neglected stage. People often get caught up in stabilising and examining memories but forget about integration. Integration should be woven into the whole recovery process. This way changes along the way can be integrated into daily life. Integration may mean talking to your friends or partner about the changes you are making. For example, if you have decided to stop drinking alcohol as you have found this has led to unhealthy behaviour patterns; you may like to think through how you can continue to socialise with your friends without it involving alcohol. It also may help to keep a log or diary to help you see changes in reactions. This can also be a time when you take time to assess your relationships and friendships and whether there are people in your life who can give you more support and care than perhaps you have been open to before.
Through this process, the trauma no longer is a defining and organising principle in someone’s life. The trauma becomes integrated into their life story but is not the only story that defines them.
Recovery is an individual process and will look different for everyone. Recovery is not defined by complete absence of thoughts or feelings about the traumatic experience but being able to live with it in a way that it isn’t in control of your life. It is important to gentle, patient and compassionate with yourself as you move through this healing process.
(Source www.trauma-recovery.ca/recovery/phases-of-trauma-recovery
Source: Eight Keys to Safe Trauma Recovery Babette Rothschild Published Norton 2010)