Trauma-Informed Care: Why Health Care Practitioners Can't Afford to Ignore It

I recently had a client share with me that she was shamed while working with another Pelvic Health Physiotherapist. When we think of a healthcare visit, we imagine a safe space where we can be vulnerable and receive compassionate care. Unfortunately, this isn't always the case. For many patients, particularly those with a history of trauma, a simple medical appointment can be a minefield of triggers, leading to feelings of shame and blame that can severely impact their health. That’s why trauma-informed care isn't just a buzzword; it's an essential approach that every healthcare practitioner needs to adopt.

Trauma-informed care is a framework that recognizes the widespread impact of trauma and understands potential paths for recovery. It integrates knowledge about trauma into policies, procedures, and practices, and actively resists re-traumatization. It shifts the question from “What’s wrong with you?” to “Are you willing to share that something happened to you?” I often discourage sharing details because repeating the story can be traumatizing in itself. This subtle but profound change in perspective can make all the difference in a patient's experience.

The Consequences of Shame and Blame

When a healthcare provider lacks a trauma-informed perspective, they may unintentionally inflict shame and blame on a patient. This can happen in many ways:

● Dismissing symptoms: A provider might attribute a patient's physical symptoms to anxiety or stress without exploring a potential underlying medical cause, especially if the patient seems emotionally distressed. This invalidates the patient's experience and can lead to a misdiagnosis or a delay in treatment.

● Judging lifestyle choices: A provider might make judgmental comments about a patient's weight, diet, or substance use without considering the role that past trauma may have played in these behaviors. For example, a patient with a history of abuse may use food or substances as a coping mechanism.

● Using a confrontational tone: A provider might use a harsh or accusatory tone when discussing a patient's medical history or adherence to a treatment plan. This can trigger a fear-based response in a patient with a history of trauma, causing them to shut down or become defensive.

These actions can have serious consequences. When a patient feels shamed or blamed, they are less likely to be open and honest about their health concerns. They may avoid future appointments, skip necessary screenings, and disengage from their own care. This can lead to a breakdown in trust, poor health outcomes, and a cycle of avoidance that perpetuates their health issues.

ImplementingTrauma-Informed Care

Adopting a trauma-informed approach is about being a more compassionate and effective practitioner. Here's how to do that and what a client should expect to see and feel:

Create a safe environment: This begins with the physical space. Ensure waiting rooms are calm and private. During an appointment, speak in a gentle, non-judgmental tone.

● Emphasize patient autonomy: Give patients choices whenever possible. Instead of saying, “You need to get a medical test,” you can say, “We can do a test now, or we can schedule it for another day—whichever you're more comfortable with.” This empowers the patient and gives them a sense of control.

● Explain procedures clearly: Many medical procedures, especially those that involve physical touch, can be triggering for trauma survivors. Always explain what you're doing and why, and ask for consent before touching the patient.

● Practice active listening: Listen to the patient's story without interrupting or making assumptions. Acknowledge their feelings and validate their experiences. Saying something like, “That sounds like it’s been really difficult for you,” can build rapport and trust.

By integrating these practices, healthcare providers can create an environment where patients feel safe, respected, and empowered. This not only improves the patient's experience but also leads to better health outcomes and a more effective healthcare system for everyone. We strive to meet these expectations and show care and compassion here at ATP! We are committed to continuing to grow and learn to make sure we integrate these principles into our practice.