Understanding Trauma and the Power of Trauma-Informed Care: A Comprehensive Guide

Trauma is a profound disruption in someone’s sense of safety, typically following exposure to events that are physically or emotionally harmful or life-threatening. While many associate trauma with dramatic or singular incidents, such as violence or disaster, its origins can be broad, encompassing adverse childhood experiences, ongoing neglect, systemic oppression, and even subtle daily stressors in healthcare encounters[1].

What Is Trauma?

Psychological trauma affects mental, emotional, and physical well-being. Nearly 90% of adults will experience or witness a traumatic event during their life, even healthcare settings can be sources of initial trauma or retrigger trauma responses for vulnerable patients[2]. In psychiatric inpatients, for example, over 30% reported lifetime exposure to interpersonal trauma, with higher rates among women and those exposed to parental substance abuse[3]. Older adults, too, experience trauma’s effects throughout their lifespan, influencing behaviors and well-being, especially when dealing with chronic or deteriorating health conditions[4].

Common types of trauma include:

• Acute trauma: Sudden, single events (e.g., accidents, assaults)

• Chronic trauma: Ongoing experiences (e.g., domestic violence, childhood abuse)

• Complex trauma: Exposure to varied and multiple harmful events, often interpersonal and prolonged

• Historical and cultural trauma: Collective harm experienced by groups across generations due to racism, colonization, or systemic inequalities[1].

The health effects of trauma are vast, spanning mental health conditions like PTSD, depression, and anxiety, as well as poor physical health outcomes, lower resilience, and even workplace challenges for healthcare professionals themselves[5].

What Is Trauma-Informed Care (TIC)?

Trauma-Informed Care is an evidence-based framework that seeks to create a safe, empathetic, and empowering environment for individuals affected by trauma. Instead of asking “What’s wrong with you?”, TIC encourages healthcare professionals to ask, “What happened to you?” This subtle but powerful shift forms the core of trauma-informed philosophy.

Six key principles guide TIC, as outlined by leading organizations and research:

1. Safety: Creating settings where patients and staff feel physically and emotionally secure.

2. Trustworthiness and Transparency: Building collaborative, honest communication.

3. Peer Support: Recognizing the healing value of shared experiences.

4. Collaboration: Emphasizing partnerships in care and shared decision-making.

5. Empowerment and Choice: Prioritizing individuals’ voices, autonomy, and strengths.

6. Cultural, Historical, and Gender Sensitivity: Considering the broader context and diversity of lived experiences[1], [2].

Why Trauma-Informed Care Matters in Healthcare

Healthcare environments can unfortunately be sources of retraumatization, especially when invasive procedures, insensitive interviewing, or lack of patient autonomy occur[2]. For instance, the simple act of a rushed or impersonal exam can feel deeply triggering for trauma survivors, impeding trust and care engagement.

Trauma-informed approaches recognize these risks and aim to minimize them. In maternity care, TIC can improve perinatal outcomes, strengthen provider-patient trust, and reduce the risk of adverse events for those with trauma histories[6]. In cancer care, especially gynecologic oncology, implementing TIC can greatly improve patient satisfaction and mental health while reducing the risk of retraumatization from frequent and invasive medical procedures[7].

Impact on Special Populations

• Older Adults: Up to 70% have experienced serious trauma, affecting their emotional responses and behaviors in hospital settings. TIC helps staff adapt care to address these needs, reducing aggression and distress[4].

• Pregnant Individuals: Many OB/GYN providers feel unprepared to address trauma history, yet TIC modules and role-plays can significantly boost clinician efficacy and patient outcomes[6].

• Healthcare Workers: Nurses and other professionals themselves frequently carry trauma histories, which can lead to burnout, lower organizational belonging, and compassion fatigue. Organizations benefit from supporting staff with TIC principles, improving both staff well-being and patient care[5].

Barriers and Implementation Strategies

Integrating trauma-informed care isn’t without challenges. Barriers include limited resources, leadership engagement, and resistance to change. Key facilitators for adoption include committed leadership, relevant and accessible training, flexible protocols, and ongoing feedback from both patients and staff[8].

Implementation is most successful when:

• Interdisciplinary teams are engaged in co-designing strategies[9].

• Education goes beyond principles and focuses on practical, real-life role-play and feedback[10].

• Policies reflect diversity, cultural sensitivity, and account for organizational culture shifts[11].

• Regular self-care and resilience-building opportunities are offered to staff[12].

Real-World Applications

Trauma-informed care is being steadily recognized and integrated into healthcare curricula, patient interactions, and organizational policies worldwide. Simulation programs, practical training, and reflective exercises in both acute and primary care settings demonstrate improved confidence, reduced burnout, and higher patient and staff satisfaction[9], [10], [13].

Research also shows that trauma-informed practices are particularly valuable in emergency medicine, mental health, maternity care, and when supporting marginalized communities that have experienced historical or structural trauma[14], [11], [15].

Become a Leader in Trauma-Informed Care

As trauma-informed care moves from theory to practice, there is an urgent need for skilled, compassionate leaders who can implement and champion TIC principles within healthcare and social service environments. You can be part of this transformative movement by becoming a Board Certified Trauma-Informed Practitioner.

Through certification offered by the Trauma Informed Care Institute, you gain access to comprehensive training that equips you to lead trauma-sensitive transformation in your organization.

This certification empowers you to:

• Enhance your understanding of trauma and its effects on diverse populations

• Develop concrete skills for implementing trauma-informed interventions

• Promote organizational culture shifts that support healing and resilience

• Advocate for patient and staff safety, trust, and empowerment

Taking this step not only elevates your professional expertise but contributes meaningfully to improving the experiences and outcomes of the individuals and communities you serve. Trauma-informed care is more than just a practice change, it is a compassionate commitment to recognizing trauma’s impact and fostering environments where healing is possible.

Visit https://www.traumainformedcareinstitute.com/traumainformedboardcertification to learn more about certification options and join a growing community of trauma-informed leaders dedicated to making care safer, more effective, and deeply humane.

Embrace the power of trauma-informed care to shift perspectives, transform healing, and inspire change. Become a certified practitioner and lead the way toward trauma-responsive systems that honor every person's story.

References:

1. C. Cunha, M. Gomes, "The Imperative of Trauma-Informed Care: A Comprehensive Review and Strategies for Implementation in Health Services," European psychiatry, 2024. https://doi.org/10.1192/j.eurpsy.2024.1699

2. K. Buttafuoco, D. K. Ragheb, M. Wallace, J. M. Connell, T. W. Crook, "Trauma informed care: A necessity for curricula," The Clinical Teacher, 2023. https://doi.org/10.1111/tct.13583

3. E. Gatov et al., "Epidemiology of Interpersonal Trauma among Women and Men Psychiatric Inpatients: A Population-Based Study," SAGE Publishing, 2019.

   https://doi.org/10.1177/0706743719861374https://doi.org/10.1192/j.eurpsy.2024.1699

4. L. Couzner et al., "Delivering Trauma-Informed Care in a Hospital Ward for Older Adults With Dementia: An Illustrative Case Series," Frontiers in Rehabilitation Sciences, 2022. https://doi.org/10.3389/fresc.2022.934099

5. L. Williamson et al., "Negative effects of adverse childhood experiences and absence of positive childhood experiences on healthcare employees: survey findings built on 10years of trauma-informed development," Frontiers in Public Health, 2025. https://doi.org/10.3389/fpubh.2024.1494587

6. N. R. Stevens, L. Holmgreen, S. E. Hobfoll, J. A. Cvengros, "Assessing Trauma History in Pregnant Patients: A Didactic Module and Role-Play for Obstetrics and Gynecology Residents," Association of American Medical Colleges, 2020. https://doi.org/10.15766/mep_2374-8265.10925

7. J. Fulton, H. Snyder, J. Chalif, K. Delwiche, L. M. Chambers, "Evidence and best practices for trauma-informed care in gynecologic oncology patients," International Journal of Gynecological Cancer, 2024. https://doi.org/10.1136/ijgc-2024-005300

8. Y. Huo, L. Couzner, T. D. Windsor, K. Laver, N. Dissanayaka, M. Cations, "Barriers and enablers for the implementation of trauma-informed care in healthcare settings: a systematic review," BioMed Central, 2023. https://doi.org/10.1186/s43058-023-00428-0

9. F. Vallires et al., "Co-developing, piloting, and evaluating a translational simulation (TS) delivery model for the promotion of psychological trauma-informed care (TIC) to improve service delivery within acute hospital settings: A Research Protocol," HRB Open Research, 2023. https://doi.org/10.12688/hrbopenres.13727.1

10. A. J. Kopstick et al., "Trauma-Informed Care as a Universal Precaution: A Brief, Case-Based, Educational Primer Featuring Role-Playing and Individual Self-Reflection Exercises," Journal of Continuing Education in the Health Professions, 2024. https://doi.org/10.1097/CEH.0000000000000552

11. N. Ranjbar, M. Erb, O. Mohammad, F. Moreno, "Trauma-Informed Care and Cultural Humility in the Mental Health Care of People From Minoritized Communities," None, 2019. https://doi.org/10.1176/appi.focus.20190027

12. M. L. Marsac et al., "An Initial Evaluation of the Impact of Trauma-Informed Care Training in Pediatrics," Clinical Practice in Pediatric Psychology, 2025. https://doi.org/10.1177/21694826251353756

13. Y. Stokes, J. D. Jacob, W. Gifford, J. E. Squires, A. Vandyk, "Exploring Nurses Knowledge and Experiences Related to Trauma-Informed Care," SAGE Publishing, 2016. https://doi.org/10.1177/2333393617734510

14. H. Ashworth, A. Lewis-OConnor, S. Grossman, T. Brown, S. Elisseou, H. M. Stoklosa, "Trauma-informed care (TIC) best practices for improving patient care in the emergency department," International Journal of Emergency Medicine, 2023. https://doi.org/10.1186/s12245-023-00509-https://doi.org/10.1177/2333393617734510\

15. R. Misra, A. Mishra, R. Reddy, D. Singh, "A Knowledge, Attitude, and Practice Study on Trauma-Informed Care Among Nurses Working in a Hospital in Lucknow District," Cureus, 2025. https://doi.org/10.7759/cureus.84652