Trauma-Informed Environment
Trauma informed environments are designed to promote safety and healing, and to prevent re-traumatization via interactions within the treatment setting. Trauma informed systems should provide:
- Safety – physical and emotional
- Sense of trust – clear tasks, appropriate boundaries
- Choice – allowing clients to choose, and to have some control
- Collaboration – sharing power with clients
- Empowerment – and skill building as goals
Within a trauma-informed system, “symptoms” are looked at not as pathology but rather as efforts to cope and survive.
Trauma-informed systems understand that the treatment environment can contribute both to symptoms as well as to solutions.
Staffing
One of the most important components of a trauma-informed environment is staffing. All program staff should be provided with initial training and booster sessions in trauma issues. Staff should be encouraged to examine their own practices to assess whether they support a trauma-informed environment, or work against it, and make changes accordingly. For example, if room searches in a residential program are conducted without warning and even when a woman is not present, a policy may need to be created that provides adequate and appropriate advance notice. Or if staff typically have bunches of keys on a lanyard that they swing around, this may be traumatic to women who have been incarcerated or who have spent time in psychiatric in-patient settings. Other options may have to be considered.
It is impossible for clinical staff to truely support a trauma-informed environment if senior management is not part of the training process, and if clinicians are not involved with developing appropriate policies and procedures. Trauma-informed environments require top down and bottom up involvement.
Physical Environment
Some simple sensory enhancements that support a trauma-informed environment include:
- Art work
- Plants
- Fish tanks
- Music
- Comfortable seating
- Rocking chairs or gliders
- Bedrooms w/ new bedspreads
- Pace to exercise
- Curtains
Trauma Triggers
A trauma-informed setting recognizes and removes or modifies trauma triggers from the environment. Trauma triggers are individual: what is a trigger for one person may not be for another. But there are some common triggers for adults with co-occurring trauma and substance abuse, especially women, including:
- Bedtime
- Room checks
- Large men
- Yelling or loud noises
- People being too close
- Not being listened to
- Lack of privacy
- Darkness
- Being teased or picked on
- Feeling pressured
- Arguments
- Being isolated
- Not having control
- Being stared at
Early Warning Signs
Another important element of a trauma-informed system is an effort to recognize early warning signs that a client may be distressed and be headed for a crisis. Some warning signs are not easily observable, but many are, such as restlessness and agitation, pacing, crying, or rocking.
Once triggers and warning signs of impending crisis have been identified, the next step is identifying strategies for calming and minimizing stress to de-escalate the situation. Click here to learn more about de-escalation strategies.
