Trauma Informed Universal Precautions

Department of Health, Division of Behavioral Health Services

Key principles of a Trauma Informed Care (TIC) approach include organizational safety, trustworthiness, transparency, cultural sensitivity, collaboration and empowerment among and between staff and patients (SAMHSA, 2019). Adoption of TIC is an on-going process that requires full leadership support, commitment, extensive learning, supervision, accountability, and a change in attitude with several core beliefs and values. It is also important to be aware of current trauma related challenges, as we are adjusting to COVID-19 or other widespread crises. Leadership embraces a TIC culture, leads through example, provides training and unlimited support towards a successful implementation of five core areas:

1. Take into consideration the impact of pervasive crises (i.e. COVID-19)

2. Use therapeutic communication

3. No room for judgements

4. Create a healing environment

5. Practice self-care

Take into consideration the impact of pervasive crises

Crisis awareness: everyone is affected physically, emotionally, psychologically, cognitively, and/or financially in some way or another
All our stress levels are much higher and applying coping skills might feel more difficult
Our loss of normalcy comes with grieving and forces us to adjust
Adaptation should be individualized and not be rushed
Establishing a new level of safety is essential towards healing trauma and preventing retraumatization
Heightened emphasis needs to be placed on applying Universal Precautions during these traumatic times

Use therapeutic communication

Be aware of your body language and evaluate what it might be conveying
Inform the patient who you are and what you are going to be doing with them
Don’t be authoritarian in your communication instead convey a collaborative approach
Identify and support personal choice and personalize your reactions to the specific needs of the patient
Never yell or raise your voice when working with patients
Always practice compassionate listening and take in what patients communicate from their point of view

No room for judgements

Do not label a patient’s feeling or behaviors as pathological. It invalidates their emotions and experience
Assume that patients don’t feel safe which prompts their particular behavior
Assume that patients are coping the best way they know how and don’t take their behavior personally
Behavior is always functional and never manipulative or attention seeking
Do not blame or shame- patients are in the hospital because they need treatment, help and support
Identify patient strengths and help them to use and build on them

Create a healing environment

Promote and support each other (patients and staff) through daily positive and meaningful interactions
A patient’s diagnosis does not define a person or overshadow his or her life history/traumas
Do not ignore a patient or their needs, instead help find solutions
Support patient choice and control when possible
Avoid unpleasant/punitive interventions (e.g., seclusion, restraints, yelling)
Convey that healing and recovery is possible
Keep noise levels low

Practice self-care

Know your own traumas and triggers and how they might interfere with your working with patients
Know and understand your own traumatic reactions and how to minimize them in the work environment
Have a self-care plan and use it regularly
Utilize peer support and clinical supervision to address feelings regarding patient interactions
Assume staff have traumas and use TIC practices with those who you interact with
Utilize training and other resources leadership provides for effectively teaching and applying self-care

Trauma Informed Universal Precautions

Department of Health, Division of Behavioral Health Services

Trauma Informed Universal Precautions

1. Take into consideration the impact of pervasive crises (i.e. COVID-19)

2. Use therapeutic communication

3. No room for judgements

4. Create a healing environment

5. Practice self-care

Take into consideration the impact of pervasive crises

Crisis awareness: everyone is affected physically, emotionally, psychologically, cognitively, and/or financially in some way or another

All our stress levels are much higher and applying coping skills might feel more difficult

Our loss of normalcy comes with grieving and forces us to adjust

Adaptation should be individualized and not be rushed

Establishing a new level of safety is essential towards healing trauma and preventing retraumatization

Heightened emphasis needs to be placed on applying Universal Precautions during these traumatic times

Use therapeutic communication

Be aware of your body language and evaluate what it might be conveying

Inform the patient who you are and what you are going to be doing with them

Don’t be authoritarian in your communication instead convey a collaborative approach

Identify and support personal choice and personalize your reactions to the specific needs of the patient

Never yell or raise your voice when working with patients

Always practice compassionate listening and take in what patients communicate from their point of view

No room for judgements

Do not label a patient’s feeling or behaviors as pathological. It invalidates their emotions and experience

Assume that patients don’t feel safe which prompts their particular behavior

Assume that patients are coping the best way they know how and don’t take their behavior personally

Behavior is always functional and never manipulative or attention seeking

Do not blame or shame- patients are in the hospital because they need treatment, help and support

Identify patient strengths and help them to use and build on them

Create a healing environment

Promote and support each other (patients and staff) through daily positive and meaningful interactions

A patient’s diagnosis does not define a person or overshadow his or her life history/traumas

Do not ignore a patient or their needs, instead help find solutions

Support patient choice and control when possible

Avoid unpleasant/punitive interventions (e.g., seclusion, restraints, yelling)

Convey that healing and recovery is possible

Keep noise levels low

Practice self-care

Know your own traumas and triggers and how they might interfere with your working with patients

Know and understand your own traumatic reactions and how to minimize them in the work environment

Have a self-care plan and use it regularly

Utilize peer support and clinical supervision to address feelings regarding patient interactions

Assume staff have traumas and use TIC practices with those who you interact with

Utilize training and other resources leadership provides for effectively teaching and applying self-care