“Trauma-informed” describes a therapeutic approach acknowledging trauma’s prevalence and impact. Trauma informed therapy isn’t a specific technique but an orientation. Different from trauma-focused therapy.
Core principles
Trauma-informed care recognizes:
- Trauma is widespread (most adults experience some)
- Trauma significantly affects functioning
- Trauma reactions are normal responses to abnormal events
- Approach should empower rather than re-traumatize
- Safety, choice, collaboration central
Six key principles
SAMHSA framework:
- Safety (physical and emotional)
- Trustworthiness and transparency
- Peer support
- Collaboration and mutuality
- Empowerment, voice, choice
- Cultural, historical, gender awareness
Trauma-informed vs trauma-focused
Trauma-informed: General orientation. Any therapy can be trauma-informed.
Trauma-focused: Specifically targets trauma symptoms. Includes:
- EMDR
- Trauma-Focused CBT
- Prolonged Exposure
- Cognitive Processing Therapy
What to look for
Trauma-informed therapists:
- Ask about trauma history sensitively
- Don’t push too quickly
- Provide stabilization before processing
- Pace based on patient needs
- Provide safety information
- Avoid coercion or shame
- Recognize cultural factors
Stabilization first
Important concept: stability before deep trauma processing:
- Manage current crises
- Build coping skills
- Ensure adequate support
- Then deeper processing if appropriate
When trauma processing isn’t right
- Active substance use
- Active severe symptoms
- Inadequate support system
- Active dangerous relationships
- Severe dissociation needing skills first
These don’t preclude therapy but do affect approach.
Frequently Asked Questions
Is all therapy trauma-informed?
Should be but training varies. Worth verifying.
Do I need trauma-focused therapy?
Depends on symptoms and goals. Not all with trauma need trauma-focused work.
Can therapy retraumatize me?
Poorly done can. Trauma-informed approach minimizes risk.
How do I find trauma-informed therapist?
Ask about training and approach. Look for trauma specialty.
Is EMDR always trauma-focused?
Yes — specifically designed for trauma processing.
The bottom line on trauma-informed therapy
Important orientation in modern therapy. Different from trauma-focused techniques. Ask about therapist’s approach to trauma.