To be trauma-informed means to have the foresight and ability to look beyond an individual’s presenting problem/concern or any behavioral symptoms an individual may be expressing in the therapy space. “When a non-trauma-informed approach is employed, the focus is on the survivor’s presenting symptoms rather than on understating the context within which those symptoms develop” (Clark & Classen, 2014, p. 282). To be trauma-informed means that, as therapists, we are constantly creating an environment that ensures safety, stability, appropriate boundaries, and empowerment. The therapeutic relationship is the most important aspect in the beginning stages of an individual’s healing process. Briere and Scott highlight three key principles of effective trauma-focused therapy which include providing and ensuring safety, providing and ensuring stability, and maintaining a positive and consistent therapeutic relationship all while making sure that we are tailoring the therapy to the client (Briere & Scott, 2015). No matter what therapeutic approach you decide to utilize with a client, the base foundation that which therapy is built on and determines the overall success of therapy is based on the therapeutic relationship. “In fact, a number of studies indicate that therapeutic outcome is best predicted by the quality of the treatment relationship, as opposed to the specific techniques used. Although some therapeutic approaches stress relationship dynamics more than others, it is probably true that all forms of trauma therapy work better if the clinician is compassionate and attuned, and the client feels accepted, liked, and taken seriously” (Briere & Scott, 2015, p. 108).
A key aspect of trauma-informed therapy that can impact the client’s relationships with others, including the therapist, is attachment. “Core beliefs about oneself and the world are formed out of early experiences with attachment figures. When these early experiences are characterized by abuse or neglect, an individual may develop cognitive distortions out an attempt to make sense of the abuse” (Clark & Classen, 2014, p. 613). There appear to be five areas of beliefs that are more prone to disruption due to trauma and can have negative impacts on the therapy space/within the therapeutic relationship if not acknowledged and appropriately addressed. Those five areas are; Safety, Trust/Dependency, Esteem, Intimacy/Connection, and Power/Control. When these five areas are appropriately implemented in the therapy space, only then will the client be in a space to begin to heal and process.
- Safety: “Those individuals who feel safe within themselves and their world will believe that the world is generally safe, that they are safe, and that they are able to protect themselves” (Clark & Classen, 2014, p. 613).
- Trust/Dependency: “Those who are able to trust and allow themselves to depend on others when they need to will believe that other people are worthy of trust and others are able to meet their needs” (Clark & Classen, 2014, p. 613).
- Esteem: “Those individuals who have good self-esteem believe that they are valued and have inherent worth and that this is also true of others” (Clark & Classen, 2014, p. 623).
- Intimacy/Connection: “Individuals who have the capacity for intimacy and connection believe that they belong and are connected to others” (Clark & Classen, 2014, p. 623).
- Power/Control: “Individuals who possess a sense of having power and control in the world believe that they have some measure of power and control over themselves and their environment and are comfortable with it” (Clark & Classen, 2014, p. 632).
In trauma-informed care, the therapeutic relationship is the most important aspect of and indicator for successful therapy treatment and healing. The disrupted attachment beliefs that individuals come into therapy with, need to be acknowledged and addressed. As therapists, we need to create an environment that redefines those disrupted attachment beliefs so that the individual regains that sense of safety, trust/dependency, esteem, intimacy/connection, and most importantly, power and control.
References
Briere, J. & Scott, C. (2015). Principles of trauma therapy: A guide to symptoms, evaluation and treatment (2nd ed). Thousand Oaks, CA: Sage Publications.
Clark, C., Classen, C.C., Fourt, A., & Shetty, M. (2014). Treating the trauma survivor: An essential guide to trauma-informed care. New York, NY: Routledge
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