The Six Guiding Principles of Trauma-Informed Care

A principle-based approach to trauma-informed care is effective in promoting healing and chapter two explores the crucial aspects of each of The Six Guiding Principles of Trauma Informed Care as recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA). They consist of safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues. The discussion begins by describing the physical, social, and psychological aspects of safety. They include the location of the health facility, the atmosphere of the healthcare clinic, staff attitudes, ensuring that health professionals are kept emotionally safe, and avoiding re-traumatization. It is pointed out that people who have been intentionally harmed by others do not easily trust. Therefore, trust must be earned through compassionate connection, and by protecting a person’s privacy. Transparency is highly recommended and occurs when a person is fully informed about all aspects of the plan of care. Peer support is the help received from others who have lived through similar experiences and facilitates healing. Collaboration and mutuality are suggested to create a shared environment where there is an assumption that everyone, including the client/patient, will be involved in decision-making. Empowerment, voice, and choice when consistently applied foster an environment that utilizes a person’s strengths to help them overcome adversity, gives them an opportunity to be listened to, and to make their own choices. The power of empathy and other-focused listening, and the importance of addressing cultural, historical, and gender issues are emphasized. Poor health outcomes experienced by people of the LGBTQ2S community are highly correlated with stigma. Nurses are identified as harbouring prejudicial attitudes toward members of this population, and educational efforts are strongly suggested to change these behaviours. Cultural humility is recommended as an effective way to counteract racism and power difficulties through empowerment, excellence in care, and an atmosphere of mutual respect. Self-awareness and self-reflection are recommended to incorporate cultural humility into practice. Two Narrative Case Studies are reviewed. The first one emphasizes the importance of safely conducting a client assessment, and the second one explores how peer support helps a bereaved child. Participation in these four learning activities is advised, strategies that enhance the environmental safety of a healthcare facility; when breaching confidentiality is necessary; situations that promote or impede trust; and actively communicating other-focused listening. The Chapter ends with a self-care strategy that encourages nurses to participate in mindfulness techniques to enhance the overall well-being.

Keywords: Cultural sensitivity, Cultural awareness, Cultural safety, Cultural humility, Confidentiality, Collaboration, Choice, Empathy, Empowerment, Gender issues, Mutuality, Microaggressions, Mindfulness, Other-focused listening, Physical safety, Psychological safety, Peer support, Resisting retraumatization, Reflective journalling, Social safety, Safety, Self-awareness, Selfreflection, Strength-based approach, Secondary traumatic stress disorder (STS), Trustworthiness, Trauma-informed care, Transparency, Unconditional positive regard, Voice.