Trauma-informed & equitable care
Learning objectives
- Name SAMHSA's trauma-informed principles and give a unit example of each.
- Offer real choices and explain what will happen before it happens.
- Ask permission before touch and arrange an interpreter when one is needed.
- Notice bias in language, assumptions, and who gets heard.
- Avoid asking someone to retell a trauma story for staff curiosity.
Learn
This module follows SAMHSA Trauma-Informed Approaches. SAMHSA describes six principles: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice and choice; and cultural, historical, and gender issues.
On a unit, that looks like predictable routines, saying what you are about to do, offering two acceptable options instead of an order, and using a qualified interpreter rather than a family member when clinical information is shared. Peer support is a role, not a slogan: know how your facility involves peers. Equity work includes who is searched, who is believed, and whose language is treated as agitation.
Standards: Built on SAMHSA's trauma-informed approach: safety; trustworthiness and transparency; peer support; collaboration; empowerment, voice and choice; and cultural, historical and gender issues. Sources: SAMHSA Trauma-Informed Approaches.
Practice
Behavioral Skills Training:
- Instruct the six principles with one facility example each.
- Model an approach from the side, an introduction, and a choice.
- Rehearse rewriting a commanding script into one that explains and offers a choice, including a scene that needs an interpreter.
- Feedback on whether the choice was genuine and whether the person was talked about as if they were not there.
Simulate
Scenarios: a person who startles when staff approach from behind; a family meeting in which staff talk over the person; a request to repeat a trauma history that is already in the record. Debrief safety, choice, and what staff could have explained first.
Measure
| Skill | Observed? |
|---|---|
| Explains what will happen before doing it | ☐ |
| Offers at least one real choice | ☐ |
| Asks permission before touch | ☐ |
| Arranges a qualified interpreter when needed | ☐ |
| Does not require a trauma story to be retold for staff curiosity | ☐ |
| Names one assumption they checked | ☐ |
Set your own mastery threshold, for example all safety items plus most others. Reassess at one month.
Further reading
- SAMHSA, SAMHSA Trauma-Informed Approaches.