Trauma-Informed Approaches

Recognition of the significance of psychological trauma and its impact on individuals, families, communities, and society at large has greatly expanded over the past 20 years, calling for the need to develop both trauma-sensitive and trauma-responsive healthcare services. Nurses, as direct care providers who practice within a holistic perspective, are positioned to play an integral role in the advancement of both trauma-informed care (TIC) and trauma-specific services (TSS). This chapter will provide an overview of the concept of trauma, as defined by three complex interrelated elements; the event, the experience, and the effects. Neurophysiological effects of unpredictable, severe, and/or prolonged stress as they relate to our stress-response systems and the ability to relate within the intrapersonal and interpersonal will be reviewed. The concepts of TIC, an approach based on principles that are sensitive to the needs of those with histories of trauma to be delivered universally to all that engage with the system, as well as TSS, services designed to treat trauma, will be explored within the implications for nursing practice. Issues raised in the current literature related to operationalizing and implementing TIC and TSS care will be presented and offer insights for future directions.