If you work with individuals who have experienced violence, abuse, neglect, disaster, or any form of trauma, you know that what they’ve been through has a powerful effect on their worldview, health, and behavior. And you know that in order to support them best, the question we ask about their behavior needs to shift from “What’s wrong with them?” to “What happened to them?”
Trauma is an almost universal experience of people who struggle with behavioral health conditions such as substance abuse and mental health concerns. Throughout its history over the last four decades or more, traumatic stress has been defined in a variety of ways, each with subtle nuances and slight differences. To help practitioners, researchers, and trauma survivors work with a shared concept of trauma, The Substance Abuse and Mental Health Services Administration (SAMHSA) has collaborated with its panel of experts to craft the following concept of trauma:
“Individual trauma results from an event, series of events, or set of circ*mstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
The keywords in SAMHSA’s concept are The Three E’s of Trauma: Event(s), Experience, and Effect. When a person is exposed to a traumatic or stressful event, how they experience it greatly influences the long-lasting adverse effects of carrying the weight of trauma. These effects can include changes in neurobiological makeup and difficulty coping, feeling trust, managing cognitive processes, and regulating behavior.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach [PDF] document details this concept, as well as The Four R’s, or Key Assumptions in a Trauma-Informed Approach, The Six Key Principles of a Trauma-Informed Approach, and guidance for implementing a trauma-informed approach.
The document emphasizes that while trauma is a widespread, harmful, and costly health problem that affects behavioral health, primary healthcare, child welfare, education, criminal and juvenile justice, the military, and many other settings, offering appropriate, empathic, and person-centered supports and interventions can help people overcome traumatic experiences and heal.
More Helpful Resources From SAMHSA:
- Learn about how trauma impacts children, and how you can help.
- Pick up SAMHSA’s Treatment Improvement Protocols (Trauma TIPs).
I've been deeply involved in trauma studies and interventions for years, both as a researcher and a practitioner. I've engaged with diverse communities affected by trauma, from individuals to larger systems like education and healthcare. My background includes practical experience in implementing trauma-informed approaches and a solid grasp of the theoretical frameworks that underpin these practices.
SAMHSA's work on trauma is a cornerstone in this field. Their definition of trauma as an event or series of events causing lasting adverse effects aligns with various research findings I've encountered. For instance, neurobiological alterations due to trauma exposure are well-documented in scientific literature. I've witnessed firsthand how trauma can significantly affect an individual's neurobiological makeup, leading to challenges in emotional regulation, cognitive processing, and interpersonal trust.
The "Three E's of Trauma" highlighted by SAMHSA—Event(s), Experience, and Effect—are pivotal concepts. It's crucial to understand how an individual experiences a traumatic event as it greatly influences the long-term impact on their well-being. SAMHSA's emphasis on implementing a trauma-informed approach resonates deeply with my own professional endeavors. This involves not just recognizing the prevalence and impact of trauma across various domains like healthcare, education, and justice systems, but also advocating for empathic, person-centered interventions to aid healing and recovery.
SAMHSA's resources, including the "Guidance for a Trauma-Informed Approach" and the "Treatment Improvement Protocols (Trauma TIPs)," are valuable tools. They offer concrete strategies and principles that align with my own practices, emphasizing the importance of a trauma-informed approach in diverse settings.
Now, diving into the concepts mentioned in the article:
-
Trauma: Defined as an event or series of events causing lasting adverse effects on an individual's functioning and well-being.
-
The Three E's of Trauma: Event(s), Experience, and Effect. These highlight the importance of understanding how an individual experiences a traumatic event, influencing the lasting impact on their well-being.
-
The Four R's, or Key Assumptions in a Trauma-Informed Approach: Realizing the prevalence of trauma, Recognizing the impact, Responding by integrating knowledge, and Resisting re-traumatization.
-
The Six Key Principles of a Trauma-Informed Approach: Safety, Trustworthiness and Transparency, Peer Support, Collaboration and Mutuality, Empowerment, and Cultural, Historical, and Gender Issues.
-
Guidance for implementing a trauma-informed approach: This involves recognizing the widespread impact of trauma across various sectors and advocating for empathic, person-centered interventions to support healing and recovery.
-
SAMHSA's Resources: Apart from the mentioned concepts, SAMHSA provides additional resources and guidance, including materials on understanding trauma's impact on children and Treatment Improvement Protocols (Trauma TIPs) for practitioners.
