Building a Trauma-Informed Practice: Steps for Aspiring Therapists
Creating a trauma-informed practice is essential for providing effective and compassionate care to clients who have experienced trauma. Developing the tools, strategies, and ways of being with clients has been a cornerstone of my practice and development. Here, I try to put together some basic ideas as a roadmap for new therapists to build a trauma-informed practice, including key skills and knowledge areas to focus on.
1. Understanding Trauma and Its Impact
To create a trauma-informed practice, you need a solid understanding of trauma and its effects. Educate yourself on the different types of trauma, including acute, chronic, and complex trauma, and their impact on mental and physical health. This foundational knowledge will guide your therapeutic approach. Remember that trauma, in reality, can have a broader scope than the DSM definition of a “traumatic event.” When I am engaging in reprocessing work with clients, it often happens that the event that looked small on paper is the one that is harder to work through.
Pro Tip: Regularly train and educate to stay updated on trauma research and best practices. For example, Bessel van der Kolk’s work highlights that no single treatment will likely work alone, and no combination will be the same for every patient (Van der Kolk, 2014). This understanding underscores the importance of a flexible, individualized approach in trauma treatment. This thinking has driven me to continue developing my skill sets and seeking new ways to help others heal.
2. Creating a Safe Therapeutic Environment
Safety is the cornerstone of trauma-informed care. Ensure that your office space, whether physical or virtual, is welcoming and comfortable. Establish clear boundaries and consistent practices to help clients feel secure.
Pro Tip: If you’re conducting telehealth sessions, it’s crucial to help clients create a safe and supportive environment on their end. Virtual sessions can still foster a sense of safety—think of it as creating a shared space where screens can melt away. Support clients in structuring their surroundings to enhance their comfort and security during sessions, ensuring they feel as safe in a virtual space as they would in person. Additionally, I start with every client, letting them know they never have to tell me anything they don’t want to (with the exception of gathering more information if there is a safety concern). I make sure to set this precedent with them from the beginning and then reinforce it throughout our work together
3. Enhancing Therapeutic Skills
Develop and refine therapeutic skills such as active listening, empathy, and validation. These skills are essential for building trust and rapport with clients, especially those who have experienced trauma.
Pro Tip: Enhance your skills in active listening and validation. My journey through Internal Family Systems (IFS) and the use of ‘Self’ has profoundly shaped my understanding of this process. In IFS, ‘Self’ refers to the core, compassionate, and calm part of a person. By embracing ‘Self’ and taking a step back, I can help clients navigate their journeys successfully while creating a shared understanding of the patterns they engage in that get in the way. By focusing on being present and attuned, I’ve learned to better support clients in finding their own paths to healing.
4. Integrating Trauma-Informed Assessment and Intervention
Incorporate trauma-informed techniques into your assessment and intervention practices. Recognize the symptoms of trauma and use interventions that are sensitive to these symptoms while promoting resilience and coping strategies.
Pro Tip: Most of my clients start with me for reasons other than “trauma.” Just because a client may have come to therapy for reasons unrelated to trauma doesn’t mean trauma is not present or impactful. Even conditions like biological mood disorders can be significantly influenced by trauma, including the negative internal narratives and beliefs clients may hold. Stay vigilant for signs of trauma and consider how it might be interacting with other presenting issues to provide the most effective and comprehensive care. Learning how to take an informed and gentle approach to trauma assessment is so important in gaining a full understanding of our clients.
5. Practicing Self-Care and Managing Burnout
Working with trauma can be emotionally taxing. It’s important to practice self-care and seek supervision to avoid burnout. Regularly engage in activities that rejuvenate you and seek support when needed. A healthy therapist is better equipped to support their clients effectively.
Pro Tip: As a therapist in an all-virtual private practice, I’ve learned the importance of meaningful connections with other professionals. Whether these interactions are in person or virtual, they have been vital for my professional rejuvenation and well-being. Engaging with peers, sharing experiences, and supporting one another can provide significant relief and perspective, helping to sustain and enhance your practice. Remember, you are not alone in this journey. Building a network of supportive colleagues can provide the encouragement and inspiration you need to continue your professional growth.
It’s increasingly important to ensure that you are effectively managing the number of clients you work with at any given time. So often, in community mental health centers, therapists are given caseloads that create burnout. Setting limits and boundaries for yourself is crucial in making sure that good therapists don’t lose their drive to work in this field. Remember, you have the power to set your own boundaries and manage your workload. By doing so, you can ensure that you are providing the best possible care to your clients while maintaining your own well-being.
6. Educating and Empowering Clients
Education is a powerful tool in trauma-informed care. Help your clients understand how trauma affects them and provide them with tools and strategies to manage their symptoms. Empower them to be active participants in their healing journey.
Pro Tip: I’m often taken aback by how many clients are deeply appreciative when their reactivity is explained to them. Many have spent years feeling as though something was inherently ‘wrong’ with them, only to find significant relief in understanding their responses from biological and neurological perspectives. This explanation normalizes their experiences and empowers them to engage more fully in their therapeutic process. My go-to phrase is often “Well, that makes perfect sense given…” when clients share some of their upsetting responses to situations.
7. Creating a Culturally Competent Practice
Trauma is experienced differently across cultures, and cultural competence in your practice is essential. Understand and respect cultural differences in the experience and expression of trauma. Adapt your approach to fit your client’s cultural context.
Pro Tip: It is essential to understand how culture impacts your client. However, it is vital to remember and recognize that some experiences normalized within a culture may still be traumatic. Just because something is common or happens “all the time” does not make it acceptable or okay. Navigating the cultural needs of your clients while educating them about how their experiences impact their current day-to-day lives can be a delicate balance. To provide the most sensitive and effective care, it’s crucial to become well-versed in your clients’ cultural backgrounds, especially from their own perspectives.
8. Establishing Clear Policies and Procedures
Developing clear policies and procedures is crucial for smooth and effective practice. This includes setting boundaries, defining your practice’s scope, and ensuring clients understand what to expect from their therapy experience.
Pro Tip: Establish a clear Scope of Practice for yourself, both clinically and within the structure of your practice. This means recognizing if there are certain symptom sets, behavioral presentations, or client needs that fall outside your expertise or practice setup. For instance, I cannot provide crisis management support between sessions as a sole practitioner without an on-call system. Understanding these limitations ensures that clients receive appropriate care and helps you make necessary referrals. It can also guide how you want to continue developing your skills moving forward and where you want to focus.
Wrapping it Up
Building a trauma-informed practice involves a deep understanding of trauma, creating a safe environment, enhancing therapeutic skills, integrating trauma-informed interventions, practicing self-care, educating clients, and maintaining cultural competence. By following these steps, you can provide compassionate and effective care that supports the healing and growth of your clients.
Want to Learn More About…
Want to learn more about Trauma-Informed Assessment, cultural competence, and Ethical Boundaries? Join me on August 28th, 2024, for the second part of our training series on Empowering the New Clinical Social Worker. CEUs are available through the NASW NH.
For more information and to register (and for updated training sessions past this date), click the link here for my Eventbrite Page.
Consultation for Clinicians
If you're a therapist seeking guidance, I offer both clinical and practice consultation services. Feel free to contact me for a complimentary initial consultation here.
References
Van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
Greenfield, R. (2007). A Fairy Tale. Trauma Institute & Child Trauma Institute, Greenfield, MA.
Greenfield, R. (2013). Progressive Counting Within a Phase Model of Trauma-Informed Treatment. Routledge, New York.
Greenfield, R. (2005). Child Trauma Handbook: A Guide For Helping Trauma-Exposed Children and Adolescents. Haworth, New York.
