Trauma-Informed Care Model

The Trauma-Informed Care (TIC) model is an approach that accounts for a person's past experiences of trauma to ensure provision of the appropriate and effective mental health services. One of the goals of TIC is to make patients feel safe and welcomed when receiving mental health treatment. It emphasizes creating a safe and supportive environment where mental health professionals can tailor their approaches to be sensitive, empathic, and non-triggering. TIC seeks to:

Prevent re-traumatization
Integrate information about trauma into practices, procedures, and policies
Recognize the extensive impact of trauma and understand paths for recovery

Using TIC can improve acceptability of mental health services by recognizing and responding to the impact of trauma on individuals. TIC uses six guiding principles to help patients feel safe, develop a relationship with their provider, and achieve lasting mental health support. The six guiding principles include:

Safety
Choice
Collaboration
Trustworthiness
Empowerment
Cultural, historical, and gender issues

TIC also promotes collaboration between individuals and their provider, leading to more effective and respectful mental health practices. Collaborative relationships reduce power differences and increase shared decision-making between providers and patients.

Examples of Rural Trauma-Informed Care Programs

The Alaska Veterans Telehealth and Biofeedback Services program offers trauma-informed mental health services via telehealth in rural communities. This program helps veterans address symptoms of trauma, including stress, chronic pain, and sleeping issues. Patients meet with trained counselors weekly for trauma-informed therapy. After participating in the program, participants were more willing to pursue additional mental health treatment options.
La Pine Community Health Center (CHC) is a Federally Qualified Health Center with five clinic sites in rural areas of Central Oregon. La Pine CHC serves approximately 7,500 individuals per year. In 2015, La Pine CHC added trauma-informed care (TIC) as an approach for their programming. Working in a health center with a priority on person-centered care, the Chief Medical Officer recognized that many patients have complex situations, including histories of trauma. Integrating TIC helped staff better understand root causes associated with many of their patients' social and physical health outcomes. Using TIC has helped La Pine CHC understand how trauma affects both staff and patient engagement with the clinics.

Implementation Considerations

Implementing a TIC approach involves changes at both the clinical and organizational levels. The Implementation Resource Center provides foundational steps to consider when adopting a TIC approach. These include learning the basics of TIC, learning from the experiences of others who have implemented TIC, and accessing implementation resources. Rural organizations seeking to implement TIC can take steps to do so gradually over time.

Policy efforts can also support the implementation of TIC approaches. Additional considerations for policymakers include:

Identify potential areas for cooperation to enhance adoption across sectors and within systems
Assess the impact and return on investment of TIC
Promote the integration of TIC screening and treatment
Advocate for the involvement of families and communities with firsthand experiences to contribute to the development and application of TIC policies

Program Clearinghouse Examples

Resources to Learn More

Lessons Learned Implementing a Trauma-Informed System of Care in Rural Communities
Document
Provides details on how trauma-informed care networks in rural healthcare systems can be successful with long-term support and investment from multiple stakeholders.
Author(s): Minnich, C. L., Stehley, F. J., Bills, L. J., et al.
Citation: Progress in Community Health Partnerships: Research, Education, and Action, 17(3), 495-501
Date: 11/2023

SAMHSA Spotlight: A Series on Building Resilient and Trauma-Informed Communities
Document
Highlights strategies with examples using SAMHSA's trauma-informed principles to build resilient trauma-informed communities, and improve public health and well-being.
Organization(s): Substance Abuse and Mental Health Services Administration
Date: 2017

Trauma-Informed Strategies for Rural Schools: Prevention and Treatment for Adult Personnel
Document
Examines the implications of trauma found in adults while working in rural school systems, and discusses strategies addressing education, treatment and prevention to promote healing and re-occurring trauma.
Author(s): Schuermann, H.
Citation: Theory & Practice in Rural Education, 13(2), 29-50
Date: 10/2023

What is Trauma-Informed Care
Website
Presents an overview of the process of trauma-informed care (TIC) and identifies the key components to TIC.
Organization(s): Buffalo Center for Social Research