The Problem with Trauma-Informed Practice

The conversation about Trauma-Informed Practice is happening everywhere. You can't throw a stick at an education, addiction, mental health (or any other helping profession) conference without hitting something related to Trauma-Informed Practice.

Author's note: You shouldn't throw sticks at conferences.

This has been one of the most important revolutions in our thinking about people, behaviour and "human problems" in a very long time (maybe ever?). Understanding the neurobiology of human development, and how trauma impacts that development, has given helping professionals a much needed perspective on behaviour (addiction, mental illness, behavioural "dysfunction"), a perspective grounded not in the question of "I wonder what's wrong with you?", but;

"I wonder what happened to you?"

Trauma-Informed Practice, in an over-generalized nutshell, has allowed the helping professional to embrace "compassionate presence" (as Dr. Gabor Mate would refer to it) as a legitimate approach to counselling or responding to someone's needs. And that's the entire point..."I wonder what happened to you?" should make us pump the brakes on anything and everything except exploring the perspective of the other person, including their trauma history BUT ALSO their history and perspective on other important domains in life, like strengths and capabilities.

One of the problems with Trauma-Informed Practice that I've encountered recently is that it's moved away from providing a spark of curiosity for the helping professional, instead becoming a checklist of screening questionnaires and prescribed interventions.

"If trauma, insert standard intervention". The temptation to take any model or framework and turn it into unquestioned orthodoxy and "evidence-based practice" runs the risk of over-generalizing and stretching the ideas into territory that don't quite fit.

The "if trauma, insert (take your pick of drumming, running, EMDR, mindfulness, equine therapy etc.)" approach, if rigidly built into program structures, risks being just as un-responsive and manual-ized as any other treatment approach.

In fact, I recently encountered a program that was using the ACE's questionnaire (Adverse Childhood Experiences Scale) as a screening tool. Not enough trauma? No services for you...never mind the frequency or severity of your actual issues and challenges! Most trauma-informed practitioners would see the problem with that type of deterministic & administrative approach, but it's awfully tempting to become rigid with any tool, including the trauma-informed ones.

If you haven't explored ACE's yet, here's a great resource compliments of the Alberta Family Wellness Initiative: https://www.albertafamilywellness.org/what-we-know/the-brain-story

Don't get me wrong, the learning coming out of trauma and neurobiology research is incredibly important and should transform a lot of the helping professions in a positive way.

And the single most important thing it should teach us is that our clients need us to be compassionately present with them, not their trauma.