Frontline Initiative Trauma-Informed Care

Years ago, I was sitting through my umpteenth workshop on trauma. I could barely contain my frustration. Eight hours of describing what trauma is, and not a minute on how to help or what to do. More recently, amazing information is coming out on traumainformed care and I finally feel like I have some practical tools to help. When I was asked to write this article for Frontline Initiative, I went to my colleagues, Cynthia Alvarado, LBSW, and Jacqueline Valencia, BA, to brainstorm. Cynthia and Jacqueline run a familybased shelter program for homeless children and youth. They work directly with people receiving supports, their families, and the shelter parents that care for them. Often the children that come into their program have extensive trauma histories and are often in emotional crisis. Here are a few items from the bag of tricks we’ve developed over the years working with children, youth, and their families.

1. Always look at a trauma survivor’s challenging behavior as perfectly understandable given what he or she has been through. 1
2. If you don’t know if the person you are supporting has a trauma history, it’s better to assume he or she does. (This technique works great with anyone who is upset.).
3. Don’t think, “What’s wrong with you?” Instead, think, “What happened to you?” 1
4. People with trauma in their history tend to fear being rejected or pushed way. So, instead of “time out” try a “time in.” Keep the person nearby. Stop what you’re doing, and pay attention to the person (not the behavior). Speak quietly and calmly. If they respond well to touch and are not too escalated, try a hand firmly on the shoulder, or holding their hand. Always ask permission before touching. Sit quietly together.
5. Use the word “safe.” Use it a lot. “I’m going to keep you safe. This is a safe place for you. Are you feeling safe?”
6. Help the person use their words if he or she has them. If the person doesn’t have words, speak for him or her. Based on your observation, validate and normalize those feelings. “You seem to be very frustrated now, and that’s OK. I would be too, if I were you.” 2
7. Check for sensory needs. Is the person too hot? Too cold? Hungry, tired? Is it too bright? Too loud? Adjust the environment. 3
8. Offer an alternative activity; one that usually calms them. Try offering repetitive movement such as swinging on a porch swing, or rocking in a rocking chair.
9. Avoid the temptation to argue, lecture, nag, and remind. A trauma survivor in crisis cannot hear any of that, and it is likely to backfire.
10. After everyone is calm, look for the success. “Thanks for not hurting yourself,” (even if they smashed all the plates). “You used your words really well!” (Even if they called you every name in the book).
11. First and foremost, take care of yourself.