An Invitation to Trauma-Informed Care
This blog was originally written as a guest post for the Canadian Poverty Institute (CPI), which is an inter-disciplinary institute that seeks to heal through teaching, research and public education. Click here to learn more about the great work being done by the CPI.
The income support system is an essential part of the social safety net that exists to help individuals and families meet their basic needs. Between 2010 and 2017, the number of individuals who accessed income support in Alberta increased by 14,192, resulting in 54,374 individuals as of January 2017.i This growing need demonstrates the importance of designing a system that responds to individuals’ unique needs. If there is one thing we have learned through the consultations that took place with Canadians for the National Poverty Reduction Strategy, it is that poverty is complex and a one-size-fits-all approach does not work when it comes to poverty reduction efforts.ii
While the social service sector finds itself entrenched in conversation around social welfare reform, it is important to remember that many individuals and families rely on the current system in order to make ends meet. Further, while debate exists over whether an individual can truly meet their basic needs on a limited amount of dollars each month, it is essential that policy makers are working to ensure that the current system does not create barriers limiting access to this vital source of income. Without income support, families and individuals will inevitably struggle and risk falling deeper into the trap that is poverty. Thus, it is essential that we momentarily set aside the overarching debate around overhauling the social welfare system and look at the experience of individuals relying on the current system.
While some may fall into poverty for a short amount of time, others may spend their entire lives living within its ugly shadow. Research shows that trauma is often a factor in poverty, homelessness, and poor mental and physical health outcomes.iii If you have experienced poverty or have worked with individuals who fall below the poverty line, you know that it is traumatic. Individuals who are living in poverty are consistently faced with difficult decisions; the choice between buying healthy food and maintaining a roof over their head or buying a bus pass versus buying diapers is never easy. Trauma in and of itself is traumatic.
Furthermore, due to extensive trauma histories – often both as a child and as an adult – a large percentage of the individuals that access social services struggle with various mental and physical illnesses, addictions, increased levels of stress, attachment difficulties, and chaotic behaviour.iv
As a result of the numerous impacts of trauma, many individuals accessing income support may exhibit impairment in executive functioning and emotional regulation, low self-efficacy, and high levels of anxiety and stress.v Thus, prolonged trauma has a profound impact on the well-being of our communities and we must search for solutions that attempt to mitigate the effects of trauma and encourage access to important resources such as income support.
Enter trauma-informed care (TIC). The concept of TIC is simple, it “offers a framework for providing services to traumatized individuals within a variety of service settings.”vi TIC within the service delivery context is characterized as:
Providing a safe environment to clients that is free from physical harm and re-traumatization.vii
Genuine collaboration between the agency and clients.viii
Acknowledging the role that trauma has in the lives of the clients.ix
As TIC has grown in popularity and moved outside the healthcare sector, social service agencies have begun to adopt this approach when working with clients. In Alberta, many social service agencies have recognized the importance of TIC resulting in a slow and steady march towards embedding this approach within programs and services. While not always a standardized process, this positive movement towards TIC highlights many agencies’ desire to find a balance between service delivery, reporting on measurable outcomes, and building trusting relationships with clients.
TIC simply provides a lens through which to approach relationships with clients; it exists to inform practice, regardless of the service delivery context. Therefore, it is essential that TIC is embedded in policies and procedures throughout the entire social services, from government ministries to privately funded non-profit organizations. Trauma exists throughout every segment of society and is especially important for those agencies that exist to serve vulnerable Canadians.
i “Income Supports Caseloads in Alberta,” Social Policy Trends The School of Public Policy, (April, 2017) https://www.policyschool.ca/wp-content/uploads/2016/02/Social-Trends-Income-Support-for-April-Issue.pdf
ii Opportunity for All – Canada’s First Poverty Reduction Strategy,” Government of Canada (2018), https://www.canada.ca/en/employment-social-development/campaigns/poverty-reduction.html.
iii Mental Health Commission of Canada, Klinic Community Health Centre, “Trauma-informed systems and organizations,” (2014) https://www.mentalhealthcommission.ca/sites/default/files/2014-0408_mhcc_trauma-informed_care_0.pdf
v Robin L. Aupperle, Andrew J. Melrose, Murray B. Stein, Martin P. Paulus, “Executive Function and PTSD: Disengaging from Trauma,” Neuropharmacology 62,2 (2012): 686-694. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719148/
vi Hopper, K. Elizabeth, Bassuk, L. Ellen, Oliver, Jeffrey, “Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings,” The Open Health Services and Policy Journal 3, (2010): 80-100. http://www.homelesshub.ca/sites/default/files/cenfdthy.pdf.
vii Bincy Wilson, Thomas H. Nochajski, “Evaluating the Impact of Trauma-Informed Care (TIC) Perspective in Social Work Curriculum,” Social Work Education 35,5 (2016) https://www.tandfonline.com/doi/abs/10.1080/02615479.2016.1164840.