Mental Disorders and Illnesses: Part Five
Trauma-Informed Care
Trauma-informed care is an approach used in mental health and healthcare settings and it is designed to create an environment where the healthcare practitioners lower the chance that they will re-traumatize an already traumatized patient. Trauma-informed care will be yet another topic I will address in more detail in future.
For now, the key premise that is relevant here is that trauma-informed care embeds universal precautions. Similarly, in healthcare settings, you are washing hands and wearing gloves and masks because you are applying universal infection control precautions. It is no longer important to know the specific infection status of a patient when universal infection control precautions are in place and everyone is pre-emptively protected right out of the shoot.
Universal precautions for trauma-informed care is the same: assume the patient has past trauma and interface with them accordingly. This removes the burden the patient may feel to reveal trauma as a way to ensure that a safe set of interactions might be possible with the practitioner. We know that having to speak about trauma in and of itself can be re-traumatizing. Trauma treatment is a highly specialized field where patients are not directed through basic talk-therapy processes precisely because those can worsen symptoms and reinforce feelings of helplessness. Providing trauma-informed care is not trauma treatment and vice versa.
There are many elements to trauma-informed care, but the foundation is information and choice. Information and choice create psychological stability and safety. The mindset is to recognize that the behaviours that are present were once adaptive in some way and that there is resilience embedded in behaviours that are traditionally viewed as maladaptive, disruptive and harmful.
Choice does require a limited framework and cannot be endless as this will also exacerbate feelings of helplessness and anxiousness. Information has to be targeted and timely – again, questions are answered honestly, simply and completely, and details are provided ahead of any action that will be taken.
When your under-18 child is suffering with any kind of coping continuum condition, it is absolutely normal to not have the techniques for responding in a way that will help. All the great skills you have honed as a parent for socializing your child are of no use when coping continuum behaviours creep in. Distraction, cajoling, bargaining, laying down clear consequences, or conversely hoping it just goes away on its own (i.e. “it is a phase”) are techniques that work best when a child is essentially traveling on a developmental path that is in that broad range of “average” for that child. When coping behaviours show up and they start to harm the child, then it is a good idea to enlist the help of a psychologist (or to read their books) to learn the techniques you will need to help support your child.
Limited Time and Resources
Parents with limited financial resources almost always have limited time as well. It is often not helpful to tell a parent in this situation that they can access information that would be provided with a psychologist by heading instead to the library and getting out all the books on the topic and reading them. They do not have the time to get to the library, let alone subsequently read and assess the dense information on the topic.
In fact, it is highly unlikely that a parent in that circumstance is going to be reading anything on this site either – it takes way too long just to read through the basics here. Really, I am directing these ideas to those who have friends or family members struggling with time and resources issues who have a child struggling with coping behaviours right now. You can help.
If it is possible for the child to get involved in any activity with either multi-generational or broad peer participation, that costs nothing, then that is a powerful way to help curate peers and create possibilities for different ways to be in the world. Sometimes a child being exposed to the potential for other ways of being in the world is all that is needed to shift their alignment with the coping behaviours that they currently have.
If the activity costs money, then putting your own money forward is such a great way to support both the parent and child. If you can be the one to get the kid to and from the activities, that will help your friend or family member immeasurably as well.
One of the fascinating things that has happened for my colleagues with school-aged children has been how much more embedded their children are in their neighbourhoods as a result of remote learning during that first year of the pandemic. In fact, whole families in the same neighbourhoods have gotten to know each other through the pandemic. Making friends with the neighbourhood kids and the elderly couple missing their own grandkids who live far away, has been life changing.
A recent study that came out of Toronto confirms that black students had the most marked improvement in reading skills while attending on-line learning during the initial phase of the pandemic. Anecdotally, those I know with children with learning difficulties have absolutely thrived and excelled for the first time in their schooling experience when classes went online. These examples reinforce what the Times segment ‘Normal’ Was Not Working for Everyone––And We’re Dreading Its Return that I embedded in a prior installment of this series: being “othered” significantly lowers quality of life.
Children with coping continuum challenges need places and spaces that allow them to experience mastery and self-direction on their own terms. Adults need this too.
Next week in Part Six, we look at how comparing ourselves to others is absolutely life limiting as I move into more details on curating your environment.
