Trauma can have a profound and long-lasting impact on individuals. If you have experienced a traumatic event in your life, you may benefit from traumainformed care. Many people experience trauma in their lives and often more than once. The experience of trauma is very individual as is the impact. Experiencing trauma can affect you psychologically, physically and socially. It can result in a person not feeling safe, not feeling they have a voice, not feeling valued, not trusting other people and not being able to connect with support and services. People can struggle to engage with health services because of experiencing trauma. Trauma-informed care aims to provide you with support and not reinforce the impacts of the trauma you have experienced. Trauma-informed care aims to increase awareness of the prevalence of trauma as a very common experience and the need to avoid re-experiencing the trauma when you attend health care services. Therefore, especially if you are a trauma survivor, you may want to find out if the health service or health care professional you are considering, including continence related, provides trauma- informed care to help you feel more at ease.

What does trauma-informed care look like?

Based on the Substance Abuse and Mental Health Services Administration (SAMHSA) Trauma-Informed Approach, it should involve the following four ‘R’s as key assumptions:

  • Realisation. The service-wide realisation or knowledge of trauma and its impacts on clients, families and communities.
  • Recognise. All staff can recognise the signs of trauma.
  • Responds. The service responds by using a trauma-informed approach in all areas. This includes staff training and service policies.
  • Resist re-traumatisation. Re-traumatisation of clients and staff is avoided, if possible. Staff are aware of practices that may be triggers to cause re-traumatisation of clients.

The samhsa trauma-informed approach also follows six key principles:

  • Safety. Ensuring physical and psychological safety. This includes an environment which is safe, including interactions with staff.
  • Trustworthiness. Maximising trustworthiness through consistent and clear boundaries.
  • Peer support. To help establish safety, hope, trust and collaboration by involving people with lived experience.
  • Collaboration and mutuality. Sharing of power and decision-making with clients, staff and the service.
  • Empowerment, voice and choice. The individual’s strengths and experiences are recognised to promote recovery from trauma. Choice and control are maximised for clients with supported decision making.
  • Cultural, historical and gender issues. Cultural stereotypes and biases are not reinforced. The service offers culturally and gender responsive services and is aware of historical trauma.

Using these key assumptions and key principles,  a health/continence service can better support you, especially if you are a trauma survivor. Having a service that actively promotes the provision of trauma-informed care including through staff training, plus active leadership and modelling, will create a safer environment for you to receive support with continence care.

The nurse continence specialists on the National Continence Helpline are currently undergoing training in trauma-informed care. This will allow us to be more aware of and to implement the four ‘R’s, realisation of, recognise, responds to and resist re-traumatisation of trauma, when speaking to callers to allow us to provide a safe and trustworthy service.

Please call the National Continence Helpline on 1800 33 00 66 to speak to a nurse continence specialist for free confidential advice, information and resources from a trauma-informed service.

If this article has affected you in any way, please call: Lifeline: 13 11 14 or 1800 RESPECT: 1800 737 732

Reference: SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach (2014)