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“What’s wrong with you?”

These four words are common in everyday life and unfortunately all too common when it comes to serving patients and clients with the respect and dignity they deserve.

As well intentioned as the question might be, asking a patient what’s wrong with them can be a triggering experience. And, as difficult as it can be to change long-time practices, we owed it to ourselves – and more importantly, those we serve – to get it right.

Moving away from asking a client “What’s wrong with you?” and towards “What’s happened to you?” is the first step in Trauma Informed Care.

Before we go any further, you may be asking yourself, “What exactly is Trauma Informed Care?”

The Substance Abuse and Mental Health Services Administration defines this system as:

“A program, organization, or system that is trauma-informed:

1.     Realizes the widespread impact of trauma and understands potential paths for recovery;
2.     Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
3.     Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
4.     Seeks to actively resist re-traumatization.”

While every point in this system is critical, it’s point number four – the active resistance of re-traumatizing clients – that we’ve focused heavily on. Across all departments at Bread for the City, staff have come together to develop systems that help us avoid situations in which clients or staff who are dealing with trauma will be further hurt by the environment at Bread for the City.

Trauma Informed Care gained ground as a model for dealing with veterans suffering from PTSD after the Vietnam War. Despite its more than 30-year history, it began gaining steam in the social work community a few years ago and caught the attention of Tracy Knight, Bread for the City’s Northwest Social Services Director, in 2014.

“I kept reading about it and became more and more curious,” said Knight, who also attended workshops on the model. “We started talking about it at Bread for the City, but it didn’t immediately come together.”

The next year, Bread for the City enrolled in a National Council for Behavioral Health learning community where Trauma Informed Care was the working model. It was through that collaboration that Bread for the City was able to do a Trauma Informed Care pilot project.

“That gave us the structure,” Knight added.

While moving from theory to practice is challenging, Knight says that even small steps make big differences for clients. And it goes beyond social services alone: all of Bread for the City’s direct services as well as administrative offices like human resources and fundraising have incorporated trauma-informed care protocols into their work.

“It’s the whole experience,” Knight says of client interactions. “It’s making sure that the environment feels safe and not chaotic. Another component is that everyone who interacts with our patients and clients comes to the work from a place of “What’s happened to you,” as opposed to “What’s wrong with you?”

Knight continues, “It’s a frame for everything that happens from the time a person walks through the door to the moment they leave. Even the small things like yelling somebody’s name across the waiting room to ask them back for an appointment. If I’ve had my name yelled in anger or during an act of violence, that can be triggering and can set my heart rate off before I even get back to my appointment. Trauma Informed Care talks about emotional universal precautions- and not yelling someone’s name is one of them.  That’s a small change that can make a big difference.”

Empathy, safety, and compassion are at the core of Trauma Informed Care – it’s also at the heart of everything we do here, making the model a natural fit at Bread for the City.  

Want to know more about Trauma-Informed Care and Bread for the City? We’ll be blogging about the challenges, successes, and all aspects of this important work at https://breadforthecity.org/blog-cat/social-services/ this summer. Subscribe here to follow along!