: Pennsylvania HealthChoices
Minimizing risk: an important element of trauma-informed care
Magellan Behavioral Health of Pennsylvania supports and advocates for the use of a trauma-informed care (TIC) model among providers. An important component of TIC is minimizing the risk of re-traumatizing a person during behavioral health services.
In a recent survey, Magellan members told us that one of their primary reasons for not attending follow-up treatment after a hospitalization is having had past negative experiences with treatment. It is very possible that many of these “past negative experiences” included examples of re-traumatization.
“Resisting re-traumatization” is one of the “4 Rs” outlined by SAMHSA as key assumptions of TIC. Providers might inadvertently create situations or environments that could re-traumatize a person seeking treatment. Triggering painful memories or replicating aspects of past traumas can interfere with recovery and even result in withdrawal from treatment.
Examples of re-traumatization:
- Involuntary treatment, seclusion, restraints or statements that are seen as a threat.
- An office or room that is confining, causing someone to feel trapped.
- Telling someone that they are overreacting, or that what they are experiencing isn’t real or isn’t a big deal.
- Allowing group members to appear to “gang-up” on one group member.
- Not being responsive to requests for help.
- Abrupt staffing changes that can trigger feelings of abandonment.
- Not letting the individual express their feelings and opinions.
- Raising of voice or “talking over” someone.
- Rules that are experienced as unfair or punitive.
- A treatment setting that appears institutional or “prison-like.”
- A service provider who looks like someone from the person’s past.
Re-traumatization can’t be prevented 100% in every treatment setting. Each trauma survivor has different experiences and different triggers. The goal is to recognize where it might happen and minimize the risks. It might be useful to discuss this information in team meetings periodically and ask staff for recent examples of inadvertent re-traumatization or aspects of your treatment setting that could increase the risk of re-traumatization.