Julia Haskins, AAMC News, May 24, 2019.
The man in the clinic exam room looked crestfallen: he had experienced homelessness and struggled with schizophrenia and other chronic health issues throughout his life, recalls Sadie Elisseou, MD. Elisseou could have completed the man’s exam without taking his sensitive history into account. Instead, she used a trauma-informed approach, explaining every step of the exam process and moving slowly throughout. In response, her patient felt comfortable enough to share the emotional pain he’d endured.
“Trauma-informed care is putting the patient in control of their environment, their body, their experience, for people like this gentleman who perhaps haven't been made to feel in control very much at all,” says Elisseou, a primary care physician in the Veterans Health Administration system.
In fact, Elisseou and other providers of trauma-informed care (TIC) assume that every patient may enter a health care setting having experienced some form of trauma. That’s not so far off the mark: more than half of the U.S. population reports experiencing at least one traumatic event in their lives.
Often, trauma stems from sexual violence. The Centers for Disease Control and Prevention reports that more than one-third of women and nearly one-quarter of men have experienced sexual violence. But trauma has many possible causes, including surviving a natural disaster, witnessing violence, and facing poverty or bigotry. And early traumas — adverse childhood experiences (ACEs) such as neglect — can be particularly damaging.
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