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The Importance of Trauma-Informed Care

Traumatic events are those that challenge a person's coping mechanisms to their breaking point. Abuse, neglect, witnessing violence, and broken attachment relationships are all examples of childhood traumas that may have long-lasting negative effects. Forces beyond one's control may make one's latter years just as difficult, whether they be acts of violence, accidents, natural disasters, war, jail, or the death of a loved one. An individual's feeling of security, sense of self, sense of effectiveness, emotional control, and social competence may all be compromised by such experiences. Surviving a traumatic event may leave a person feeling helpless, hopeless, ashamed, and terrified.

Developing a Sensitivity to Trauma

Many persons with mental health and drug use issues have experienced trauma that has impacted their ability to seek help and their ability to recover from these conditions. Here are some links between the topics:

More than 17,000 people's histories were analyzed in the American Adverse Childhood Experiences research to find links between traumatic events in childhood and poor health as an adult (Anda et al., 2006). Specifically, they focused on eight types of maltreatment and dysfunctional family environments that might negatively affect a child's development (including witnessing violence against the mother). Anda et al. (2002) and Anda et al. (2007) discovered that ACEs were far more prevalent than previously thought, often entailed numerous occurrences, and were associated to an array of adult health issues including drug abuse and mental illness. To provide just one example, the research revealed that when women reported five or more negative childhood events, their chance for developing a depressive illness in the last two years rose by a factor of six (Chapman et al., 2004). Researchers also discovered that those who had five or more negative childhood experiences were seven- to ten-times more likely to have issues with, and addiction to, illegal substances (Dube et al., 2003). These findings have far-reaching implications for both prevention and treatment, as the authors point out.

It is widely established that exposure to violence and traumatic events may have lasting effects on a woman's mental health and lead to drug abuse issues (see, for example, Logan et al., 2002). Ninety percent of women surveyed at six different women's treatment centers in Canada said they had experienced abuse as a kid or as an adult, and that this history was linked to their alcoholism (Brown, 2009). The necessity for an integrated approach is highlighted by data collected over the last decade at women's addiction treatment clinics in Canada, which reveal that a substantial number of women seeking treatment for drug use disorders had suffered violence and abuse as children and adults (Nicchols et al., 2009; Poole, 2007; Van Wyck & Bradley, 2007). The prevalence of sexual abuse among girls and the ways in which they resort to drug misuse as a coping mechanism have both been highlighted in other Canadian research (Ballon et al., 2001). The gendered, structured, and persistent character of these encounters must be acknowledged.

Less is known about the incidence of male trauma in Canada, nor its connections to drug abuse and mental health issues. More over half of American males have experienced some kind of traumatic incident, according to a source cited in Chapter 13 by Fallot and Bebout; this figure is based on surveys conducted in 1995. (Kessler et al., 1995). According to data collected in 2008 by the Males's Trauma Centre in Victoria, British Columbia, 32% of men with mental health issues and 50% with alcohol and other substance issues sought treatment and/or assistance for physical, sexual, and emotional trauma at the facility. Men's Trauma Centre (2009) found that 20% of their clientele also struggled with mental health issues in addition to drug abuse.

The legacy of Canada's residential schools has caused trauma that affects several generations of Aboriginal people. Increased incidence of complicated posttraumatic stress disorder (PTSD), drug abuse, broken families, violence, and suicide are all symptoms of unresolved historical trauma (Chansonneuve, 2005; Haskell & Randall, 2009; Wesley-Esquimaux & Smolewski, 2004). Sixty-four percent of residential school survivors in British Columbia were diagnosed with post-traumatic stress disorder, twenty-six percent with drug addiction disorder, and twenty-one percent with serious depression, according to a study of their mental health outcomes (Corrado & Cohen, 2003).

In a nutshell, there is substantial evidence that people's struggles with mental health and drug use stem from their exposure to violence, abuse, and trauma. In addition, as the chapters in this book show, the interplay of gender, color, socioeconomic background, culture, disability, immigrant status, and other types of diversity increases vulnerability to trauma and necessitates individualized solutions.

The effects of trauma are not only far-reaching but also potentially devastating, since it is linked to issues of drug abuse and mental health.

xiii. Introductory Materials

Growing up with a history of trauma may help one become trauma informed. She shows how trauma experienced at a young age may permanently alter a person's sense of self. She warns that without using a trauma lens, such coping mechanisms with childhood and adulthood trauma might be ignored or misunderstood. Individuals' sense of identity and safety in the world, as well as their trust in and commitment to care providers, are profoundly impacted by traumatic experiences. Clients with histories of trauma are often the most in need of assistance but also the most challenging to connect with.


Mimi Rothschild

Mimi Rothschild is the Founder and CEO of the Global Grief Institute which provides Certification training programs forGrief Coach, Trauma Coach, End of Life Coach, and Children's Grief Coach. She is a survivor who has buried 3 of her children and her husband of 33 years. She is available for speaking engagements and comments to the press on any issue surrounding thriving after catastrophic loss. MEDIA INQUIRIES:

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