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Written by: Alicia Cassels, MA, OneOp Military Caregiving blog contributor

A Case for Trauma Informed Care

According to Substance Abuse and Mental Health Services Administration (SAMSHA) trauma can be defined as,

An event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening, with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.

There tends to be a false narrative that the experience of trauma among members of the general population, as defined above is rare. This is not the case. According to the SAMSHA, more than half of adults in the U.S. report experiencing at least one trauma in their lifetime, and that the vast majority, 90 percent, of clients in public behavioral health care settings report that they have experienced trauma.

The Impact of Trauma

A 1998 study from the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente examined the long-term impacts of childhood trauma in the lives of adults. In this study, individuals were provided with a set of questions which asked about their experiences in childhood. More than 13,000 adults completed the survey, recording their responses in seven distinct categories of Adverse Childhood Experiences (ACES). More than half of the survey respondents indicated that they had experienced at least one ACE in childhood, and twenty-five percent of respondents identified two or more categories of exposure in childhood. Survey data revealed links between childhood trauma exposure and negative health outcomes for these individuals in adult life. Individuals reporting  multiple categories of trauma in childhood were more likely to have several health risk factors later in life, with those reporting four or more categories of childhood exposure exhibiting a four to twelve percent increased risk for alcoholism, drug abuse, depression, suicide attempts, and a host of other negative health outcomes including heart disease, cancer, chronic lung disease, and liver disease. Given these serious and lasting impacts, it is essential that service professionals implement trauma-informed approaches to the delivery of care (Am J Prev. Med. 1998).

The Trauma-Informed Approach

 Trauma-informed care offers the opportunity to engage more fully in their health care, develop a trusting relationship with their provider, and improve long-term health outcomes. Trauma-informed care can also help reduce burnout among health care providers, potentially reducing staff turnover(Trauma-Informed Care Resource Center).

Trauma-informed approaches seek to address the impact and widespread nature of trauma and address the potential paths for recovery, identify signs and symptoms of trauma in clients, families, staff, and others involved in the care delivery system, respond through the integration of trauma knowledge into policies, procedures, and practices, and resist approaches that cause re-traumatization (Substance Abuse and Mental Health Services Administration. 2019).  

The 6 Core Principles of Trauma-Informed Care

Agencies providing trauma – informed care employ six core principles which include:

Trauma Informed Care

Download the CDC Infographic

Want to ensure that your organization is delivering trauma-informed care?

Free resources are available to help your organization get started. The Trauma – Informed Care Resource Center has a number of excellent resources and training materials for organizations and care providers.


  1. Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma.
  2. HRSA Center for Integrated Health Solutions. Substance Abuse and Mental Health Services Administration (US). 2019. (clinical-practice/trauma-informed).
  3. The Adverse Childhood Experiences (ACE) Study. Am J Prev. Med. 1998;14(4):245–258.