The Buzz of Trauma-Informed Therapy

Over the course of history, one will not fail to find something that represents a specific era or decade.  You had flapper dresses and bob haircuts in the 1920s, fedora hats in the 1930s, big band music in the 1940s, TV dinners in the 1950s, psychedelia in the 1960s, bell-bottoms in the 1970s, leg warmers in the 1980s, Tamagotchis in the 1990s, flip phones in the 2000s, and Instagram in the 2010s.  The decades and lists go on and the mind can only wonder what trends will emerge in times that have not yet arrived. 

Similar to apparel, music, food, lifestyle, toys, and technology, words and ideas can also become “mainstream” and trendy.  In the field of psychology, the term “trauma-informed” has been one such word in the last several years, namely in the 2010s and 2020s, although the concept emerged in the late 1990s and early 2000s.  When words or terms become “buzz words,” and overuse ensues, its true meaning can get lost in assumptions, subjectivity, and misinformation.  An incorrect understanding can at best lead to a mortified self-esteem, and at worst (such as in the case of psychotherapy), lead to inadvertent harm in care originally meant to heal.

It has become a trend where people who seek out psychotherapy now list “trauma-informed” as a necessary criterion in the skills of a psychotherapist.  Requests for a trauma-informed psychotherapist, by default, suggests that not all psychotherapists are trauma-informed.  What then, constitutes a trauma-informed psychotherapist versus a non-trauma-informed psychotherapist?  An accurate understanding of the term “trauma-informed” is essential to ensuring that anyone seeking psychotherapy services is not misled by an assumed definition of the term, resulting from mainstream overuse.

What is Trauma-Informed Psychotherapy?

Before the emergence of trauma-informed care, psychotherapy worked under a traditional framework that viewed symptoms as the core problem and a patient’s presenting issues as internal defects or chemical imbalances.  In terms of the therapeutic relationship under this framework, the psychotherapist held all the power and was considered the expert who directed the treatment.  The trauma-informed framework, on the other hand, shifts the clinical focus by asking what happened to a patient, versus what is wrong with a patient.  The key goal of trauma-informed care is to create an environment where the dialogue between psychotherapist and patient accommodates the vulnerabilities of a patient’s experiences to avoid inadvertent retraumatization.

The following points elucidate what trauma-informed practice encompasses, and what it does not:

• It is not trauma-specific treatment:  Trauma-informed practices do not involve actively seeking, eliciting, or processing the explicit, painful details of a patient's trauma.  That is the role of specialized, trauma-specific services.

• It does not require disclosure:  Trauma-informed care is a universal practice that should be applied to every patient, regardless of whether they have disclosed a history of trauma or not.  It does not assume that a patient is ready or willing to discuss their experiences.

• It is not about labeling:  It avoids using pathologizing labels such as "manipulative," "resistant," "attention-seeking," or "non-compliant."  Instead, it reframes these behaviours as understandable adaptive coping or survival strategies.

• It does not replace specialized expertise:  While trauma-informed care creates the safe, foundational environment necessary for trauma recovery, it is not a substitute for the specialized clinical methodologies (such as somatic therapy or EMDR) required to directly treat trauma responses.

When the ethical conduct expected of psychotherapists are considered, the aforementioned points can be integrated seamlessly into its fundamental principals, which include but are not limited to being proactive in promoting the best interests of patients, refraining from actions that risk harm to patients, respecting the rights of patients to self-determination, respecting the dignity of patients, and honouring patients’ right to just treatment.  If licensed psychotherapists practice ethically by adhering to the code of ethics relevant to their regulatory body, it can be said that all psychotherapists and the psychotherapy they provide are trauma-informed.  Thus, when prospective patients seek psychotherapy, the question of whether or not a psychotherapist is trauma-informed can be deemed redundant, and this redundancy can be applied just as well to psychotherapists who market their services using buzz words to attract new patients.