According to the Center for Health Care Strategies, “a trauma-informed approach to care acknowledges that health care organizations and care teams need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation.” In the image we have listed a few of the key principles of trauma informed care. Hopefully trauma-informed care just becomes known as the standard of care, and here are a few ways that a pelvic floor physical therapist can implement trauma-informed approaches.
- Asking for consent prior to any form of treatment.
- When doing a technique telling the patient what you are doing, why and where.
- Showing support by validating their feelings and experiences.
- Creating a safe environment for patients: this can look like not being in between patients and the door, allowing them to be closer to an exit.
Trauma-informed approaches for a pelvic floor physical therapist continued. The images above are the core principles of trauma informed care by SAMHSA and CHCS. Below are some examples of ways we can implement these principles in the clinic.
- Providing options for patients and the space to allow them to collaborate in their treatments.
- Doing regular check-ins with patients throughout the session to allow continued opportunities to voice out if they’d like to discontinue.
- Biases and stereotypes (e.g. based on race, ethnicity, sexual orientation) and historical trauma are recognized and addressed.
- Asking patients about their preferred name and pronouns that they would like to be addressed with.
These are all referenced from the center for health care strategies (CHCS), SAMHSA, and CDC.
The Key Principles include:
All that are involved in the organization including the clients or patients feeling physiologically and psychologically safe (e.g. Allowing employees the ability to provide feedback on how safe they feel in their work environment). Some other examples provided by the Center for Health Care Strategies (CHCS) include:
- Keeping common areas well lit like bathrooms, entrances, and exits.
- Easy accessibility to doors to easily exit whether in a treatment room or in the facility.
- Welcoming patients with respect and support.
- Having staff that understands maintaining healthy boundaries and that can manage conflict.³
Trustworthiness and Transparency:
The company or organization is transparent with employees and clients with decisions and operations (e.g. Being transparent with your patient about objective findings and decisions on the treatment plan).
Supporting those who are trauma survivors with “establishing safety and hope, building trust, enhancing collaboration, and utilizing their stories and lived experience to promote recovery and healing.” This can help with burn-out that is common in health care settings, as well as, prevent secondary trauma. The CHCS provides some examples on ways to help prevent secondary trauma:
- Allowing “mental health days.”
- Recommend your staff to engage in various types of self-care like physical activity, yoga or meditation (Check out Tips for Managing the Stress of COVID-19 and Your Pelvic Floor that shares some great examples).
- Supporting regular meetings with clinicians and supervisors to discuss and address feelings about patient interactions.
- Trainings on awareness about secondary trauma.³
Collaboration and Mutuality:
Showing the importance of partnering and assessing the power dynamic between all the levels of staff and between staff and clients, so that healing can be promoted when power and decision-making is shared. (e.g. Having your patient play an active role in their treatment plan. Asking for the patient’s input and allowing space for more dialogue versus the practitioner dictating the set plan).
Empowerment, Voice, and Choice:
The organization develops and services to “foster empowerment for staff and clients alike. Organizations understand the importance of power differentials and ways in which clients, historically, have been diminished in voice and choice and are often recipients of coercive treatment.” Some examples include:
- Allowing patients or employees to have a voice and choice.
- Prior to a specific treatment explaining what you will be doing and asking the patient or client if you can precede can be a way of allowing them to have a voice and choice.
- Employees having the ability to share their voice while still feeling safe to do so.
- Not pushing a survivor to disclose their trauma history and allowing it to be their choice.
Cultural, Historical, and Gender Issues:
Also adopted as humility and responsiveness by the CHCS. Active movement “past cultural stereotypes and biases (e.g. based on race, ethnicity, sexual orientation, age, religion, gender identity, etc.)…and recognizes and addresses historical trauma.” Implementing policies that would respond to any racial, ethnic, and cultural needs of staff and clients. (e.g. Asking an individual what their pronouns are and calling the individual by the selected pronouns without judgment or biases).²
This is just a brief explanation of SAMHSA’s trauma-informed approach with some adaptations and examples from the CHCS to help bring more awareness and to hopefully start the conversation around this topic. If you would like to dive further into their concepts and educational materials check out SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach and Video: What is Trauma-Informed Care?.³
We are excited to announce Molly will be helping PHRC open their 11th location in Columbus, OH in September of 2023. Join the waitlist and be the first to be contacted!
Are you unable to come see us in person in the Bay Area, Southern California or New England? We offer virtual physical therapy appointments too!
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page.
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