What Is Trauma-Informed Medical Care?

“My daughter is so petrified; she’s terrified of needles. I don’t know where it came from.”—parent of an 11-year-old girl with cancer in Afraid of the Doctor: Every Parent’s Guide to Preventing and Managing Medical Trauma

“Trauma creates change you don’t choose. Healing is about creating change you do choose.”—Michele Rosenthal, post-traumatic stress survivor

Many healthcare organizations are starting to recognize how trauma can affect children and families. This includes both trauma exposures that children and families may have experienced outside the healthcare system (e.g., a house fire, natural disaster, or violence) and experiences within their medical care that can be traumatic (e.g., receiving a scary new diagnosis, undergoing a painful procedure, or having a bad experience with a medication).

Medical conditions and care can bring challenges that can result in medical traumatic stress. The National Child Traumatic Stress Network defines medical traumatic stress as “a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences” (NCTSN, 2020). In other words, these are the reactions that patients and their family members may when dealing with a medical condition and medical care. See this post for more information on medical traumatic stress.

To support families who are navigating exposure to potentially traumatic events and who may have trauma symptoms, many healthcare providers have begun to take a trauma-informed approach to medical care for patients and their families.

Trauma-informed care includes realizing how many patients, family members, and workers are affected by trauma; recognizing how trauma affects individuals; responding by using knowledge about trauma to inform serving families; and resisting re-traumatization/preventing further traumatic stress (SAMHSA, 2015).

What this means for patients and family members

• Many doctors and other healthcare professionals know about traumatic stress reactions and many are learning more.
• A number of hospitals and outpatient clinics are working on providing care in a way that takes into account trauma exposure and post-traumatic stress symptoms.
• Examples of trauma-informed approaches that families might observe: using child life specialists, social workers, and psychologists as members of the medical team to help with health education and coping with medical procedures.
• Integrating nonpharmacological approaches (that is, approaches other than medication) to help with pain management such as numbing sprays/creams, distraction techniques, or reward systems.
• Working to communicate medical information in ways that patients and families can understand.
• Asking patients and families about their mental health and other needs.

Does your medical team need more information on trauma-informed approaches? Consider sharing the resources at the end of this post with them.

What this means for healthcare professionals

Trauma can affect child development and the way in which patients and families experience medical care (see Forkey et al., 2021).

A number of trauma-informed approaches can be integrated into standard care without requiring additional time (see Forkey et al., 2021; Marsac et al., 2016).

A few key steps to integrating trauma-informed care into medicine include the following:

• Provide education to all healthcare team members and support staff on trauma, traumatic stress symptoms, and their impact
• Screen patients regularly for trauma exposures and symptoms
• Provide psychoeducation to patients and family members on post-traumatic stress symptoms and adaptive coping
• Identify ways to minimize additional trauma exposures in routine medical care
• Refer those who need it for more support (patients, families, and team members)
• Provide regular support for staff

Looking for more information for your institution? Many training opportunities and resources are available to support healthcare teams’ use of trauma-informed medical care. See below for additional resources.

Learn more

• Afraid of the Doctor: Every Parent’s Guide for Managing and Preventing Medical Trauma
• Center for Pediatric Traumatic Stress
• "Implementing a Trauma-Informed Approach in Pediatric Health Care Networks"
• American Academy of Pediatrics: Trauma-Informed Care
• The Sanctuary Model

The ideas in this post and resources are not a replacement for mental health care. If you are worried about your own or your child’s behaviors or emotions, reach out to your doctor for help.