What is Trauma-Informed Care?

Summary

Dr. Cruz emphasizes the importance of trauma-informed care in healthcare, highlighting the prevalence of adverse childhood experiences (ACEs) and their impact on health. By shifting the approach from 'What's wrong with you?' to 'What happened to you?', Dr. Cruz demonstrates how understanding patients' life experiences can improve care. The video outlines five key strategies for healthcare organizations to integrate trauma-informed care, including building awareness, investing in a trained workforce, creating a safe environment, engaging patients meaningfully, and identifying and treating trauma. This approach not only benefits patients but also makes work more rewarding for staff.

Takeaways

• 📚 Early in Dr. Cruz's career, a pattern of patients with multiple health issues and frequent emergency department visits was observed.
• 🧠 Many patients had been exposed to adverse childhood experiences (ACEs), which can impact brain development and stress responses.
• 🤔 ACEs are prevalent in the U.S., with 60% of adults having at least one, and 25% having three or more.
• 🏥 ACEs are more common in low-income and minority populations, affecting a significant portion of the community.
• 🧪 Repeated trauma in childhood can lead to long-term issues such as depression, anxiety, substance use disorders, and chronic diseases.
• 🔄 Dr. Cruz shifted the approach to care by asking about patients' experiences rather than just their symptoms.
• 🏢 Trauma-informed care is crucial for understanding the root causes of health issues and improving patient outcomes.
• 👥 Building awareness and involving both staff and patients is the first step in adopting a trauma-informed approach.
• 🛠️ Investing in a trauma-informed workforce includes training for all employees, not just clinical staff.
• 🌟 Creating a safe and welcoming environment, engaging patients meaningfully, and involving them in treatment planning builds trust.
• 🩺 Identifying and treating trauma through appropriate screening and ensuring availability of treatments is essential.

Q & A

What is the significance of the phrase 'Don't judge a book by its cover' in the context of the script?

The phrase 'Don't judge a book by its cover' is used to emphasize the importance of not making assumptions about patients based on their outward appearance or initial symptoms, but rather understanding their underlying experiences and traumas, which can significantly impact their health.

What does Dr. Cruz identify as a common pattern among some of his patients?

Dr. Cruz notices that some patients have multiple health issues, are uneasy during office visits, frequently visit the emergency department, and do not improve despite multiple visits.

What is an ACE, as mentioned by Dr. Cruz?

An ACE, or Adverse Childhood Experience, refers to traumatic events experienced in childhood such as abuse, violence, neglect, discrimination, poverty, and other adverse events that can have long-term impacts on health and well-being.

How prevalent are ACEs among US adults according to the statistics provided in the script?

According to the script, 60% of US adults have experienced at least one ACE, 25% have three or more ACEs, and 16% have four or more.

Why are ACEs more common in certain populations?

ACEs are more common in low-income and minority populations, likely due to a higher prevalence of the adverse conditions and stressors that contribute to such experiences.

How can repeated exposure to trauma during childhood impact brain development?

Repeated exposure to trauma can impact brain development by rewiring the brain's response to stress, which may lead to difficulties in emotional regulation and an increased risk of mental health issues later in life.

What is the approach Dr. Cruz suggests for healthcare providers when dealing with patients who have experienced trauma?

Dr. Cruz suggests a trauma-informed approach where healthcare providers ask 'What happened to you?' instead of 'What's wrong with you?' to recognize and address the root causes of poor health related to life experiences.

What are the five key ways that healthcare organizations can integrate trauma-informed care into their practices?

The five key ways include: 1) Building awareness and generating buy-in, 2) Investing in a trauma-informed workforce, 3) Creating a safe and welcoming environment, 4) Engaging patients in meaningful ways, and 5) Identifying and treating trauma through appropriate screening and treatment.

How does involving patients in their own treatment planning build trust?

Involving patients in their own treatment planning empowers them and ensures that their perspectives and needs are considered, which can lead to a stronger therapeutic alliance and increased trust in the healthcare provider.

What is the ultimate goal of implementing trauma-informed care in healthcare settings?

The ultimate goal of implementing trauma-informed care is to transform the caregiving experience from simply treating symptoms to healing the whole person by addressing the underlying traumas and experiences that contribute to their health issues.

Outlines

00:00

📚 Understanding the Impact of ACEs on Patient Health

Dr. Cruz discusses the importance of not judging patients by their outward appearance and instead understanding the underlying issues that affect their health. Early in his career, he noticed a pattern among patients with multiple health issues who frequently visited the emergency department but didn't improve. He realized that many of these patients had experienced trauma and adverse childhood experiences (ACEs), which can include abuse, violence, neglect, and poverty. These experiences are common in the U.S., affecting 60% of adults, with 25% having three or more ACEs. Exposure to trauma in childhood can impact brain development and lead to emotional regulation issues, chronic diseases, and even suicide. Dr. Cruz emphasizes the need to shift the approach from asking 'What's wrong with you?' to 'What happened to you?' to better address the root causes of poor health and provide trauma-informed care.

Keywords

💡Trauma and Adverse Childhood Experiences (ACEs)

Trauma and Adverse Childhood Experiences (ACEs) refer to a range of potentially harmful experiences occurring in childhood, including emotional, sexual, or physical abuse, violence, neglect, discrimination, poverty, and other adverse events. In the video, Dr. Cruz emphasizes that ACEs are more common than many realize, with 60% of US adults having at least one ACE. These experiences can have profound and lasting effects on an individual's physical and mental health, rewiring the brain's response to stress and potentially leading to chronic diseases, behavioral health problems, and even suicide.

💡Emotional Regulation

Emotional regulation is the ability to manage and respond to one's emotions in a healthy way. The video explains that individuals who have experienced trauma, particularly during childhood, may struggle with emotional regulation, leading to issues such as depression, anxiety, or substance use disorders. Dr. Cruz's approach to care involves recognizing the impact of these experiences on patients' lives and addressing the root causes of their health issues.

💡Trauma-Informed Care

Trauma-Informed Care is an approach to healthcare that recognizes the widespread impact of trauma and seeks to actively involve patients in their treatment. It requires understanding, recognizing, and responding to the effects of trauma. In the video, Dr. Cruz discusses how shifting from asking 'What's wrong with you?' to 'What happened to you?' is a fundamental part of trauma-informed care, which helps in providing greater insight into patients' needs and how to address them.

💡Chronic Diseases

Chronic diseases are long-term health conditions that require ongoing management. The video script mentions that trauma survivors are more often at risk for chronic diseases due to the impact of adverse childhood experiences on their overall health. This connection highlights the importance of understanding the root causes of health issues, rather than just treating symptoms.

💡Behavioral Health Problems

Behavioral health problems encompass a range of mental health and substance use disorders. The video script notes that trauma survivors are at an increased risk for these issues due to the stress and emotional turmoil caused by their experiences. This underscores the need for healthcare providers to be aware of the potential link between a patient's past traumas and their current health challenges.

💡Suicide

Suicide is mentioned in the video as a potential outcome for individuals who have experienced significant trauma and have not received appropriate support or treatment. It serves as a stark reminder of the severity of the impact that trauma can have on a person's life and the importance of trauma-informed care in addressing these deeper issues.

💡Awareness and Buy-In

Awareness and buy-in refer to the process of educating staff and patients about the importance of a trauma-informed approach and gaining their commitment to it. The video script suggests that building awareness and generating buy-in are crucial first steps for healthcare organizations to integrate trauma-informed care into their practices.

💡Trauma-Informed Workforce

A trauma-informed workforce is one that is trained and prepared to recognize and respond to the effects of trauma in their patients. The video script emphasizes the importance of investing in such a workforce, including not only clinical staff but also non-clinical employees, to ensure that all aspects of patient care are informed by an understanding of trauma.

💡Safe and Welcoming Environment

Creating a safe and welcoming environment is a key aspect of trauma-informed care. The video script suggests that healthcare organizations should strive to make their spaces feel secure and comfortable for both patients and staff. This can help to build trust and foster a more supportive atmosphere for healing.

💡Meaningful Patient Engagement

Meaningful patient engagement involves actively involving patients in their own healthcare decisions and treatment planning. The video script highlights the importance of asking patients about their feelings and listening to their responses as a way to build trust and ensure that care is tailored to their individual needs.

💡Screening and Treatment

Screening and treatment refer to the processes of identifying individuals who have experienced trauma and providing appropriate interventions. The video script suggests that healthcare organizations should consider implementing screening approaches and ensuring that treatments and referral sources are available to address the needs of trauma survivors.

Highlights

The importance of not judging patients by their outward appearance or immediate symptoms.

Observation of a pattern among patients with multiple health issues and frequent emergency department visits.

Realization of the correlation between health issues and adverse childhood experiences (ACEs).

Definition of ACEs, including emotional, sexual, or physical abuse, violence, neglect, and other adverse events.

Prevalence of ACEs in the U.S., with 60% of adults having at least one ACE.

Higher ACE prevalence in low-income and minority populations.

Impact of repeated trauma on brain development and stress response in children.

Link between trauma and issues like depression, anxiety, substance use disorders, and chronic diseases.

Shift in approach from asking 'What's wrong with you?' to 'What happened to you?'

The concept of trauma-informed care and its significance in improving patient care.

Five key ways to integrate trauma-informed care into healthcare practices.

First key way: Building awareness and generating buy-in among staff and patients.

Second key way: Investing in a trauma-informed workforce with appropriate training.

Third key way: Creating a safe and welcoming environment for patients and staff.

Fourth key way: Engaging patients in meaningful ways and involving them in treatment planning.

Fifth key way: Identifying and treating trauma with appropriate screening and referral sources.

The transformational impact of trauma-informed care on patient relationships and staff satisfaction.

Trauma-informed care's role in shifting the caregiving experience from treating to healing.

Transcripts

You know the old saying “Don’t judge a book by its cover?”

Well, the same is true when you assess a patient. Hi, I’m Dr. Cruz.

Early in my career I noticed a pattern with some of my patients. They often had multiple

health issues, were uneasy during office visits, and frequently visited the

emergency department. But worst of all - they never got better despite multiple

visits. Then, I realized something from an early age many of my patients were

exposed to trauma and adverse childhood experiences or ACEs. This includes

emotional, sexual, or physical abuse, violence, neglect, discrimination, poverty,

and other adverse events. ACEs are more common in the u.s. than you'd think.

In fact, 60% of US adults have one ACE, 25% have three or more ACEs, and 16% have

four or more. ACEs occur in all socio-economic groups but are more

common in low-income and minority populations. For young children, repeated

exposure to trauma can impact brain development and literally rewire the

brains response to stress. So, as they grow up, many struggle with issues

related to emotional regulation like depression, anxiety, or substance use

disorders. Trauma survivors are also more often at risk for chronic diseases,

behavioral health problems, and even suicide. Knowing all this, I began to

rethink my approach to care. Instead of asking patients "What's wrong with you?" I

ask "What happened to you?" Recognizing that life experiences are often a root

cause of poor health is integral to improving patient care. Trauma-informed

care has helped me take these experiences into account providing

greater insight into my patients needs and how to address them. Here are five

key ways that health care organizations can gradually integrate trauma-informed

care into their practices to help patients and staff. First, build awareness

and generate buy-in. Involve both staff and patients in

adopting a trauma-informed approach. Second, invest in a trauma-informed

workforce. Hire staff that embrace trauma-informed care and provide

training not only for clinical staff - but also for non clinical employees like

front desk workers or security guards, who are often the face of your

organization. Next, create an environment that is safe

and welcoming for patients and staff. Engage patients in meaningful ways. Ask

how they feel and listen. You can also build trust by involving them in their

own treatment planning. Finally, identify and treat trauma – consider a screening

approach that works for your patients and ensure that treatments and referral

sources are available. These changes take time, but each step improves our ability

to connect with and care for patients. Today, our patients appreciate the

changes we've made. Plus our staff is more in tune with patients, so work is

less stressful and more rewarding. Trauma-informed care — it can truly

transform the caregiving experience from being treaters to being healers.