Exploring Trauma-Informed Care For Marginalized Families
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Traumatic events can have mental, emotional, and physical impacts on individuals and their relationships, including within a family. When families face trauma, seeking support can be a way to effectively cope and support each other through challenges. Finding trauma-informed care can be beneficial during these times, centering on the trauma and its diverse impacts. Marginalized families may be uniquely impacted by these challenges, which can showcase the benefits of culturally informed trauma care for those from these communities.
Trauma and its effects
According to the Global Health Action journal, approximately 70% of individuals experience a traumatic event at some point in life. The prevalence of trauma can be even higher in marginalized families, who may face not only discrimination and racial trauma but also barriers to mental healthcare to recover from trauma.
The American Psychological Association (APA) defines trauma as “an emotional response to a terrible event like an accident, crime, natural disaster, physical or emotional abuse, neglect, experiencing or witnessing violence, death of a loved one, war, and more.” The effects of trauma may show up months or even years after the event and may be physical, emotional, and behavioral in nature.
Physical effects may include substance abuse and more
Emotional effects on mental health
Emotional symptoms of trauma may include fear, sadness, anger, and shame. However, symptoms can vary according to someone’s culture. Some people may come from a background where emotional expression is uncommon. Other people may experience denial or have a sense of numbness after a traumatic event.
Behavioral effects
Regarding behavioral symptoms, trauma may lead a person to avoid certain people, places, or situations that remind them of a traumatic event. This avoidance behavior may lead to changes in a person’s daily routine. For example, a person who survived a car accident may avoid driving or riding in a car for some time after the accident.
A person doesn’t necessarily have to live through a traumatic event firsthand to experience the effects of trauma. In some cases, witnessing a traumatic event can have similar effects. In this way, trauma can extend beyond the individual to family members, and this effect may be more pronounced in cultures with many family members living together. In some cases, families may also experience intergenerational trauma, where impacts of trauma in certain generations trickle down into others to create a complex dynamic of individuals being impacted by the traumatic events other people have gone through in their families.
How does trauma-informed care help marginalized families?
A therapist trained in trauma-informed care may be equipped to detect the various effects of trauma on marginalized families. When someone from such a family seeks mental health services, a therapist may ask about the person’s family history and any potential traumatic experiences in the family. In some cases, this questioning may lead to a recommendation for family therapy, which may not only promote healing from trauma but also improve intra-family communication.
According to the Centers for Disease Control and Prevention (CDC), there are six core components to trauma-informed care, including:
- Safety
- Trustworthiness and transparency
- Peer support
- Collaboration and mutuality
- Empowerment and choice
- Cultural, historical, and gender issues
Trauma-informed care for marginalized families
A therapist who understands trauma-informed practices for marginalized families may pay special attention to the needs of people who are racial or ethnic minorities. In some cultures, people may not have received much information on the importance of mental health care. Individuals from these families may not be aware of trauma and its potential effects, including how trauma can ripple through a family. Cultural differences may also make people hesitant to seek help, possibly out of fear of how help-seeking behaviors may be perceived in their family. Also, some immigrant families fear seeking help due to fear of immigration authorities or deportation.
Marginalized families may also include those with a parent who is part of the LGBTQIA+ community. Some people from this community may have experienced discrimination, whether overt or covert, and this discrimination may affect everyone in the family. Trauma-informed care in these cases might be best provided by a therapist who understands the complexity of living in a world in which many people don’t understand the unique challenges of people from various LGBTQIA+ communities. In some cases, individuals can choose a therapist who specializes in helping LGBTQIA+ individuals and their families or is part of the community themselves.
Trauma care for those in economically disadvantaged families
Trauma-informed care may also involve helping economically disadvantaged families. Poverty may prevent individuals and families from receiving care following a traumatic event. Even if there are free or low-cost services in the community, some families may be unable to attend appointments due to limited transportation or work obligations. Therapists who are trained in trauma-informed care might consider these factors and connect marginalized families with wraparound services that promote patient health and overall well-being.
Trauma-informed therapists may benefit from being aware that some families experience multiple types of marginalization. Some people may experience cultural and linguistic differences in addition to economic disadvantages that make it challenging to seek mental health care, which could lead to worse mental health outcomes for trauma survivors.
Therapy for marginalized groups
Individuals from marginalized families may face several barriers to therapy. Aside from a lack of awareness of resources in the area, marginalized groups may experience economic barriers to traditional in-office therapy, which can exacerbate mental health disparities. In these cases, online therapy through a platform like BetterHelp may be a more viable option. Online therapy is often more affordable than in-person therapy without insurance.
Online therapy with a trauma-informed therapist
At the individual level, online therapy with a trauma-informed therapist may help a person become more comfortable than in traditional in-office therapy. They can connect with a therapist in a way that’s most comfortable for them, whether via audio, videoconferencing, or live chat. For some people who have experienced trauma, the latter option may be more comfortable if they experience difficulty speaking about trauma.
Numerous studies have demonstrated the effectiveness of online therapy. One study published in 2023 in the journal Psychology, Health & Medicine found that online cognitive-behavioral therapy (iCBT) was effective in reducing symptoms of post-traumatic stress disorder (PTSD). Another study published in 2017 found that iCBT is also effective for anxiety, depression, panic disorder, obsessive-compulsive disorder (OCD), and substance use disorders. Substance use disorders can sometimes be common among people who have experienced trauma, so online therapy may be helpful for people with these comorbid conditions.
Takeaway
A trauma-informed approach often takes into account the various ways that trauma can ripple through various generations (historical trauma) in marginalized families. Therapists trained in trauma-informed care may help individuals from these families by considering their socioeconomic and cultural background as they form a personalized treatment plan. If you’re ready to talk to a provider, consider reaching out online or in your area for support.
What are the 5 principles of trauma-informed care?
According to the National Center for Trauma-Informed Care, this type of care is “as much about social justice as it is healing.” Trauma-informed care involves five principles:
- Safety
- Choice
- Trustworthiness
- Empowerment
- Collaboration
How to spot trauma in clients?
Emotional trauma can’t be identified through a physical exam. Still, there could be many different signs for healthcare providers to look for that could indicate trauma. Many patients may have:
- Extreme mood swings
- Avoidance of certain subjects
- Sleep problems
- Trouble concentrating
- Physical symptoms like headaches and stomach aches
- Adverse childhood experiences
What is a trauma-informed mental health assessment?
A trauma-informed mental health assessment involves a full evaluation of the patient’s mental and physical state, including any past trauma, its effects on the person’s current wellbeing, and any negative coping mechanisms the individual has adopted. During the assessment, mental healthcare professionals will take care to avoid any triggers or re-traumatization.
What is the connection between trauma and substance abuse?
The relationship between trauma and substance abuse can be complex. Many people who have experienced trauma rely on substances to cope with the painful emotional effects of trauma. Trauma also increases the risk that a person will develop a substance use disorder at some point in their lives.
What are the 4 C's of trauma informed care?
The 4 C's of trauma-informed care include:
- Calm
- Contain
- Care
- Cope
How to practice trauma-informed care?
There are many ways health care organizations can train their practitioners to practice trauma-informed care. Here are some techniques that can be employed:
- Recognize trauma as a common thing people experience.
- Focus on empathy and compassion.
- Respond to questions calmly and directly.
- Share knowledge and responsibility.
What is a common emotional behavioral effect of trauma?
There could be many emotional and behavioral effects of trauma, and they can vary by the individual experiencing it. Some common effects include:
- Irritability and mood swings
- Anxiety and hypervigilance
- Dissociation
- Trouble forming a trusting relationship
- Shame or guilt
What are the three pillars of trauma-informed care?
The three pillars of care emphasized by a trauma-informed organization include:
- Safety
- Connections
- Managing emotional impulses
What are examples of trauma-informed questions?
Some examples of trauma-informed questions include:
- What do you already know about the procedures involved in counseling?
- What helps you feel calm?
- What would you like me to know about your journey?
- Can you tell me more about your past?
- How do you feel about talking with me about this trauma?
What behaviors align with trauma-informed care?
Behaviors that may align with trauma-informed care include re-injury prevention, building resilience, creating a safe environment, being engaged through active listening, focusing on recovery, letting patients be involved in decision-making, and fostering empathy.
Trauma-informed care is not just about counseling or medical care. Today, schools across the nation are working to develop trauma-informed practices for our nation’s youth. According to the National Education Association, children of any age who have experienced trauma need support from teachers if they are to have the ability to succeed in school.
It may also be important to recognize that many mental health care providers experience secondary traumatic stress as a result of being involved with their client’s care. This may result in a high staff turnover in the mental health care workforce.
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