8.4 Trauma informed practices

Imagine for a moment that someone you know experienced a traumatic incident.  How would they cope?  Do they have positive experiences and supports in their life that can help with their ability to cope?  As a Social Service worker, it is important to recognize the scope of your practice so you do not inadvertently activate someone who has experienced trauma.

Activities

  1. Please review The Canadian Centre on Substance Abuse toolkit[1] on trauma informed practice
  2. What is trauma informed?
  3. What are the four principles of a trauma informed approach?
  4. Why does gender, age, ability and ethnicity matter when we discuss trauma?
  5. Imagine you are facilitating a substance use disorder support group.  What are two activities you could implement to ensure your group is trauma informed using an intersectional approach

Trauma Informed Practices for Women

Why is gender important when we discuss a trauma-informed approach to support the people we work with?  As we discussed in Chapter 1, the intersectional approach must include gender.  Women have different needs and women also have different experiences.  Research tells us women are more likely to have experienced sexualized violence, are more likely to engage in survival sex, and are more likely to live in poverty.[2]  Knowing the issues that impact women specifically, for example, “adverse and traumatic experiences in early childhood, continuation of adversities and trauma in adulthood, intimate partner violence, structural violence, and transgenerational traumas” [3][/footnote] service providers must look beyond the substance use to help address the trauma.

[4]

 

Activities

  1. The British Columbia Centre of Excellence for Women’s Health created the following discussion guide to focus on supporting women’s health by ensuring a gendered approach.  Please review the Guide.[5]
  2. Brainstorm a list of services that would be specific for programs for women with a substance use disorder
  3. What are some of the concerns women may have?  How can these be addressed?
  4. In the creation of a women’s program, what are some of the supports that need to be embedded in the program?
  5. How do the social determinants of health impact women

According to Homes, “the majority of substance use services lack a gender-responsive and anti-oppressive approach, that specifically addresses the intersectional violence, oppressive barriers, and diverse experiences of women and femmes”.[6]  This will take a concerted effort to change; being aware of gender in service provision is a start.

Trauma Informed Practices for Indigenous communities

Trauma due to genocide, colonization, residential schools, and the concerted effort to eradicate Indigenous communities in Canada has had a tremendous impact on Indigenous people.  Understanding these experiences using a two-eyed seeing approach will help provide a more culturally safe and trauma informed service.

Food For Thought

  • Review the Medicine Wheel Booklet[7]
  • What did you notice about the contributors to the document?
  • Why is this booklet helpful in developing trauma-informed programs?
  • How can you learn more about trauma informed, culturally respectful programs and services in Nova Scotia?

Trauma Informed Practices for 2SLGBTQ communities

Research suggests that individuals who identify as 2SLGBTQ* are impacted by discrimination, victimization, bullying, violence, and trauma; consequently, sexual and gender minority youth are at elevated risk for suicide.[8]  This group is also at a higher risk of substance use disorders due to the trauma they face because of their sexuality.[9] To provide a trauma-informed practice for this group, Social Service workers must understand the daily realities of people who identify as 2SLGBTQS.  Rojas et al.[10] suggest the following when working with 2SLGBTQ* communities and substance use disorders.

  • Focusing on the psychological impact of homophobia and heterosexism can help explain vulnerability to mental health disorders.
  • Asking about compounded stigma: how does the client feel about having a substance use disorder, mental health disorder, and/or trauma? What experiences have they had with stigma?
  • When referring out, confirming providers are knowledgeable in LGBTQ+ affirming practices
  • Consulting frequently and refer when outside of your area of expertise
  • Encouraging participation of partner/significant other in treatment
  • Querying about family of origin messages toward LGBTQ+ patients
  • If applicable, querying about “coming out” process and/or experiences with family

Activities

  1. Review Rainbow Health Ontario for resources that may support learning about  2SLGBTQ* individuals and a substance use disorder. https://www.rainbowhealthontario.ca/[11]

    Home

  2. Can you identify one learning?

  1. Canadian Centre for Substance Use and Addiction. (2014). Trauma informed care. https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Trauma-informed-Care-Toolkit-2014-en.pdf
  2. Torchalla, I., Linden, I.A., Strehlau, V., Neilson, E.K., & Krausz, M. (2014).  “Like a lot’s happened with my whole childhood”: Violence, trauma, and addiction in pregnant and postpartum women from Vancouver’s Downtown Eastside. Harm Reduction Journal, 12(1), 1-10. https://doi.org/10.1186/1477-7517-11-34
  3. [footnote]Ibid, p. 2
  4. Centre of Excellence for Women’s Health. (2018). Trauma, gender, sex and substance use. [Video]. Youtube. https://www.youtube.com/watch?v=MxiYc7Kw25w
  5. The British Columbia Centre of Excellence for Women’s Health. (2010). Trauma-informed approaches in addictions treatment: Gendering the national framework. https://bccewh.bc.ca/wp-content/uploads/2014/02/2010_GenderingNatFrameworkTraumaInformed.pdf
  6. Homes, C. (2021). Bridging the gap in women’s substance use services: A trauma-informed, gender-responsive, and anti-oppressive approach, (p. 2). http://repository.cityu.edu/bitstream/handle/20.500.11803/1465/ChristineHolmesCapstone.pdf?sequence=2&isAllowed=y
  7. University of Regina. (n.d.). Medicine wheel booklet. https://www.uregina.ca/science/biology/people/faculty-research/gendron-fidji/documents-fidj/Medicine-Wheel-Booklet.pdf
  8. Fulginiti, A., Rhoades, H., Mamey, M., Klemmer, C., Srivastava, A., Weskamp, G., & Goldbach, G. (2021). Sexual minority stress, mental health symptoms, and suicidality among LGBTQ youth accessing crisis services. Journal of Youth and Adolescence, 50(5), 893-905. https://pubmed.ncbi.nlm.nih.gov/33206318/
  9. Rojas, J., Leckie, R., Hawks, E., Holster, J., Del Carmen Trapp, M., & Ostermeyer, B. (2019). Compounded stigma in LGBTQ people: A framework for understanding the relationship between substance use disorders, mental illness, trauma, and sexual minority status. Psychiatric Annals, 49(10), 446-452. https://doi.org/10.3928/00485713-20190912-01
  10. Ibid.
  11. Sherbourne Health. (2020). Rainbow Health Ontario.  https://www.rainbowhealthontario.ca/

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