What are the main components of trauma-informed care, why is the ACEs model of screening is so important in primary care and psychiatric mental health care for ALL patients?
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Main Components of Trauma-Informed Care (What are the main components of trauma-informed care
Physicians are experts in recognizing emerging diseases but often fail to appreciate the role of external forces on the well-being of an individual. Adverse childhood experiences (ACEs) affect the individual’s well-being by increasing allostatic load, inflammation, other dysfunctional states, and disease primarily due to the trauma they leave behind. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), individual trauma is any event, a series of events, or a combination of circumstances that leads to either physical or emotional harm (Dawson et al., 2021). The damage could be life-threatening and causes adverse effects on the victim’s functioning psychological, physical, social, emotional, or spiritual well-being. To counter this trend, modern healthcare providers recommend applying Trauma-Informed Care (TIC) since this approach endeavors to understand the individual. Most importantly, it is only by understanding the core principles of TIC that the provider can unravel the effects of trauma on the person’s sense of self, their sense of fellow humans, and their beliefs of the world.
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The five principal components of TIC are safety, choice, collaboration, trustworthiness, and empowerment (Knight, 2019). In practice, safety means the provider must ensure all the common areas are welcoming and ensure the patient’s privacy is respected. The element of choice details the individual to have definite and appropriate messages concerning their rights and responsibilities, while collaboration effectively means the patient is involved in decision-making concerning the planning and evaluation of services. The provider is expected to exhibit task clarity and respect interpersonal and professional boundaries to nurture trust. The fifth and last main component is empowerment so that the individuals concerned operate in an atmosphere that allows them to feel validated by every contact they make at the healthcare organization. Suffice it to say that utilization of the TIC approach when offering patient services significantly lowers the chances of re-traumatization and comprehensively incorporates the traumatic experiences into all aspects of health care services provided. All these principles can be generalized across different service care settings so that instead of offering a set of practices and procedures, the core components need customized interpretation and application in line with a specific type of service setting.
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Why the ACEs Model of Screening Is Important In Primary Care and Psychiatric Mental Health Care for ALL Patients
Rariden et al. (2021) opine ACEs model of screening remains relevant in the primary care setting because it enables the provider to identify individuals at the highest risk of toxic stress and therefore take the necessary steps to perform the complete individualized assessment on the identified persons. This is because professionals have identified several ACEs that are traumatic. These events include but are not limited to physical, emotional, or sexual abuse and physical or emotional neglect. One must appreciate that these ACEs continue to mess up a person’s life across the lifespan due to the unresolved stress, anxiety, and misguided beliefs the individuals carry at present yet have their origins in the past. Successful completion of ACE screening captures the ACE score to determine adversity, the clinical manifestations of the resultant toxic stress, and the protective factors the provider can use to help guide the mental health treatment plan. In both settings, ACE screening enhances health promotion and prevention of mental illnesses and helps in nurturing strong therapeutic relationships.
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References
Dawson, S., Bierce, A., Feder, G., Macleod, J., Turner, K. M., Zammit, S., & Lewis, N. V. (2021). Trauma-informed approaches to primary and community mental health care: protocol for a mixed-methods systematic review. BMJ Open, 11(2), e042112.
Knight, C. (2019). Trauma-informed practice and care: Implications for field instruction. Clinical Social Work Journal, 47(1), 79-89.
Rariden, C., SmithBattle, L., Yoo, J. H., Cibulka, N., & Loman, D. (2021). Screening for adverse childhood experiences: literature review and practice implications. The Journal for Nurse Practitioners, 17(1), 98-104.
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