What is "Trauma Responsive" Care?


​Over the years, the words “trauma” and “Trauma Informed Care” have been used in various settings, including outpatient and inpatient. The sole purpose is to bring attention to the providers of a potential trauma history with the patient/client/family, so that the provider can respond accordingly. Recently, “Trauma Responsive Care” has been added to the mix, but to an outsider it may sound similar, if not the exact same as the other phrases being used. So what is “Trauma Responsive Care” exactly?

Trauma Responsive Care has many components to it, so it’s best to break it down to the basics. This particular certification is offered through Finding Hope Consulting, LLC, which is a local consulting firm that specializes in Trauma Informed and Trauma Responsive trainings for professionals in various fields. The certification series utilizes neuroscience and resilience based interventions to rebuild neuronal networks that have been damaged by trauma and to assist people in healing from their trauma in order to lead resilient lives.   Mary Vicario is a Certified Trauma Specialist and founder of Finding Hope Consulting, LLC. She put together a curriculum that is based upon the ACEs (Adverse Childhood Experiences study) and included research from leading scientists in the field, including Drs. Bessel van der Kolk (author of The Body Keeps the Score), Gabor Mate (author of In the Realm of Hungry Ghosts: Close Encounters with Addiction), Dan Siegel, Louis Cozolino, Pat Ogden, Sandra Bloom, Stephen Porges and others.   What are ACEs and why are they so important? I’m glad you asked! As stated above, ACE stands for “Adverse Childhood Experiences” and laid the groundwork for the links between trauma in childhood and medical conditions, psychiatric problems, addiction, and/or other unsafe behaviors later in life. The study actually happened quite serendipitously; it resulted from a researcher (Vincent Felitti, head of Kaiser Permanente’s Department of Preventive Medicine in San Diego) noticing that about half of the participants in a weight loss program dropped out, despite being successful in losing weight. Upon further investigation, he noticed that a number of the participants also endured childhood sexual abuse. He conducted interviews with participants in this program and was able to uncover more links between childhood abuse and the various outcomes listed above. The results were remarkable. According to the CDC, the questions referred to the experiences that the respondents had during their first 18 years of life. They include emotional abuse, physical abuse, sexual abuse, mother being treated violently, substance abuse in the household, mental illness in the household, divorce/separation of parents, a member of the household being incarcerated, emotional neglect and physical neglect (https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html). The results of the study found that ACEs are frequent: according to the CDC website, “almost two thirds of the study participants reported at least one ACE and more than one in five reported three or more ACEs.” The research and its findings were officially published in 1998.   The study showed that the more ACEs that someone reported, the higher the risk of having co-occurring medical and psychiatric issues and behavioral problems. Problems such as chronic illnesses (cancer, diabetes), risky behaviors (alcohol and drug abuse), bodily injuries (TBI, fractures, burns), mental health issues (depression, anxiety, suicide, PTSD), maternal health issues (unintended pregnancies, pregnancy complications, fetal death), and infectious diseases (HIV,STDs)are some examples. (https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/about.html) ccording to the TRCC handbook, research has identified additional stressors that could play a role in a person’s mental and physical development. These are called Compounding Adverse Toxic Stressors or CATS. These include poverty, war/community violence, witness to or experiencing violence (includes seeing abuse of siblings), bullying, homelessness, early childhood intrusive surgeries and discrimination (Garner et al, 2012). Some additional statistics show the affects of ACES without resilience based experiences to offset them (Vicario, 2019). They include:

  • Four or more ACES result in a 1,350% increase in becoming a victim of opiate abuse.

  • Six or more ACES result in a 4,600% increase in becoming a victim of opiate abuse.

  • With or without smoking, individuals with an ACE score of 5 or greater have 2.6 times the risk of developing Chronic Obstructive Pulmonary Disease (COPD) (Anda, 2008)

  • Individuals with 7 or more ACEs have 5 times the risk of reporting hallucinations (Whitfield, 2005)

  • Six or more ACEs in infancy, childhood, or adolescence shorten an individual’s life expectancy by almost 20 years (Brown, 2009).

Physical health effects were not cause by poor health habits. They were a result of organs that were damaged by the stress chemicals repeatedly released in connection with the adverse childhood experiences (Vicario, 2019).   Building upon this research and utilizing the need of “felt safety”, we begin to redefine what safety is and how someone can identify it within themselves. We also utilize techniques that assist the client in feeling safe in unpredictable situations, identifying Vagus Nerve responses and calming techniques, education surrounding the Limbic System and its purpose, and rebuilding their lives. This task is no small undertaking, but with validation and support from the appropriate people, healing can be a reality.   If you or someone you know is struggling with the effects of trauma, depression, anxiety or any other related issues, feel free to schedule an appointment with me! I’m happy to utilize TRCC interventions or any other interventions that will assist in ensuring your success.