If you work with individuals who have experienced violence, abuse, neglect, disaster, or any form of trauma, you know that what they’ve been through has a powerful effect on their worldview, health, and behavior. And you know that in order to support them best, the question we ask about their behavior needs to shift from “What’s wrong with them?” to “What happened to them?”
Trauma is an almost universal experience of people who struggle with behavioral health conditions such as substance abuse and mental health concerns. Throughout its history over the last four decades or more, traumatic stress has been defined in a variety of ways, each with subtle nuances and slight differences. To help practitioners, researchers, and trauma survivors work with a shared concept of trauma, The Substance Abuse and Mental Health Services Administration (SAMHSA) has collaborated with its panel of experts to craft the following concept of trauma:
“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
The keywords in SAMHSA’s concept are The Three E’s of Trauma: Event(s), Experience, and Effect. When a person is exposed to a traumatic or stressful event, how they experience it greatly influences the long-lasting adverse effects of carrying the weight of trauma. These effects can include changes in neurobiological makeup and difficulty coping, feeling trust, managing cognitive processes, and regulating behavior.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach [PDF] document details this concept, as well as The Four R’s, or Key Assumptions in a Trauma-Informed Approach, The Six Key Principles of a Trauma-Informed Approach, and guidance for implementing a trauma-informed approach.
The document emphasizes that while trauma is a widespread, harmful, and costly health problem that affects behavioral health, primary healthcare, child welfare, education, criminal and juvenile justice, the military, and many other settings, offering appropriate, empathic, and person-centered supports and interventions can help people overcome traumatic experiences and heal.
More Helpful Resources From SAMHSA:
- Learn about how trauma impacts children, and how you can help.
- Pick up SAMHSA’s Treatment Improvement Protocols (Trauma TIPs).