Trauma-Informed Care Training
Evidence-based principles and de-escalation techniques for staff
Six Core Principles
Safety
Create a physically and emotionally safe environment where patients feel protected.
- Minimize unexpected surprises or transitions
- Explain procedures and give choices when possible
- Maintain clear boundaries and consistency
Trustworthiness
Be transparent, consistent, and follow through on commitments.
- Explain what will happen before it happens
- Be honest about limitations and what you can/cannot do
- Keep confidentiality agreements
Choice & Control
Empower patients by offering choices and respecting autonomy.
- Offer options: "Would you prefer option A or B?"
- Validate choices even when different from recommendations
- Involve patients in care planning and goal-setting
Collaboration
Work WITH patients, not TO them; partnership in healing.
- Ask patients what helps them feel safe and grounded
- Involve patients in treatment decisions
- Recognize and build on patient strengths
Empowerment
Focus on strengths, resilience, and capacity for growth.
- Recognize trauma as an injury, not a character flaw
- Highlight coping skills and resilience
- Set achievable goals to build confidence
Cultural Humility
Recognize and respect diverse trauma experiences and healing practices.
- Acknowledge how culture shapes trauma experience
- Learn about patients' cultural backgrounds
- Avoid assumptions; ask respectfully
Common Trauma Responses (Fight/Flight/Freeze/Fawn)
Fight Response
Aggressive, confrontational, anger-driven behavior
⚠️ Warning Signs
- •Verbal aggression
- •Physical aggression
- •Oppositional behavior
- •Blame-shifting
- •Argumentative tone
✓ Staff Response
- Stay calm; don't match their energy
- Use slow, steady speech and movements
- Offer space—don't crowd or corner
- Acknowledge anger: "I see you're upset"
- Provide choices to regain sense of control
- Focus on safety, not compliance
Six-Step De-escalation Process
Recognize Early Signs
Watch for escalation cues before crisis
Create Safety
Establish a safe environment
Calm Your Own Nervous System
You cannot calm someone else if you are dysregulated
Connect & Validate
Show empathy and understanding
Offer Choice & Control
Empower by providing options
Problem-Solve Together
Partner to find solutions
Trauma Myths vs. Truth
❌ Myth
Trauma survivors just need to "get over it"
✓ Truth
Trauma changes the brain. Healing is a process requiring time, support, and evidence-based treatment. Recovery is possible with proper care.
❌ Myth
If they don't talk about trauma, they're avoiding it
✓ Truth
Silence is often a coping mechanism. Some survivors need to feel safe before disclosing. Pushing too hard can re-traumatize.
❌ Myth
All trauma survivors become violent
✓ Truth
Most trauma survivors are not violent. Common responses are withdrawal, freezing, or self-harm—not aggression toward others.
❌ Myth
Punishment/tough love helps
✓ Truth
Punishment re-traumatizes and harms recovery. Trauma-informed care emphasizes safety, trust, and healing over control.
❌ Myth
They're overreacting to minor triggers
✓ Truth
The nervous system doesn't distinguish past from present. Triggers activate survival responses—not logical overreaction.
❌ Myth
Trauma is always obvious/visible
✓ Truth
Many survivors hide trauma well. They may seem fine while struggling internally. Quiet pain is still real pain.
Key Reminders
- •Behavior is communication. Dysregulated behavior often reflects unmet needs or triggers, not choice.
- •De-escalation first, restraint last. Always exhaust alternatives before physical intervention.
- •Self-care is essential. Vicarious trauma is real. Practice grounding, seek supervision, use support systems.
- •You can't pour from an empty cup. Model healthy coping and boundaries to patients.