Trauma-informed care recognises that past harm can affect how a person experiences services, authority and loss of control. It emphasises safety, clear explanations, collaboration and choice wherever possible. It does not require everyone to disclose trauma or assume that all symptoms arise from traumatic experiences.
Trauma refers to experiences involving serious threat, harm or overwhelming distress, and the effects those experiences can have. Trauma exposure is associated with psychosis in research, but it is neither necessary nor sufficient for schizophrenia. People differ in their responses, and experiences should be discussed sensitively without assumptions or pressure.
Practical examples include explaining examinations before touching, discussing who will be present and asking what makes appointments more manageable. Staff should recognise that restraint, abrupt instructions or unexplained decisions may intensify fear. Emergency situations can limit choices, but respectful communication and review still matter. Trauma-informed care differs from trauma-focused therapy, which directly treats trauma-related symptoms through specific methods. Both can be relevant, but they serve different purposes. The aim is to make ordinary care more predictable and respectful while addressing present mental, physical and practical needs without unnecessary retraumatisation.
Choice can be restored through small, concrete actions, such as explaining a procedure, asking permission and offering a pause. These practices can improve ordinary care even when no trauma history is known. Trauma-informed work is therefore a way of organising respectful services as well as responding to disclosure, with attention to safety, predictability and the person’s continuing participation.
Further reading: Research record 22461484; National Institute of Mental Health; Research record 23599019.
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