What is trauma-informed care? And what would that mean in the context of a community that has experienced a traumatic event?
Understanding the principles of trauma-informed care is essential for helping individuals heal from their past experiences.
Two weeks ago, NYU’s Silver School of Social Work held a one day conference on the “Core Principles of Trauma-Informed Care: The Essentials” to address these very questions. This post is the first of a three part series exploring the principles of trauma-informed care, with a focus on how trauma impacts the brain, body, and our capacity for regulation and connection.
The principles of trauma-informed care focus on creating a safe space for clients to express themselves.
Below is a brief overview of what trauma and trauma-informed care are, according to Cheryl S. Sharp, MSW, ALWF from the National Council for Behavioral Health.
Trauma-informed care involves understanding the principles of trauma-informed care to promote recovery.
What Is Trauma?
According to SAMHSA, individual trauma results from an:
- Event, series of events, or set of circumstances that is
- Experienced by an individual as physically and/or emotionally harmful or threatening and that has lasting adverse
- Effects on the individual’s functioning and/or physical, social, emotional, or spiritual well-being.
The principles of trauma-informed care are crucial for organizations aiming to provide effective services. This is because:
- 61% of men and 51% of women report exposure to at least one lifetime traumatic event
- In public behavioral health settings, 90% of clients have experienced trauma
—> We all need to provide trauma-informed care to ensure the best possible health outcomes.
Principles of Trauma-Informed Care Incorporate:
- Realizing the prevalence of trauma
- Recognizing how it affects all individuals involved with the program, organization or system, including its own workforce
- Resisting re-traumatization
- Responding by putting this knowledge into practice
Understanding the Principles of Trauma-Informed Care
Implementing the principles of trauma-informed care can significantly enhance the therapeutic environment.
- Safety – ensuring physical and emotional safety
- Trustworthiness – maintaining appropriate boundaries and making tasks clear
- Choice – prioritizing (staff) consumer choice and control (people want choices and options; for people who have had control taken away, having small choices makes a big difference)
- Collaboration – maximizing collaboration
- Empowerment – prioritizing (staff) consumer empowerment and skill-building
7 Domains of Trauma-Informed Care:
Adhering to the principles of trauma-informed care ensures that clients feel secure and valued.
- Early screening and comprehensive assessment – If the client isn’t talking, ask: “What’s happened?” (Don’t ask: “What’s wrong with you?”) Not everyone is ready to talk but we give them permission to talk when they are ready.
- Consumer driven care and services – Listen to the people who are coming to us for services. Ask them if you can improve your services. Ask what can we do to help you better?
- Trauma-informed, responsive and educated workforce – Everyone in the system from the receptionist through the doctor matters. Disrespect can be triggering.
- Emerging and evidence-informed best practices – We need to use universal precautions. We need to expect either childhood experience or a current trauma but once we ask what happened, we need to provide EBP assistance.
- Safe and secure environments – It is important for the clinician to make it safe for the client. The organization also needs to make the client feel safe and comfortable (or is the waiting room dingy and dark?).
- Create trauma-informed community partnerships – This is very important to include in our work. Reach out to other organizations such as schools, the juvenile justice system etc. We need to spread this information to our partners in the community.
- Develop a performance monitoring system – Develop a data collection system to demonstrate what are the outcomes that you are seeing.
Moving onto Nelba L. Marquez-Greene, LMFT. She opened the conference on the principles of trauma-informed care with a powerful keynote that set the tone for the entire gathering. Marquez-Greene embodies the lived reality of trauma-informed work through the meaning and depth of what she has carried forward since becoming a trauma survivor herself.
Marquez-Greene’s experience highlights the principles of trauma-informed care as vital in recovery.
In her public speaking, including her well known TED talk, she shares the devastating loss of her six year old daughter, Ana, who was killed in the Sandy Hook school shooting in December 2012. Her son survived.
Listening to Marquez-Greene speak about her family’s tragedy and its impact on her life and community is profoundly moving. Her presence offers a clear reminder that trauma-informed care is not theoretical. It is rooted in lived experience, relational healing, and the courage to transform pain into purposeful action on behalf of others.
While it is true that Marquez-Greene is a mental health professional, the guidance she offered us came from her heart, from her being a trauma survivor.
As Marquez-Greene explains:
- Trauma overwhelms one’s ability to cope
- A trauma survivor is on a continuum from feeling:
What Was Most Helpful to Marquez-Greene and Her Family?
Those affected by trauma should be aware of the principles of trauma-informed care to facilitate healing.
- Her parents moved in for 3 months to help care for their son.
- A neighbor brought over her son everyday to play with their son.
- A volunteer social worker assigned to her family to check in everyday, providing practical help.
- Large extended network of college friends banded together to form love and support; they provided a sense of safety, control, community, connection and love in the midst of chaos and loss.
Marquez-Greene’s Suggestions for Mental Health Professionals:
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- Educate clients about their bodies’ natural flight, freeze or flight response
Understanding the principles of trauma-informed care can empower clients during their recovery journey.
- Encourage clients to connect with their friends and family for support
- Be curious without being voyeuristic
- Do not let the story get too big for the client; interrupt client (suggest wiggling toes in shoes or other grounding technique to allow client to self-regulate)
- Offer hope, for ex., “You’re going through the most horrible event in your life but I know you’re going to make it.”
- Try to be available for more than just 50 minutes/per week
- Be helpful with practical needs and still be around six months later
Marquez-Greene’s Observations:
The principles of trauma-informed care emphasize the importance of supportive relationships.
- Help/services are provided/offered for the deceased but nothing is offered for the survivors [living witnesses of the trauma].
The tragedy isn’t only when my daughter died; it’s for my son when my his sister died and his parents fell apart. The statistics for couples who lose a child are very stark.
- Being handed a list of unvetted resources is not helpful. You can’t think straight after trauma and being handed a long list list is too long and/or overwhelming.
Alternatively, receiving a piece of paper with a couple of resources with an explanation as to why you recommend those specific ones would be helpful.
- People think there’s a time limit to grief. You can use their gift certificate for 6 months and/or it is non-transferable.
She would have loved to have been able to honor some of the people who helped her with some of those gifts.
Practicing the principles of trauma-informed care is essential for effective mental health services.
- Some parents did not talk to their children about what had happened to their kids at Sandy Hook school. This mean that they had to come up with a script for their son b/c kids would ask him where is his sister.
It would have been helpful had all parents found a way to speak to their children about what had happened.
Marquez Greene ended her moving presentation by reflecting on a deeply personal letter written by her husband, Jimmy Greene. Titled Dear Jimmy, the letter speaks to his experience of grief following the loss of their daughter and captures the ongoing process of mourning, love, and meaning making within their family.
As difficult as it was for Marquez Greene and her family to make sense of the profound trauma they and their community endured, she has since become a fierce and compassionate advocate for survivors.
She is the Founder and Director of the Ana Grace Project, an initiative of Klingberg Family Centers. The organization is dedicated to supporting individuals and communities affected by the Sandy Hook tragedy in Newtown, Connecticut, and to advancing trauma-informed approaches to healing and resilience.
By understanding and applying the principles of trauma-informed care, clinicians can support regulation, restore a sense of safety, and help survivors rebuild meaning after overwhelming experiences.
Ready to learn about specific evidence-based treatments for trauma? Continue to Part 2: Evidence-Based Practices for Trauma where you’ll discover Narrative Exposure Therapy (NET), learn a simple grounding exercise you can use immediately with clients, and explore how EMDR works to reprocess traumatic memories.
Lastly, I highly recommend that you check out Dr Nancy Smyth‘s post on trauma-informed care. It not explains this important concept in depth but provides a wonderful list of resources on the topic. If you prefer hearing Dr Smyth talking on the topic, you can listen to her informative interview by Jonathan Singer.
Please share your thoughts below.
References: (2012). SAMHSA. for definitions of trauma and trauma-informed care; (n.d.) SAMHSA for prevalence figures.
The principles of trauma-informed care play a crucial role in supporting survivors and their families.
It’s important to share knowledge about the principles of trauma-informed care widely.
About the author:
Dorlee Michaeli, MBA, LCSW, specializes in EMDR therapy for high-achieving professionals struggling with imposter syndrome. She provides consultation for complex cases involving perfectionism and workplace anxiety. Learn more.
Last updated: December 25, 2025
Excellent! Will look forward to the other 2 parts. CHERREL, LCSW
Thanks, Cherrel 🙂
Thank you!!
Diego
It was my pleasure. Thanks for stopping by, Diego 🙂
Thanks for posting this! I’ve been learning in the past 2 yrs how important trauma-informed care is, and now I’m using the UCLA PTSD screen every time I get a referral that indicates trauma.
I get really surprised by the scores I get on it sometimes…and I’ve been seeing that there is a strong correlation between acting out in anger and past traumatization. Even traumas that people don’t necessarily see as traumatic…like a successful medical surgery that the child perceived as invasive, terrifying, etc.
Thanks so much, Bonnie, for visiting and taking the time to share some of your experience and learnings.
You’re absolutely right – even a successful medical surgery may have been perceived as a trauma… we have to broaden our definition of trauma… it is in the eye of the beholder.