Trauma-Informed Therapy
As a mental health nurse and therapist I have specialist knowledge and skills in trauma therapy, and have also led and supported improvement in culture change to reduce and prevent re-traumatisation and harm in NHS mental health services. As a therapist, my practice is rooted in the values that underpin trauma-informed care- Safety, Choice, Trust, Collaboration and Empowerment.
This means that I work in a particularly mindful way to support your wellbeing during therapy, whether or not you have direct experience of trauma.
You might notice this in the way I collaborate with you, in how I work to ensure your choice and preferences, and support your emotional, physical and nervous system safety during the therapy process, and in how I use my therapy room and environment to support this.
Trauma-informed therapy recognises how trauma can be caused from early life onwards, and their impact on thinking, memory, emotions, sense of self; nervous system and body; attachment and wider interpersonal relationships. Experiences like watchfulness / hypervigilance, dissociation, hyper-independence or emotional numbness are not "abnormal" or a sign something is "wrong" with you. They are often natural, protective adaptations by your mind and nervous system.
Trauma, or re-traumatisation, can also arise from later experiences that feel invalidating, discriminatory, abusive, or dismissive, and the sense of fear, vulnerability or shame that can be activtated by reminders in certain situations, environments, or relationships.
Such trauma can be experienced in the workplace, when bullying and the dynamics that enable this are allowed to flourish, when work systems create impossible demands that lead to a reduced sense of competence, moral injury (having to engage in practices that go against your values or ethics), or through repeated exposure to details of child sexual or physical abuse, or domestic violence, in health or social care safeguarding meetings, without proactive debrief or clinical supervision for all involved.
For people coming into contact with services, even 'trauma-informed' services, experiencing repeated exclusion from access to services, lack of support, or non-collaborative processes and negative attitudes can be traumatic and isolating.
The areas below represent some of the foundations of mental health and well-being that can be impacted by trauma and difficult experiences, but which can also be strengthed during therapy to support personal, relational and physical recovery, wellbeing, and growth.
Safety & Stabilisation
Identifying triggers for stress, distress or nervous system overwhelm, and learning to cope with difficult emotions, memory gaps or intrusions, and process difficult experiences. Recognising that freezing, hypervigilance, self-criticism, people-pleasing, or avoidance are protective survival strategies.
Trust
Learning to trust your inner wisdom and developing confidence in your own judgement to guide your relationships and boundaries, with yourself and others. This can also be about gradually developing trust in the predictability and safety of the therapy environment and process.
Autonomy
Being in charge of your own life and regaining personal agency, choice and control. Being able to make choices that are based on what's important to you. Feeling comfortable communicating in your own style, and processing interactions or experiences at your own pace.
Confidence
Building trust in your own inner capacity and resources for healing and growing, and changing old patterns of self-doubt.
Identity
Reclaiming and affirming your internal sense of worth and self image, that doesn't depend on other people's approval, or society's expectations, of you.
Reconnection
Identifying what really matters to you and rediscovering purpose, meaning, interests or relationships. From surviving to thriving.
What to look for in a trauma-informed therapist
'Trauma-informed' has become a bit of a buzzword in many people-facing services. Below are just some of the basic features you would expect to see in trauma informed counselling or therapy.
Physical & Environment Safety
The therapist or counsellor:
Is welcoming and gives clear information about-, and accessible- communication channels.
Provides transparent information at the outset about the therapy process: what you can expect in a first assessment / intake appointment; processes or policies in place-such as complaints procedure.
Offers choice in appointment times.
Provides details on how to find their therapy practice, any parking and access arrangements in entering.
Offers you choice in use of lifts or stairs, access to the toilet and refreshments, and choice in seating, heating, lighting and door proximity in the therapy room.
Respects your physical boundaries -won't make sudden movements, and will check in with you when moving around, and check where you prefer they sit in relation to you.
Won't ask you to close your eyes during any exercises, unless you wish to, and won't touch you without your consent, or at all.
Maintains predictability - like room layout, session start and finish times, and session 'flow'.
Client-Therapist
Relationship
The therapist or counsellor:
Strives to create a warm, positive and supportive relationship with you where you feel safe and sees you both as as equal collaborators, recognising that you are the expert on you.
Explains the purpose of any exercises, and seeks your permission before suggesting to try these, respecting your choice.
Models healthy relationship boundaries and communication -they are reliable and neither rigid or overly casual in their approach, and is adaptive to your gender, cultural or other needs, including physical health or neurodivergence.
Makes sure you feel seen, heard and respected, and that you feel in control of the therapy process and that you're working to your goals.
Treats you as a whole, resilient person, not as 'symptoms' to be fixed,
Doesn't ask you to do anything you don't want to do or feel uncomfortable with, and checks in with your comfort levels during session.
Regularly invites your feedback or experience of therapy with them.
Nervous
System
Regulation
The therapist or counsellor:
Notices any activation of your nervous system, or change in body language, and offers support in a sensitive way.
Will check out with you the best ways to help you re-regulate, recognising that deep breathing, for some people, may make things feel worse, and will use trauma-sensitive methods of grounding instead.
Encourages any need you may have to move around or pause.
Recognises the mind-body connection and how they influence each other.
Therapy Approach & Language
The therapist or counsellor:
Focuses on "What happened to you?" instead of "What is wrong with you?"
Will respect your personal, relational and emotional boundaries - won't use coercive ('You must') or dismissive ('It could have been worse') language, and won't share or try to influence you through their own experiences ('I went through that trauma too, this is what worked for me').
Respects diversity of experience and doesn't judge or make assumptions about your experiences, or how you feel or react in relation to these.
Doesn't ask for information about you or others that is not relevant to your therapy.
Doesn't promise things they can't provide, and provides evidence-informed interventions only.
Is mindful of the potential for any trauma or difficult experiences you may have previously experienced, including within wider services.