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What are the principles of trauma-informed care?

Following are recognized core principles of a trauma-informed approach to care that are necessary to transform a health care setting:

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Throughout the organization, patients and staff feel physically and psychologically safe


Trustworthiness + Transparency

Decisions are made with transparency, and with the goal of building and maintaining trust


Peer Support

Individuals with shared experiences are integrated into the organization and viewed as integral to service delivery

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Power differences — between staff and clients and among organizational staff — are leveled to support shared decision-making



Patient and staff strengths are recognized, built on, and validated — this includes a belief in resilience and the ability to heal from trauma


Humility + Responsiveness

Biases and stereotypes (e.g., based on race, ethnicity, sexual orientation, age, geography) and historical trauma are recognized and addressed

(Adapted from the Substance Abuse and Mental Health Services Administration’s “Guiding Principles of Trauma-Informed Care.”)
  • Historical adversity, which includes slavery, sharecropping, and race-based exclusion from health, educational, social, and economic resources, translates into socioeconomic disparities experienced by Black and African American people today. Socioeconomic status, in turn, is linked to mental health: people who are impoverished, homeless, incarcerated, or have substance use problems are at higher risk for poor mental health.

  • Despite progress made over the years, racism continues to have an impact on the mental health of Black and African American people. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences. Historical and contemporary instances of negative treatment have led to a mistrust of authorities, many of whom are not seen as having the best interests of Black and African Americans in mind.

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