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Every person goes through life with the experiences that shape them, good and bad. As the adage goes, “Be kind. You never know what someone is going (or has been) through.”
In a healthcare setting, the application of this is known as trauma-informed care.
“It’s an approach to interacting with patients and clients that is respectful of their backgrounds, their experiences and makes as few assumptions as possible about their lives,” said Michael Latady, MSW, MPH, client services manager – retention in care specialist for Allies for Health + Wellbeing. “[Trauma-informed care] approaches interviews and assessments and care in a way that is patient-client centered, takes into account people’s communities, their race, gender, sexuality … in an extremely nonjudgmental way.”
“Being trauma-informed means you’re going to have context – they have triggers, they have memories,” added Matthew Reinhart, LPC, behavioral health manager and therapist at Allies. “Being mindful of that, being sensitive to that, is essential to gain trust with the person you’re dealing with and how to help them.”
At Allies being trauma-informed also means understanding that we, as the helpers may set off those triggers unintentionally. We must then help the person process de-escalate in the moment, before moving continuing with the appointment.
Unfortunately, negative experiences in a healthcare setting can lead people to mistrust healthcare providers at best or to feel re-traumatized at worst.
“Having bad experiences in the past with healthcare can certainly impact visits going forward,” said Dr. Sarah McBeth, medical director at Allies. “People may have mental health concerns around healthcare, like PTSD, if something extreme happened in the past.”
Allies for Health + Wellbeing staff take a trauma-informed approach across all its services, from the medical clinic to outreach to case management for people living with HIV.
“It’s having people acknowledge that you don’t know what anyone is bringing,” said Anitra Branch, director of outreach and education. “We shouldn’t make assumptions about what they’ve been through when they come to us.”
Building trust is the cornerstone to much of trauma-informed care. For Allies outreach and education staff, trust must be established quickly. To assess a person’s risk for HIV and STIs, Allies staff may need to ask questions that patients or clients find triggering or upsetting. Staff focus on building a rapport with the person in front of them to gain trust and make that person as comfortable as possible in the moment.
“In testing, one of the things we do from the beginning is make people feel welcome in the space,” Branch said. “One of the first things we do in the session is talk about confidentiality. I want to set us up in this space to have a meaningful dialogue, so you know I’m here to get this information from you, not to judge you, and I hope you feel comfortable to share what you’re sharing.”
McBeth said that open communication between the patient and provider can help during a medical appointment.
“A … common example is mistrust of healthcare providers because they’ve had bad experiences before,” McBeth said. “If someone has been through that, they can vocalize it to their provider. That sort of thing can just remove a barrier – address the elephant in the room. If both parties are aware, they can move on more readily.”
Allies for Health + Wellbeing values a trauma-informed approach as part of its commitment to quality, holistic healthcare and keeping patients and clients at the center of their own care.
“We all have trauma and acknowledging that is valuable,” Reinhart said. “In a basic sense, it’s having empathy. It does help if you educate yourself about different marginalized groups, about different medical diagnoses, about lived experiences of people who have gone without.”
Using a trauma-informed approach is about building trust, listening and offering understanding rather than judgement.
Allies for Health + Wellbeing staff take a trauma-informed approach across all Allies services, from primary care, HIV specialty care, case management for those living with HIV, testing and outreach and more. If you’d like to experience this kind of patient-centered care for yourself, visit AlliesPGH.org or call 412-345-7456 to schedule an appointment.
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