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Moving Upstream in Trauma-Informed Care

“The journey of a thousand miles begins with a single step.” Lao Tzu

This month, we’ve been exploring the topic of trauma and how addressing trauma is an important aspect of care delivery to enable a healthy population. Many healthcare systems are investing time and resources to embedding trauma-informed principles and practices into care delivery, anticipating benefits to patient experience as well as improvements in provider well-being. While it is necessary and important for healthcare to incorporate new capabilities into existing practice, like in many areas, it is also important to think “upstream.”

In June, I had an opportunity to speak with faculty and administrative leaders from Belmont University who had been exploring ways to incorporate the science of trauma-informed care into their health sciences curriculum, to prepare future health services professionals for supporting individuals who had experienced trauma. With funding from a Building Strong Brains grant from the State of Tennessee, Belmont leaders created curricular modules for students in nursing, social work and public health that addressed foundational content such as: the impact of trauma on the developing brain; the impact of adverse childhood experiences, or ACEs, on communities, and building community resilience; and the implications of ACEs for health professionals. In addition, Belmont leaders created a poverty simulation that enabled faculty and staff to better understand the challenges faced by children and families living in poverty, since poverty is highly correlated with adverse childhood experiences. This work is showing promising results, with the first cohort of students reporting increased awareness of and appreciation for the impact of trauma on their future patients, as well as a recognition of the applicability of this knowledge in their profession.

I believe our next opportunity is to move even further upstream, to build resilience factors among children, families and communities, and eliminate exposure to trauma in the first place. Doubting it’s possible? The research suggests otherwise. A number of studies have identified evidence-based practices and programs that create safe, stable, nurturing relationships for children, and policies that support healthy environments for children and families. In addition, several cities across the United States have already begun investing in efforts to build trauma-informed, resilient communities.

So where can we begin? We begin with each of us asking new questions, and committing to following the learning where it may lead. Below are some questions for you to consider:

  • How effective am I in recognizing when a colleague, patient or client is struggling to process a traumatic experience?

  • How might a patient or client who has experienced trauma feel when they interact with my organization? With me?

  • What is the largest source of trauma for those with whom I most frequently interact? What is one change I could make to ensure these interactions are trauma-informed?

  • What is one practice that will help me build resilience within myself? Within my family? Within my community?

Creating “upstream” changes that promote safe, healthy and nurturing environments for children will require action in multiple sectors and may seem overwhelming, but it is certainly possible for all of us to take the first step.

Genesis Health Consulting has significant experience facilitating change within organizations and working across sectors to manage change within industries or communities. We welcome the opportunity to learn about your particular challenge, and to share more about our experiences. Please contact us at:

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