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Understanding and Implementing Trauma-Informed Care for Clients in Pain: Summary
• Staff reported a greater understanding of trauma • Staff reported needing training to deliver TIC effectively Implementing trauma-informed care in pain management can lead to reduced pain levels and increased patient adherence to treatment plans. This approach strengthens the therapeutic relationship, leading to better patient engagement and more effective pain relief. Additionally, it minimizes patient distress and the risk of retraumatization, contributing to higher overall patient satisfaction and improved long-term health outcomes. NTRODUCTION TO THE AUTONOMIC NERVOUS SYSTEM Humans are wired for survival. Fortunately, we don’t have to consciously and continuously scan our environment for threats. That is the role of our autonomic nervous system. Stress responses include: • Increase in heart rate • Increase in respiratory rate • Postural changes • Protective movements These stress responses are automatic, calculated quickly, and refined over many thousands of years of evolution. When this stress response doesn’t get completed or if it is prolonged, our physiology remains functioning under a state of threat.
competencies across the lifespan in various settings, populations, and care team models. What Are the Connections Between Trauma and Chronic Pain? People who have experienced childhood trauma or suffer from PTSD are 10 times more likely to experience chronic pain . Two in three patients who experience a traumatic injury have chronic pain for at least 1 year following. Approximately 15% to 35% of patients with chronic pain also have PTSD. Survivors of physical, psychological, or sexual abuse are at higher risk for developing chronic pain later in life. By understanding the prevalence and impact of trauma and chronic pain, providers can implement strategies that address the root causes and improve patient outcomes. The Role of Early Life Trauma in Chronic Pain Patients The Biopsychosocial Model: This approach describes pain as a multidimensional, dynamic integration among physiological, psychological, and social factors that influence one another. The model was touted heavily by George L. Engel in 1977, who specialized in chronic inflammatory diseases. All three levels, biological, psychological, and social, must be taken into account in every health task. This model led to the development of the most therapeutic and cost-effective interdisciplinary pain management programs, and makes it far more likely for the chronic pain patient to regain function and experience vast improvements in their quality of life. The PPP Method : This method states that we need to repattern how the brain, nervous system, and body are perceiving and therefore responding to input so we don’t activate and reinforce the old neural protective patterns of pain. • Psychological : What is the story our client is telling themselves about their pain? • Physiological : How can we support the autonomic nervous system and subcortical brain structures to decrease stress, inflammation, and pain sensitivity? • Physical : How can we support the physical body to move with less tension, compensation, and pain? EXPECTATIONS AND FUNCTIONAL OUTCOMES This chapter identifies the results and outcomes our clients may experience when we approach our work from a trauma-informed perspective. The rates of restraint and seclusion decreased. When we implement trauma- informed approaches in acute, crisis, emergency, and residential health care, we can expect outcomes such as: • Service users reported feeling trusted and cared for • Staff reported feeling greater empathy for service users
A Completed Stress Cycle
An Incomplete Stress Cycle
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