For those of us working on the front line in the human services field during COVID-19, the urgency of providing services with a trauma-informed approach has never been more obvious. In employment and training, we have seen our clients affected on so many levels – from sudden job loss, to the illness and sometimes passing of friends, family members and loved ones, to painful, ongoing reminders of racism and violence across our public institutions.
The events of 2020 and 2021 have affected us all, but the harm has been most significant against already-marginalized groups. As employment service practitioners (ESPs), this means we are seeing clients who were already facing discrimination and living in precarious contexts face even more barriers – and this is often especially true for our clients with disabilities, our newcomer clients, our racialized clients and our young adult clients.
As we seek to support all of our clients, a trauma-informed approach can become a compass that helps us chart and move through these rough waters. This article is the first in a two-part series that aims to provide you with a snapshot of some ways you can use trauma-informed principles in your client work, and why this approach can be helpful.
Trauma-informed vs trauma-specific
When we think about trauma-informed care in non-clinical settings, we need to understand the important distinction between trauma-informed services and trauma-specific services.
Trauma-specific services are interventions that target the processing and healing of traumatic stress. This includes things like individual psychotherapy, group psychotherapy or psychiatric diagnosis and pharmaceutical treatment. Trauma-specific services are delivered by regulated professionals, who are accountable to specific regulatory Colleges and codes of ethics, and are supervised by more senior practitioners.
Trauma-informed services are services that are designed to be accessible to people who have experienced trauma, but that don’t intentionally target the processing and healing of that trauma. Any and all human services can and should be trauma informed – from education to emergency housing, primary health care to employment services; anyone who is working frontline can deliver trauma-informed service.
Starting with safety
Safety is the No. 1 principle of a trauma-informed approach to practice. In our work around trauma-informed approaches to employment and training services, Purpose Co uses the six principles of trauma-informed care as developed by SAMHSA (the Substance Abuse and Mental Health Services Administration). Safety is the first SAMHSA principle, and the subsequent five principles all rest heavily on this.
The reason safety is a top priority is because one of the distinguishing features of post-traumatic stress is an elevated threat response. Put simply: people who have experienced trauma are especially on alert for anything or anyone that might hurt them. If our clients who have experienced trauma sense danger, responses of fight, flight or freeze will often arise, and we will see our clients thrown into a state of significant stress. As a practitioner, you’ve probably seen this firsthand – a client who jumped at a loud noise and had difficulty calming back down, or a client who was extremely anxious about working with you and took a long time to trust you enough to open up.
All of our clients need to feel safe when accessing our services, but for our clients who have lived through trauma, this need is heightened and not meeting it can have serious consequences.
Ensuring physical and emotional safety
So, what is safety, and how can we learn to create it? In this case, safety means both physical and emotional safety. Physical safety is often the easiest of these two to understand, assess, improve and monitor. It involves obvious infrastructural pieces (entrances that are accessible from the street, clear sightlines that allow staff to monitor activity within the office, etc.) and design choices that affect mood and ambience (lighting that is non-abrasive but effective, offices painted in warm tones, available toys or reading material).
We can often get a read from our clients about their sense of physical safety by asking lateral, generative questions. Lateral questions are open-ended, centre on a suggestion and help us understand a client’s experience of a space. Some examples are:
- “What’s your favourite room in this office? I like the XYZ room, I find it very calming. What do you think?”
- “We’re thinking about improving the lighting in the hallways, because we find it a little harsh. Is there anywhere else you think we could do to improve the hallway?”
- “We’re thinking about opening evening hours on Wednesdays, but we know a lot of our clients don’t like being out after dark. We’ve heard people would like to meet at the bus stop together before walking to the office. Do you think that would help?”
Emotional safety is more complex, but is as crucial – if not more – than physical safety. Emotional safety is what happens when I, as a client, trust that you, as a practitioner, will not hurt or harm me, and I feel that I can be open and honest with you.
Emotional safety is a felt state. That means it is internally determined, in response to external cues. Often, when clients have experienced trauma, and particularly when the trauma has involved betrayal or abuse by people and institutions of authority, it is challenging to feel emotionally safe. This creates a deep experience of loneliness and isolation, which can lead to depression and hopelessness.
We know our clients are feeling emotionally safe with us when they:
- Share openly
- Make a lot of eye contact and use open body language
- Laugh, make jokes or are silly
- Tell us that they feel comfortable or supported
- Express interest to keep working with us
Unfortunately, many agencies and organizations use internal processes that damage emotional safety. For instance, in an agency relying on short-term contract labour, shifting clients between workers may negatively impact emotional safety. Or, in an agency that offers different programs, asking highly personal questions in an online screening tool may be triggering for clients.
Learning to co-create emotional safety (and repair it when it gets fractured) is a key skill in delivering trauma-informed care. As the examples above show, it’s something that both practitioners and agencies need to learn. ESPs can be highly attuned and responsive, but if their agencies are unable to reform processes that don’t account for emotional safety, clients who have experienced trauma will continue to disappear or experience poor outcomes.
For individual ESPs who want to work on emotional safety, some useful principles to think about are:
- Offering to share information proactively. If you take notes, consider doing so collaboratively. If collaborative note taking is not possible, sharing a copy of your notes with the client is also a good practice.
- Mirror the client’s body language and non-verbal communication. Don’t push them for eye contact if they are not initiating it.
- Avoid asking intrusive questions and allow the client to disclose information about themselves at their own pace.
- Share transparently about your philosophy of service, including your efforts at establishing a good connection and where you are learning.
As frontline providers delivering employment and training services throughout 2020 and 2021, we have all seen the wide-ranging and profound impacts of trauma on our clients. We have also seen the vital importance of delivering employment services from a trauma-informed lens. In this article, we have shared some techniques for applying safety, the first principle of trauma-informed care, to employment and training services. In the next instalment of this series, we will focus on how ESPs can apply two more principles of trauma-informed care in their work: trust and transparency, and empowerment, voice and choice.