What does trauma-informed care look like?

What does trauma-informed care look like?

 By Sarah-Ashley Robbins, MD

Trauma-informed care for me starts with asking permission. This can look like asking permission to do a procedure, asking permission to talk about a difficult life event, or asking permission before starting a physical exam. However, the key to this is being prepared to stop if I am not given permission, even if I think completing the task is beneficial to the patient. Allowing the patient to maintain full autonomy of their body and mind while in a doctor’s exam room is vital. It’s amazing how much I can learn about someone by just actively listening, without interruption, to their lived experience. Being able to bear witness to another’s story is truly a privilege and can be healing for both storyteller and listener. Allowing genuine time to get to know my patients (and them me) allows us to build a trusting and solid patient-physician relationship. Once I have a good sense of who my patient is, I can create a medical plan that aligns with them as a whole person and not just a diagnosis.

I strive to keep open and engaging communication between a patient’s other team members including dietitians, therapists, and other specialists. As team members, we can each address the patient’s needs according to our unique disciplines while staying on the same page with each other. We want to work together to hold the patient accountable to their goals without being domineering. I often gain great insight to my patient’s personality and what type of support works best for them from a therapist or dietitian who has known them longer than I have. There are times where the multi-disciplinary team members need to come together, as a “convening of minds” so to speak, to discuss ways to help a patient progress when we seem to be at a stalemate. By putting our heads together and sharing our thoughts or concerns, we can often make a unified plan to help our patients take steps forward.

As an example of trauma-informed care that I provide, let’s say a patient needs a Pap smear for cervical cancer screening. This procedure has been very daunting and triggering in the past which has led to the patient avoiding this cancer screening recommendation all together. I, as the doctor in this scenario, would discuss the procedure in detail with the patient while they are still fully dressed. While explaining, I would not assume that the procedure is going to be “painless” or “easy” as everyone experiences this procedure differently. If they didn’t want to complete the procedure after detailed explanation of what it entails, I would respect that. I would have them discuss with their therapist more about their past experiences that might make this procedure more challenging to complete. If they were willing to go forward with the procedure, I would remind them at the beginning of the procedure that they are completely in control, and we can stop the procedure at any time. I would explain step by step what I am doing so there are no surprises. I would leave space for debriefing after the procedure if the patient needs this. I will always be open to humbly accept feedback on how I can make any visit, procedure, or exam more comfortable to my patients in the future.

The Gaudiani Clinic provides trauma-informed care for patients seeking HAES-informed primary and eating disorder medical care. If you would like to find out more information, please call 720.515.2140 or e-mail info@gaudianiclinic.com.