The topic on which I have chosen to focus my main internship project is trauma informed care. According to the U.S. Department of Health and Human Services, 85-95% of women in the public mental health system report a history of trauma, with trauma most commonly occurring in childhood. Not all individuals with a trauma history have or develop a mental illness, but most individuals who suffer from mental illness have also experienced trauma, and most of the patients I have interacted with have experienced some kind of trauma.
Historically, people who suffered from mental illness were not expected to recover, nor were they treated as individuals. The mental health care system in the US has been improving steadily, from improvements to facilities and inpatient institutions in the mid 1800s to deinstitutionalization (moving individuals from asylums and hospitals to homes and community-based care) since the 1950s. However, it has only been during the past 30 years or so that an interest has been taken in the impact of traumatic experiences on mental and behavioral health, and it did not become a direct focus in direct mental health care until a few years ago.
A trauma-informed approach to treatment is one in which the focus of healing is sensitive to the root or underlying trauma causing symptoms. Trauma-informed caregivers recognize the signs and symptoms of trauma in staff, patients, and families, and their treatment is sensitive to the continuing effects of trauma in individuals.
This approach focuses on a set of principles rather than a list of rules for treatment. It offers a new paradigm in which the premise of treatment shifts from asking, "What's wrong with you?" to asking "What happened to you?"
Trauma-informed interventions focus on the safety, empowerment, and support of individuals. Trauma-informed staff focus on building trust and transparency, on collaboration with patients in treatment, and on the unique nature of each patient's needs.
I chose this topic to do my project on because I believe the shift towards trauma sensitive care and trauma-informed services is an important step in mental health care. I want to work in this setting because I believe individuals can and do experience recovery from trauma, and that understanding the experience of individuals is part of the foundation of a therapeutic relationship.
One of the things I've seen mentioned several times while I've been researching trauma-informed care has been the importance of offering services that allow patients the time to build trust and the safety to share their story, to share about what happened. This especially resonated with me. Before I had ever heard of trauma informed care, I wrote a paper for a counseling class about my motivations for working as a counselor. In this paper, I used a metaphor of each person's life as their own personal story that is being written, and about my desire to see individuals share their stories and "make their next chapter better than the last".
Because of this, I chose to use the theme of story sharing in my "special project" for internship as well. I'm working on writing a program plan tying story sharing in with music therapy; specifically, giving group members an opportunity to build trust and write songs telling a part of their story. I am hopeful that this project will be meaningful for participants in this group and for my internship.
One of the prompts on the description for what this journal could be about is, "Why have I chosen this path?" This is a question I've been reflecting on throughout my internship so far. The truth is, there are many reasons why I chose this path, but I think that this project and trauma-informed care in general play a big part in why I've chosen this path. I have chosen this because, as the National Center for Trauma-Informed Care states on their web page, "people with lived trauma experience can and do recover and heal".
Among other things, I am continuing to learn how to practice this kind of care and will continue to do so throughout my internship and career. Next week I will also have the chance to attend a special training about Trauma-Informed Care, which I'm really excited about. I'm hopeful that the hospital is making steps in the right direction towards having a trauma-sensitive environment where people can and do heal.
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