Trauma-informed care is a service delivery approach whereby AOD services: i) recognise the high rates of trauma exposure among their clients and its potential impact on clients’ circumstances; ii) respond by integrating that knowledge into policies, procedures, programs and practices; and iii) create a safe environment that accommodates the needs of clients presenting with a history of trauma [141]. Physical and psychological safety are core to the fundamental goal of trauma-informed approaches, which is to create treatment environments that are more healing and less re-traumatising for both clients and staff [141].
A trauma-informed care approach has multiple layers, both at the organisational and individual level [385, 386]. Ideally, services will adopt a trauma-informed approach that is visible in all aspects of the organisation and reflected in policies and procedures. Such an organisational approach provides a framework that supports all service staff (e.g., administrative reception staff, cleaners, security and kitchen staff, management, board members), not just those involved in clinical care, to implement trauma-informed care at the individual level in all interactions and processes. That is, from when a potential client makes first contact with a service, all the way through treatment to discharge, and follow-up [385]. In this chapter, we focus on aspects of trauma-informed care that may be employed by AOD workers at the individual level and suggest that at a minimum, all staff working with AOD clients should: i) have an awareness of the extent of trauma exposure among their clients; ii) understand the consequences of trauma exposure and its potential to impact on recovery; iii) be able to recognise the signs and symptoms of PTSD and other mental disorders; and, iv) integrate that knowledge into their practice in ways that are relevant to their role and capacity [136, 387].
It should be noted that there is a distinction between trauma-informed care and trauma-informed practice. Trauma-informed practice involves the provision of psychological treatment for trauma-related symptoms by trained and accredited professionals [388]. While these treatments may form part of a trauma-informed care approach (i.e., they may form part of treatment planning), trauma-informed care can still be provided in their absence. It is nonetheless useful for AOD workers to be aware of the evidence base regarding effective treatments and options that may be available to clients should they wish to engage in these treatments. AOD workers are encouraged to read about this evidence base described in Chapter B7.