Trauma-Informed Care at Outside In

Trauma-Informed Care is Integral at Outside In 

Here are Outside In, we often talk about incorporating trauma-informed care throughout our services. But what is trauma-informed care, and what does it look like at Outside In?  

First – what is trauma-informed care? It starts with a baseline assumption that we have all experienced some level of trauma. It is being aware that many people have had traumatic experiences, having an understanding of how trauma affects people, and creating environments where people are able to feel safe.  

What Does Trauma-Informed Care Look Like at Outside In’s Clinic? 

We start with the assumption that everyone has experienced trauma. And when our providers walk into the exam room to meet a patient for the first time, they have no idea what that trauma might be. 

There has been a lot of research done on allowing space for patients to share their trauma, without re-traumatizing them. So, we start by creating a safe space, without digging into details.  

Many patients have had negative experiences with the health care system or a past healthcare provider. Patients know that if at any point they’d like to share more about that, we’re here for that. Opening the door with open-ended questions can be helpful, and lets the patient know that they are welcome to share if and when they feel inclined. 

We also always ask patients for permission before doing part of their exam, and we never make assumptions about what will trigger a patient’s past traumas. Asking patients, “Do you mind if I do this?” helps to build trust. So, if someone comes in with a cough, we might first tell them why a chest and lung exam is appropriate and then ask permission to do that exam. Asking a patient for permission rather than telling a patient what’s going to happen makes a big difference if the patient has had past traumas.  

If it is a sensitive exam, such a pelvic exam, patients are asked how they feel about it, if they are comfortable with the exam, and if there is anything they want to share before moving forward. Before an exam, the steps involved in the exam are explained and patients are assured that their safety is the most important thing. If they feel triggered or unsafe and need an exam to stop, that takes precedence over finishing the exam. Because if we lose trust, the patient won’t come back. 

Finally, trauma-informed care involves shared decision making with the patient. Patients and providers create plans together, and patients are integrally involved in their care and treatment plan.  

Trauma-Informed Care is Critical to OI’s Medication Assisted Treatment Program 

The use of a trauma-informed lens with patients with substance use disorders who are participating in Outside In’s Medication Assisted Treatment (MAT) Program can be beneficial too. Many MAT patients have experienced trauma – often many traumas. For Outside In providers, it’s important to remember and be aware of how things like a patient’s race, class, sexual orientation, gender identity, weight, and disability can impact their life experiences. Often, patients in the MAT program have had past negative experiences with the healthcare system, and our providers listen to and validate their experiences, and really hear the patient.  

Patients in the MAT program have been through a lot, and we celebrate every victory with them – no matter how big or small. We acknowledge everything that a client does that is a step in a positive direction. Patients often use substances to cope, and our providers work with them to find different and more positive coping skills. We don’t expect people to be perfect, and we always accept patients and do not judge them. We are consistent with our expectations, but also flexible and understanding of the stressors that patients live with every day. And when lapses happen, we don’t judge them for that. We talk about it, and we talk about what could be done differently in the future. We make sure our patients know that they are not failures. They have a struggle, and that’s okay. We help them to move forward in the direction of their choosing.

Benefits of Trauma-Informed Care 

Patients often tell our providers that they finally feel respected and heard when they come to Outside In, and they express gratitude for us being able to help them, rather than judging them or giving them sub-par care. Sadly, before coming to Outside In, many patients we work with have felt judged and unfairly treated when accessing care in other places. But with us, patients feel that our team respects and understands their lived experiences and the ways trauma can impact someone’s life experience.  

Resources on Trauma-Informed Care 

Everyone can apply trauma-informed care in their spaces. And any place, including workplaces, can do things in a more trauma-informed way. Below are some resources if you’d like to learn more! 

The Curbsiders Podcast: Trauma-Informed Care with Megan Gerber, MD 

Trauma-Informed Care – Making it Stick (Relias) 

What is Trauma Informed Care (OHA) 

Road Map to Trauma Informed Care (Trauma Informed Oregon)  

Trauma Informed Care Project Related Website (The Trauma Informed Care Project) 

Thank you!

It is because of you – our community –
that Outside In is able to save the lives of thousands of people each year.

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