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Trauma-Informed care is a philosophy for recovery that combines the conditions and needs of people recovering from mental illness and/or substance abuse into one framework. This framework combines all of the elements of the Recovery Approach and adds an awareness of trauma. Advocates of trauma-informed care argue the principles and strategies should be applied to individuals experiencing mental illness, substance dependence, and trauma as these three often occur simultaneously or as result of each other.<ref name=":7">{{Cite journal|last1=Harris|first1=Maxine|last2=Fallot|first2=Roger D.|date=2001|title=Envisioning a trauma-informed service system: A vital paradigm shift|journal=New Directions for Mental Health Services|language=en|volume=2001|issue=89|pages=3–22|doi=10.1002/yd.23320018903|pmid=11291260}}</ref><ref name=":1" /><ref name=":4" /><ref name=":3" /><ref name=":5" /> The paradigms surrounding trauma-informed care began to shift in 1998 and 1999. In 1998, the Center for Mental Health Services, the Center for Substance Abuse Treatment, and the Center for Substance Abuse Prevention collaborated to fund 14 sites to develop integrated services in order to address the interrelated effects of violence, mental health, and substance abuse.<ref name=":7" /> In 1999, the National Association of State Mental Health Program Directors passed a resolution recognizing the impact of violence and trauma<ref name=":7" /> and developed a toolkit of resources for the implementation of trauma services in state mental health agencies.<ref name=":1" /> Trauma-informed care has been supported in academia as well. Scholars claim that neglecting the role of trauma in a person's story can interfere with recovery in the form of misdiagnosis, inaccurate treatment, or retraumatization.<ref name=":4" /><ref name=":3" /><ref name=":0" /><ref name=":5" /><ref name=":7" /><ref name=":2" /> Some principles of trauma-informed care include validating survivor experiences and resiliency, aiming to increase a survivor's control over her/his/their recovery, creating atmospheres for recovery that embody consistency and confidentiality, minimizing the possibilities of triggering past trauma, and integrating survivors/recovering persons in service evaluation.<ref name=":5" /><ref name=":1" /><ref name=":0" /><ref name=":3" /> In practice, trauma-informed care has shown to be most effective when every participant in a service providing context to be committed to following these principles.<ref name=":4" /><ref name=":3" /> In addition, these principles can apply to all steps of the recovery process within a service providing context, including outreach and engagement, screening, advocacy, crisis intervention, and resource coordination.<ref name=":1" /><ref name=":5" /><ref name=":0" /><ref name=":2" /><ref name=":3" /> The overall goal in trauma-informed care is facilitating healing and empowerment using strengths-based empowerment practices and a comprehensive array of services that integrate co-occurring disorders and the multitude of needs a recovering person might have, such as drug treatment, housing, relationship building, and parenting support.<ref name=":4" /><ref name=":3" /><ref name=":5" />
These approaches are in contrast to traditional care systems. Advocates of trauma-informed care critique traditional service delivery systems, such as standard hospitals, for failing to understand the role of trauma in a
There are other challenges to trauma-informed care besides limits in the United States healthcare system that can make trauma-informed care ineffective for treating persons recovering from mental illness or substance dependence. Advocates of trauma-informed care argue implementation requires a strong commitment from leadership in an agency to train staff members to be trauma-aware, but this training can be costly and time-consuming.<ref name=":7" /><ref name=":5" /><ref name=":1" /> "Trauma-informed care" and "trauma" also have contested definitions and can be hard to measure in a real world service setting.<ref name=":1" /> Another barrier to trauma-informed care is the necessity of screening for histories of trauma.<ref name=":1" /><ref name=":3" /><ref name=":2" /><ref name=":7" /><ref name=":5" /> While agencies need to screen for histories of trauma in order to give the best care, there can be feelings of shame and fear of being invalidated that can prevent a recovering person from disclosing their personal experiences.<ref name=":2" />
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