What does it mean to be a trauma-informed clinician?  Theresa Dubois of Chicago’s Family Rescue shelter shares her thoughts on providing trauma-informed care to survivors of violence. She emphasizes the importance of a collaborative relationship between clinicians and clients to promote healing. Family Rescue offers comprehensive trauma-informed services to survivors of domestic violence.

Read “Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings” for a synthesis of the latest research on trauma-informed care. It’s part of the HRC Special Issue on “The Future of Homeless Services”.

What does it mean to be a trauma-informed clinician?

According to Theresa Dubois, Program Director at Chicago’s Family Rescue, “You must be familiar with the symptoms of posttraumatic stress disorder. It is critical to understand that client behaviors are a function of past trauma. The interplay between the provider and the client is very important.”

Trauma-informed care means understanding, anticipating, and responding to the issues, expectations, and special needs that a person who has been victimized may have. At a minimum, trauma-informed services seek to do no harm—to avoid retraumatizing or blaming clients for trying to manage their traumatic reactions.

Family Rescue offers comprehensive support, services, and shelter to survivors of domestic violence, especially women and their children. The shelter is one of only two Chicago domestic violence shelters to accept teenage boys with their mothers. Family Rescue is committed to training staff members in trauma-informed care. The program continues to expand trauma-informed services.

Theresa emphasizes that a trauma-informed clinician must approach a survivor of violence with an attitude of collaboration. The relationship between the client and clinician becomes a “tool for healing,” according to Theresa. “It is a collaborative relationship based on empowerment. The clinician shows respect for what the client has experienced. She understands that the client’s brain and body have been affected by things that happened to her.”

Theresa says clinicians should expect that trust will be hard to earn. “You can expect that unhealthy defenses will take time to collapse. But the defenses will come down as your client gains the experience of having a healthy relationship with the trauma-informed clinician who approaches the relationship with understanding and without judgment.”

“As a trauma-informed clinician, you can help her to make sense of her world,” explains Theresa. “The trauma-informed clinician understands that clients are often triggered in unexpected ways: the smell of something, the way a door closes, the way someone moves suddenly. All of these things can trigger a client. As she heals, she will gain an understanding of these triggers,” says Theresa. Clinicians work with clients to develop a deeper understanding of trauma response triggers.

Family Rescue offers programs to help survivors learn how to regulate their emotions. Through these programs, survivors find ways to achieve peace through meditation and relaxation. They learn about emotional and psychological abuse.

Theresa’s first experience using a trauma-informed framework was in the mid-1980s. “I got my hands on Judith Herman’s work. She was starting to crack the code on trauma by examining survivors of adult and lifelong trauma. Using Herman’s first book, I’d bring those insights to support shelters and groups.”

It is important that the clinician does not place unrealistic expectations on the client. Rather, she must understand that a client may shut down when trying to manage her emotions to block past trauma. As they work together, the clinician will learn how to help a client to move forward. At the same time, the clinician must be aware that the client may not be able to move forward at any given time. “Her boundaries have been violated at every level, and you must be sensitive to that in a respectful way,” says Theresa. It is important that the clinician learns to ask questions that will lead the client to understand more about herself.

In Chicago, Family Rescue has seen changes in how clients respond to trauma-informed care. “We are seeing women who have experienced a lot of trauma staying in our program longer. They are staying not just because of the services, but because the community living environment has changed for the better,” offers Theresa. In a trauma-informed environment, community living is more harmonious. The primary rule at Family Rescue shelters is “No Violence.”

Family Rescue is a partner with Chicago’s Domestic Violence and Mental Health Policy Initiative (DVMHPI), an innovative project designed to address the unmet mental health needs of domestic violence survivors and their children. It is a collaborative effort to increase the capacity of the local service system to provide culturally relevant, trauma-informed services that address the mental health impact of domestic violence and lifetime abuse. DVMHPI offers training, consultation, and networking initiatives and has worked with over 75 domestic violence, mental health, substance abuse and social service agencies in the Chicago area.