I am sure you have heard about Trauma Informed Care (TIC). But have you heard about Trauma and Violence Informed Care (TVIC)?
Trauma is both the experience of, and a response to, an overwhelmingly negative event or series of events, from wars and disasters, to assault, accidents and loss. Events become traumatic due to complex interactions between someone’s neurobiology (for example, their ability to self-regulate), their previous experiences of trauma and violence, including the role of others in supporting (or not) self-regulation and recovery, and the interaction of broader community and social structures. The burden of violence experienced is further compounded by the lack of services that are culturally competent and that are entrenched in historical and contemporary discrimination and racism in mainstream services, particularly from police, legal, and social services.
TIC aims to create safety for patients by understanding the effects of trauma, and its close links to health and behavior. It is not about eliciting or treating people’s trauma histories but about creating safe spaces that limit the potential for further harm. Such safety will create the conditions for disclosures of trauma, but disclosure is not the goal. TVIC expands the concept of TIC to account for the intersecting impacts of systemic and interpersonal violence, as well as structural inequities on a person’s life. This shift is important as it emphasizes both historical and ongoing violence and their traumatic impacts and focuses on a person’s experiences of past and current violence so problems are seen as residing in both their psychological state, and social circumstances. TVIC connects to broader systems
by bringing awareness and attention to the cumulative effects of multiple forms of violence including systemic violence, such as racism or discrimination. TVIC also directs attention to the importance of organizational-level actions, such as changes to policies that take patients' safety and experiences of violence into account and that recognize how broader conditions of people's lives (e.g. poverty or unstable housing) increase risk of multiple forms of violence. These could include staff/patient ratios, hospital policies and social policies.
Bottom Line: What’s the difference?
The main differences between TIC and TVIC are that the latter brings an explicit focus to:
•broader structural and social conditions, to avoid seeing trauma as happening only “in people’s minds” but is affected by the environment, society, culture, discrimination, etc. around them. .
•ongoing violence, to avoid seeing trauma as only something that happened in the past
•institutional violence, including policies and practices that perpetuate harm (“system-induced trauma”) because they are designed to satisfy the needs of the system, rather than those of the person
•the responsibility of organizations and providers, supported by resources, policies and systems, to shift
services at the point of care, rather than people having to work around services to get what they need
References:
https://gtvincubator.uwo.ca/wp-content/uploads/2020/05/TVIC_Backgrounder_Fall2019r.pdf
https://journals.sagepub.com/doi/full/10.1177/1524838020985571
