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Advocacy & Activism

Trauma-Informed Care

Most surgeons are never taught trauma-informed care, and it shows.

What surgery still has to learn

Trauma-informed care

Most surgeons are never taught trauma-informed care, and it shows. It matters most for the patients who have the least control over what happens to them, like people in jail and survivors of sexual violence, who need surgeons who understand how trauma shapes every exam, conversation, and consent.

Trauma-informed care is not a branch of mental health treatment. It is a way of practicing, and of running institutions, that recognizes how common trauma is, how it shapes people’s encounters with healthcare, and how care itself can reproduce harm. It belongs in the trauma bay and the clinic, in palliative care conversations, in teaching, and in how leaders respond when someone reports harm, whether that person is a patient or a colleague.

In practice

Seven principles

SafetyPhysical and psychological. Explaining before touching, examining, or moving someone.
Trust and transparencySaying what will happen and why, then doing what we said.
Agency and informed choiceOffering real choices, including the choice to pause.
PowerNoticing the power in a room, between clinician and patient or attending and trainee, and what it makes people feel able to say.
Recognition without disclosurePracticing as though anyone may carry a trauma history, without requiring anyone to tell us.
Avoiding retraumatizationNoticing when routine practices, such as restraint, exposure, or being talked about instead of to, can echo earlier harm.
Institutional responseHow an institution answers a report of harm can compound it or begin repair.

These overlap with the six principles in SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach SAMHSA 2014 (2014).

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