Examples of Trauma-Informed Approaches

Example 1  - Providing Information about the Effects of Trauma

Many women with lived experiences of trauma report that understanding and learning about the effects of trauma can be validating. Acknowledging that reactions and feelings are normal is a powerful step toward healing from trauma 1, 2 and can be an opportunity develop a collaborative relationship with women.

The Centre for Addictions and Mental Health has developed two pamphlets that can be incorporated into existing programming, handed out during intake and assessment, or left in waiting areas for women to pick up on their own.

Example 2 -  Trauma-Informed Screening

Screening and assessment practices can be modified in order to be "trauma-informed." There are two perspectives on asking about trauma as women begin to engage with support for substance use problems.  

On one hand, standardized screening and assessment of trauma, including gathering information about the type of trauma, the age of traumatic experience, people involved in the trauma and how it is affecting current functioning, can support many aspects of treatment such as service matching, ensuring current safety and promoting the safety of other program participants. As well, for some women, acknowledging and validating the connections between traumatic life experiences, coping and substance use at an early point in treatment can be helpful.

On the other hand, screening and assessment practices that minimize the amount of information collected about trauma ensure that women are not pushed to disclose information at a time when they may not have adequate supports and coping skills to manage such disclosures. The process of assessment can increase the potential for re-traumatization and may result in riskier patterns of substance use, self harm and/or avoid engaging in further treatment.

At a system-level, information about the prevalence of trauma can support the development and funding of more comprehensive and responsive services. Dr. Vivian Brown and colleagues have developed a short screening tool called the "COJAC screener" which uses a total of nine questions – three about mental health, three about substance use and three about trauma3. Brown recommends providing women with choice and control over the screening process, by starting with a preamble such as “We are going to ask some questions that may feel uncomfortable to you; if you don’t want to answer, please say ‘I don’t want to answer’.  You do not have to give a false answer, just don’t have to answer, you have a choice.” (BCCEWH webcast, August 4, 2010)

  1. Gose, S. & Jennings, L. (2007). Seeking Safety: Integrating substance use programming at a sexual assault centre, in Highs and lows: Canadian perspectives on women and substance use, N. Poole and L. Greaves, Editors. Centre for Addiction and Mental Health: Toronto, ON.
  2. Stenius, V.M.K., & Veysey, B.M. (2005). "It's the little things": Women, trauma, and strategies for healing. Journal of Interpersonal Violence, 20(10): p. 1155-74.
  3. Brown, V.B., Ph.D., Bachrach, K., Ph.D., & Melchoir, L., Ph.D. (2008). Introducing the COJAC Screener: A short screening instrument for COD and trauma. Accessed on March 1, 2011 at http://www.uclaisap.org/slides/psattc/cod/2008/K_The_Cojac_Screener.ppt.


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