Peer Support: Principles of Trauma Informed Care

One of SAMHSA’s 10 Guiding Principles of Recovery is that “recovery is supported by addressing trauma.” Trauma informed care is thus an intrinsic aspect of peer support. Understanding a person’s situation, both past and present, is critical for providing trauma informed supports. A peer worker’s ability to share lived experience and validate peer feelings, perceptions and experiences is often more of a healing process for people in recovery than the rigid and controlling therapy programs that are thrust upon people seeking help.  

People who have experienced deficit-based mental health or addiction services tend to expound immense feelings of confusion, shame, blame and other self-defeating thoughts and emotions due to many years of enduring pathologized labels and illness-based models for recovery. Peer support serves to provide people in recovery with a strengths-based framework for developing a self-directed narrative that is based on hope and resilience rather than recovering from an “illness.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed six principles of trauma-informed care. A trauma-informed approach requires cultural change at all levels of organizational structure, from the receptionists to the psychiatrists, from the police to the EMTs, and everyone in between.

The following are the universally accepted principles of trauma informed care. These principles may be applied differently in various sectors, however the basic principles are always the same:

Safety: Developing health care settings and activities that ensure physical and emotional safety for staff and the people they serve

Trustworthiness: Establishing transparent expectations about what proposed treatments entail, who will provide services, and how care will be administered

Peer Support: Individuals with shared experiences are integrated and viewed as integral to service delivery

Collaboration: Maximizing collaboration and shared-decision-making among health care staff, peers, and their families in treatment planning

Empowerment: Building on the peer’s strengths to empower them in the development of a wellness plan

Choice: Informing peers about the many pathways toward recovery so they can choose options they prefer. Maintaining sensitivity to cultural, historical and gender issues.

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