SAMHSA’s Six Principles of Trauma-Informed Care

Substance Abuse Mental Health Services Administration of the USA (SAMHSA) also identifies the following six principles of a trauma-informed approach:

1. Safety

We must ask people what safety means to them. If we don’t challenge our own worldview, assumptions, and life experience regarding what safety means to us, we will not be able to ensure a sense of safety for ALL. We will simply be creating safety for people like us. We must ensure that we create safety for those who have different experiences from our own.

This means that we consider all ages, cultures, races, demographics of people served. We must also consider the safety of staff, co-workers, and stakeholders. Safety means awareness of physical, emotional, and interpersonal safety.

Dr. Sandra Bloom from The Sanctuary Model defines safety in following domains:

  • Physical
  • Psychological
  • Social
  • Moral

How do you think boundaries fit in with creating safety?

Organizations that are trauma-aware tend to offer critical incident debriefing following a traumatic incident that staff and volunteers witness. Processing the event right away is very important.

2. Trustworthiness and Transparency

In trauma-informed care, operations and decisions must be made with transparency at the forefront. The goal must be to build and maintain trust with service recipients, staff, and stakeholders. Sometimes organizations must make hard decisions, especially around funding. When we uphold trustworthiness and transparency, that means that we are open about the process of making those difficult decisions, and we invite other voices to participate. Valuing and listening to other students and committees can support the maintenance of trustworthiness. Keeping secrets and withholding information is not trauma-informed.

Trustworthiness and transparency in an organization starts with a culture of connection in relationships. Everything matters from a simple warm smile when you greet someone to approaching conflict in safe and respectful ways. Conflict is a normal part of human relationships, but how we deal with conflict can be very damaging and can cause trauma. Many people have experienced trauma in the educational and work settings because of this. Establishing strong relationships that have the resilience to move through conflict in a transformative way is essential.

Do you think consistency is important? Why or why not? Can you give an example?

3. Peer Support

Organizations that are trauma-informed prioritize practices like peer support. This principle is about integrating the culture and values of peer support into the whole organization. It’s about creating opportunities for the mutuality of peer support to integrate into many aspects of the organization, including initiatives to support admin and staff. A campus, or organization that promotes peer support focuses on mutuality and possibility. Authenticity and vulnerability are essential to this work. An organization that creates opportunity for deeper mutual connections between and among all staff is trauma-informed.

4. Collaboration and Mutuality

A collaborative approach is necessary for everyone in an organization or on a campus. In a trauma-informed organization there is an intentional shoulder to shoulder approach and a focus on breaking down hierarchies. We can’t avoid the fact that there are different roles with different levels of responsibility. However, power differentials can be broken down, and though people have roles, there is a spirit of mutuality and standing together.

An organization that is focussed on being trauma-informed on and creating healing-centered connections, also supports their staff and stakeholders to reflect and attend to their own well-being. All policies should support the well-being both of those served by the organization and of the staff. When staff feel whole and engage in reflective, contemplative healing practices themselves, it is easier to create connection with others.

How can you create this kind of collaboration in your peer program?

Have you noticed this kind of collaboration in other areas of campus life? If so, do you think it is something that can be replicated in other areas?

5. Empowerment, Voice, and Choice

An important aspect of this principle is that organizations must believe in the possibility of recovery from trauma. Trauma survivors are already resilient. Empowerment means that they continue to support people’s inner resilience. We think of empowerment as coming from the person’s own inner wisdom and strength, rather than power given to them from an outside “expert.” As supporters, we get to shine a light on the strengths and abilities we see in someone, that they may not be able to see for themselves.

Many people with past trauma have experienced coercion. Therefore, choice is really important. A person must always have choice.

Peter A. Levine Ph.D, author of the book Waking the Tiger: Healing Trauma (1997) says the following:

Resilient strength is the opposite of helplessness…Empowerment is the acceptance of personal authority. It derives from the capacity to choose the direction and execution of one’s own energies. Mastery is the possession of skillful techniques in dealing successfully with threat.

6. Cultural, Historical and Gender Issues

The SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach says this about an organization with a trauma-informed approach:

The organization actively moves past cultural stereotypes and biases (e.g., based on race, ethnicity, sexual orientation, age, geography), offers gender responsive services, leverages the healing value of traditional cultural connections, and recognizes and addresses historical trauma.

We choose to see through a trauma-informed lens every day, doing everything we can to ensure we do not unintentionally retraumatize someone.

What Trauma-Informed Care is not

Trauma-Informed Care is NOT:

  • Trauma therapy. You don’t need to be a clinician to support someone. Some people may also need trauma therapy, and that needs to be offered by a trained trauma therapist.
    However, there are many things that are therapeutic that can be just as transformative, or even more so. Building healing-centered relationships is an essential part of thriving.
  • A focus on the negative. On the contrary, trauma-informed care should focus on healing and resilience. A trauma-informed approach educates service providers to be aware of how their words, attitudes, and behaviours can deeply affect someone who has experienced trauma and works to avoid retraumatizing people.
  • About justifying poor behaviour. Trauma-informed care doesn’t justify poor behaviour because someone is experiencing trauma. Trauma-informed care steers away from punishment, but supports accountability, personal responsibility, and expectations around conduct. It supports people with compassion and empathy, and boundaries are also very important.
  • Just about being nice and kind. Compassion is at the forefront of this work, but compassion isn’t soft and flimsy. A compassionate approach is firm, has clear boundaries, and is grounded in love and empathy.
  • Babying people. The goal of trauma-informed care is to avoid unnecessary retraumatization. However, stress can’t always be avoided. Attending post-secondary has some stressful elements that can’t be avoided. It’s also important for people to learn tools to cope with stress and difficult situations.
  • Just focused on the individual. Trauma-informed care supports individuals, but it is a systems approach.


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Post-Secondary Peer Support Training Curriculum Copyright © 2022 by Jenn Cusick is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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