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Building relationships with patients who have a history of trauma

April 5, 2019
A group of Camden Coalition care team members meeting in a seated circle

By Tawanna Roane

Trauma-informed care is a hot topic right now. As we learn more about how trauma affects people’s health and wellbeing, healthcare systems and providers are trying to learn more about how to effectively work with patients who have a history of trauma. In my work as a nurse on the Camden Core Model team, I’ve learned a lot about how to engage with patients in a trauma-informed way.

The Camden Core Model, the Camden Coalition’s signature care management intervention, serves people who are cycling in and out of healthcare and social services systems but who aren’t seeing much benefit from those interactions. Furthermore, more than 60% of our patients with mental health needs have also experienced trauma, which may be a contributing factor to their complex needs. In my practice, my teammates and I have seen how trauma’s long-term effects play out with our clients who experienced traumatic events in childhood.

We have a male client who has been repeatedly going to the hospital for issues that primary care could address and who might also be struggling with addiction or mental illness. My fellow care team members and I spend time with him, building an authentic healing relationship using our COACH framework. We join him at his medical appointments, get him set up with behavioral health services, help him navigate getting an ID or social security benefits, and talk with him about his goals. Eventually, as we start to address his mental health or addiction, he reveals to me the reason he’s been hurting for so long. He’s been carrying the secret of being abused. And until recently, he’s never told anyone about it. He is beginning to draw the connections between the abuse and his difficulties in adulthood.

I’ve seen a similar story play out many times. My male clients often share with me that the reason they’ve kept their secrets for so long is because they felt pressure as children to be strong, not to cry, and to act “like a man.” They express shame, believing on some level that they somehow caused the abuse. Even though it’s very emotional to hear their stories, I am honored that they feel safe enough with me to share these deep wounds. I’ve learned that the most important way to help my clients who are starting to process their trauma is by taking the time to build trusting relationships with them.

You can’t tell if a person has experienced trauma just by looking at them. Trauma happens to people from all walks of life, no matter their race, gender, or income level. This makes it especially important for healthcare providers to approach each patient — no matter who they are — as if they may have experienced trauma at some point in their lives. We need to keep in mind that our patients may carry secrets with them that they aren’t ready to share with us. This makes the kind of relationship-building that we do in the Camden Core Model especially important.

If you want to learn more about taking a trauma-informed approach to care management for people with complex health and social needs, we have two opportunities to do so. Last month, we held a webinar, Trauma-informed approaches in clinical and community settings, featuring Katy Davis from the University of San Francisco Women’s HIV Clinic and Wendy Ellis from the Building Community Resilience Collaborative. You can listen to the webinar and download the webinar slides here. On April 24 from 1-2 pm ET, our organization will hold an Office Hours for Complex Care session, Building a trauma-informed care team — an interactive discussion with two members of our Camden Core Model care team, Jeneen Skinner and Bill Nice. Register for the online discussion at bit.ly/2TlOUK7 .

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