The 12 steps of AA recognizes substance abuse as more than a mental and physical issue but also a spiritual one. This is what makes it so successful. The program looks at one’s spiritual life and values and through peers, looks to find strength to face trauma, addiction and forge a strong future with healthy coping.
Please also review AIHCP’s Substance Abuse Practitioner Program and see if it meets your Academic and professional goals. Qualified professionals in both clinical and non-clinical fields can earn AIHCP’s Substance Abuse Counseling Certification.
Trauma is part of life. Bad things occur and for some the bad things are more horrific and imprinting upon the person. Estimates themselves reflect this. It is calculated that 70 percent of all human beings will experience some type of trauma that is beyond the basic losses and pains of this temporal world. In addition, 75 percent of children will experience some type of adverse childhood experience (ACE) that can negatively effect their emotional, mental, social and physical development.
While natural disaster trauma and collective social traumas leave deep marks on human beings, it is the violent and mystifying actions of evil at the hands of other human beings that leave the most devastating marks on the soul. Wars, genocides, human trafficking, sexual abuse, rape, shootings as well as being witness to horrific murders and abusive events can all leave a horrible imprint on a person, whether child or adult. While the event itself plays a key role, amazingly some individuals can process trauma and not linger with the effects of prolonged pain or PTSD. This does not make those succumb to trauma weak, or cowardly, but illustrates the reality that trauma is not just about the horrific event but also the subjective experience and the lingering effects following it. One’s genetic makeup, the social constructs and support around them, individual character and resiliency, as well as genetic and mental makeup due to past history can all play roles in how one may digest and cope trauma as opposed to another.
Victims need their trauma identified so they can heal. Please also review AIHCP’s Trauma informed care program and other behavioral health certifications
In states of crisis, a person suffers from disequilibrium and de-stabilization of self. The brain loses ability to handle the current situation because it overwhelms one’s coping mechanism. This leads to emotional distress and inability to cope. One is unable to think or act clearly. Those who experience severe trauma in the acute moment of it usually experience this overwhelming leaving them in the aftermath confused, lost and emotional unstable. The purpose of crisis intervention and emotional triage via emotional and psychological first aid are essential in these moments to help the person find equilibrium as well as stabilization but the efforts of long term trauma care and counseling falls under trauma informed care.
Within the population there is a high level of individuals suffering from long term trauma and PTSD. It is important for mental health and healthcare professionals to understand the signs of trauma and be better equipped to help those experiencing it in the present as well as those suffering from the past lingering effects.
Please also review AIHCP’s Trauma Informed Care, as well as Crisis Intervention and other behavioral and mental health certifications. Qualified professionals can utilize these certifications within the scope of their practice to better help those in pastoral or clinical settings of needed care.
Trauma Signs
Flight, Flee, Freeze or Fawn
The most common reactions to trauma include fight, flight, freeze or fawn (Compton, 2024 p. 105-107). The latter two have been added over the years and are equally important. In understanding human survival, these mechanisms are key in helping an individual make it through a life threatening situation. How a a person responds or does not respond does not equate to inadequacy or cowardice or acceptance of an event, but relates to numerous subconscious immediate decisions in a given situation based on subjective experiences within the person’s life. These particular reactions also play key roles in later trauma recovery because individuals may question, feel guilty or be ashamed of particular reactions.
When the body experiences a threat, the brain and body activate the sympathetic nervous system. This system releases cortisol into the blood stream and other hormones to help prepare the body for danger. The heart rate rises, blood flow increases and muscles tighten to help the body fend off the threat. In this moment of extreme stress, the brain mixed with multiple emotional responses decides to fight off the situation, flee the situation, or in some cases, shuts down the body to freeze. This is seen in nature as well. Animals will fight back, flee or sometimes freeze in utter fear in hopes of being left alone. In human beings, many of the same thoughts race through the mind. With emotion, comes intellectual thoughts based on our subjective history and experience. Can I fight this threat, if not, can I flee or avoid it, or should I freeze and hope. Many times in horror movies, we see the later. We scream at the television for the actor or actress to run or move, but the person is so terrified, he or she shows no resistance to the killer, slasher or monster. This response of freeze is referred to tonic immobility and it tied to the body’s psychological attempt to detach from reality and the danger since it has accepted fight of flight as an impossible option (Compton, 2024, p. 106). Hence some women who are raped, may completely freeze and the body shuts down while the brain experiences the fear and trauma. During this shutdown, some psychologists use other terms to explain this sensation of immobility. During the intense moments of fright of the trauma, the body may flag itself into immobility. During this intense freeze or flagging, ironically the sympathetic nervous system and its reaction releases itself to the parasympathetic system which returns blood back to the core of the body, eases muscle tension, and the body becomes almost frozen. Frozen in fright, the mental brain looks to shut down or dissociate from the trauma. In these cases, many victims may not even feel physical pain, see as clearly, or hear but they remain frozen and in some cases, even dissociate to the point of almost feeling as if out of the body and looking downward. In addition, since the trauma is so intense, the body’s coping mechanism looks to detach and many details of the assault or trauma or not properly logged. Instead, the emotional part of the brain takes over. This is also why sometimes details of survivors in regards to trauma may be not be as precise as law enforcement sometimes may wish. Finally, beyond this freezing, fright and flagging, occurs the final defense mechanism of the body which involves faint. In this, the body shuts down consciousness to the horrible ideal.
Fight, flight, freeze or fawn responses to survival situations.
In regards to fawn, victims in an attempt to survive will work with the assailant and not resist but attempt to be be accepting of the situation. Children, and again women in assault cases, many times to survive will use this last option as a way in hopes of reducing the pain inflicted. Without escape or any hope, they succumb to the wishes of the assailant whether it involves laughing with them, or taking drugs with them, or pretending to enjoy, or partake to avoid physical injury. According to Compton, this response is completely unique to humans as a way to escape a situation in hopes of making it less worst and later survive (2024, p. 107). Some victims may consider the price of cooperating better than the price of being beaten and killed if they attempt to resist. Sometimes, pending on the psychopath or assailant, this may work in reducing injuries, while in some cases, the perpetrator injures or kills regardless. However, within the subjective mind of the victim, the call to fawn or not fawn is gamble that is made in the heat of the moment.
What later plays a role in prolonged and unresolved trauma for survivors are the cognitive distortions that can result from whichever action one chose. Those who did not fight back or flee, but froze may be hard on themselves and feel they could have saved themselves if they had just acted. A woman who did not flee a rapist, or a soldier who froze in an attack may all suffer deep remorse or regret for their actions. Yet, their responses were not so much conscious but related to inner wiring of how they would respond in this particular situation. The trauma was so powerful, they were forced to detach from the utter horrific nature of the event. Equally if not more harmful cognitive distortions can emerge with those who utilize fawning as a way to survive. They display shame and guilt and even to some extent may think they partook in it voluntarily. A woman may feel shame in laughing or accepting drugs during a rape and even doubt her victimhood but the reality is the woman entered into a survival mechanism to limit harm to self (Compton, 2024, p. 107). Counselors need to affirm the fears these individuals feel, listen with empathy and without judgement the reactions in the moment and help cognitively realign the experience with reality of “having to do what you had to do to survive”. The survivor needs vindicated in the choices made to keep him/her alive in a horrific moment no person should have to endure.
Intrusions
PTSD causes many forms of intrusions on victims/survivors. Please also review AIHCP’s Trauma Informed Care Program
In addition to trauma responses and their linger effects, individuals, especially those with PTSD, suffer from intrusions. Intrusions, flashbacks, or nightmares can be triggered by simple scents, sights, sounds, or places. Due to the fact the horrific trauma imprinted upon the emotional part of the brain within the amygdala, the emotions and sounds of the moments became associated with the event. Hence even a simple backfire of a car can send an Iraq or Afghanistan veteran into a flashback on a city street. Due to the trauma, many of the normal reasoning functions of the pre-frontal cortex associated with the memory were never properly filed within the brain and processed as a healthy moment in time. Instead, the memory is raw and unprocessed as closely tied to the emotional responses of the day of trauma. In turn, a sight, scent, taste, or sound closely associated with that traumatic event can trigger a response that intrudes into the mind and takes the person away from the present. Severity of these responses vary in flashbacks but some can completely cause dissociation from the present. The person will enter into a flashback where they are no longer present. Some individuals may lose hours of the day or merely minutes pending on severity. Others will be haunted by unresolved nightmares that place the survivor back in the traumatic situation. Counselors who work with trauma survivors or individuals they suspect of past trauma will be able to identify these key signs of abuse or unresolved issues.
Hyperarousal or hypervigilance
One key sign of trauma is hyperarousal or hypervigilance. Many who suffer from trauma have a heightened sense of awareness of certain places or people. This heightened awareness activates a survivor’s sympathetic nervous system and leaves them in a state of watching or preparing for the worst. A retired soldier may watch various entrances of all escape routes or doorways even when at a simple dinner with his wife and children. A rape victim may be terrified to walk by an alley. School shooting survivors may during class time also experience issues returning to school or walking into the building. Due to the hypervigilance and the imprinted trauma, ones arousal level is so high that the thinking part of the brain cannot differentiate between the traumatic historic event and current situations that pose no threat. In addition, many completely seek shelter and protection from the public eye and seek isolation to cope with their states of hyperarousal. The person hence becomes disconnected from the present, hyper-focuses on non-existent threats, and is in a state of fear or anxiety within normal situations (Compton, 2024, p.108-109). Counselors will need to employ various emotional regulation strategies, ground techniques, exposure and EDMR therapies, or cognitive behavioral to help the person gain control of these rampant emotional memories and flashbacks.
Changed World Views and Attitudes of Survivors
Hyperarousal and lack of emotional regulation are signs of past trauma. Please also review AIHCP’s behavioral health certifications
Due to this new altered sense, even when not hyper aroused, the past trauma can reshape and damage previous held world views (Compton, 2024. p, 2009). Traumatic events can alter the view that the world is a safe place. Unlike many individuals in rural areas, those who frequently experience inner city violence will definitely frame a different world view from childhood onward, especially children who were never able to experience safety and security. For those who lived the American dream, those who suddenly become victim or witness to school shooting, or experience a violent crime suddenly may come to new realities that may make them challenge their worldview, faith, God, and moral framework how the world operates. Some may become cynical, others hopeless, some angry and vindictive, others may look to over-protect others because they see danger everywhere.
World views and previous held ideas lead to different reactions to situations and life itself. Some of the key points according to Compton include a lack of safety and a sense of vulnerability that did not previously exist. In addition, Compton lists a lack of trust. This lack of trust may be towards the power of God, or the power of local government to protect oneself. Many may feel forsaken and left to fend for oneself in this state of despair. Also, Compton lists esteem and defectiveness that follows trauma. Trauma survivors can exhibit negative views about themselves and doubt their worthiness to be loved after the event, or are not deserving of a good and productive post trauma life. Others may also alter views on others and stereotype races, religions, cultures and others that are associated with the trauma itself. Through this, the person is filled with anger, suspicion and bitterness towards other people who may share the same skin color or faith of the perpetrator. Compton points out that other survivors may exhibit unnecessary power and control over others or situations in an attempt to prevent the trauma from occurring again. This type of survivor may be a person who lives in constant hyperarousal and promises that what occurred will never happen again to the point of compulsion driven by anxiety. This leads to controlling even smaller aspects of life and relationships. Some may even feel erroneously partial responsible for the trauma and will look at any cost to control all aspects to avoid the same outcome. Finally, Compton lists that intimacy and how future trauma survivors respond to others and relationships can be altered. Children who experience trauma at a young age will have different attachment disorders based on trauma ranging from anxious relationship, to avoidant ones, while adults who are reshaped by trauma may experience difficulties with intimacy. A wife who was raped may be unable to have intercourse with her husband because of the violation of the sexual act in her rape. The movements or act may activate a flashback or cause intense emotional pain. Some who are not in a relationship may seek isolation and avoid attachment and at the expense of genuine human connection, forfeit future relationships due to the traumatic event (2024. p. 109-113).
Long Term Mental and Physical Signs
Trauma damages the entirety of the human person. Untreated trauma looks to numb and escape the pains through various maladaptive ways. Whether it is isolation, avoidance, or control measures, the person still exhibits the pains of trauma. Because of this, many associated with trauma become alcoholics or drug addicts hopes of numbing the pain and escaping the memories. These short term tricks however only further damage the mind and body with addiction and all the legal, financial, social, mental and physical troubles associated with it. In addition, many mentally may attempt to numb psychic pain with physical pain and self harm themselves or even idealize suicide to escape the pain. Others may utilize sex or gambling or other unhealthy way habits. Hence, those who are associated with long term and unresolved trauma are tied to depression, anxiety, physical injuries, substance abuse, and sexually transmitted diseases (Compton, 2024, p. 116).
Long term trauma can negative effects socially, mentally, emotionally, and physically on a person.
Physically, those who deal with long term trauma even if they avoid maladaptive practices find themselves in a constant state of hyperarousal and the activation of the sympathetic nervous system. Like chronic stress, the continual state of alert has negative effects on the body, especially the cardiovascular system. Due to the constant stress, trauma survivors or life long victims of trauma find themselves with many digestive diseases, migraines and sleep issues. This leads to immune issues related to chronic inflammation throughout the body (Compton, 2024. p. 116-117). These physical issues to lead to social issues with work, education and advancement, leaving many life long trauma survivors in perilous situations beyond their trauma itself. This all has reflections on every aspect of their life and choices which can also affect other individuals negatively. When those suffer from a singular and isolated trauma, as opposed to a communal trauma, many times the individual never finds affirmation, connection, or support. These individuals, without healing, slowly rot from the vine and deteriorate. Many fall under the rug and find themselves homeless, or imprisoned for petty crimes. Others develop more severe mental illness and can lash out at others within the community.
Hence, it is a communal issue to identify trauma signs and help individuals find the help and aid they need to heal. Counselors can look for these long term mental, physical, emotional and social signs of long term trauma to better help individuals find healing via trauma informed care.
Conclusion
When signs of trauma and abuse or missed initially, or permitted to fester, the wholeness and dignity of the person erodes. Whether it is a life long series of traumas or adverse childhood experiences, or one horrible life altering event, trauma victims/survivors need help to heal. While some individuals are resilient due to numerous and multiple subjective factors, others through no fault, fall victim to PTSD or trauma induced wounds. These individuals if not helped are unable to cope in productive ways and can harm themselves, others, relationships or ruin their own careers. This overflows into society and without a empathetic and compassionate approach to help these individuals, then society as a whole suffers. Trauma Informed Care looks to identify many of the signs listed above and better help and equip individuals to find healing and healthy coping mechanisms to heal and overcome trauma. Trauma may leave a scar but it does not need to be a destructive event in the person’s life that destroys everything the person is. Instead, human beings can heal, create new neuropathways, find meaning in horror and create positive outcomes out of the darkness.
Please also review AIHCP’s Mental and Behavioral Health Certifications
Please also review AIHCP’s Trauma Informed Care Program, as well as its many behavioral and mental health certifications for human service workers, both clinical and pastoral, as well as healthcare professionals who seek to help and make a difference for those who have experienced trauma.
Abusive predators seek the most vulnerable as their prey and strike when the opportunity best presents itself. Many targets are those who have already been targeted in the past. The scars and emotional trauma associated with initial abuse signal opportunity for the predator to strike a new victim who has already once been injured. Counselors in trauma need to be aware of the potential for someone who has been abused to be abused again. This is why the work of healing is so critical. Healing helps the person find wholeness again and find strength in everyday life to proceed in a healthy way that can better equip the victim/survivor to protect oneself from future abuse at anyone’s hands. In this short blog, we will look at the most vulnerable for re-victimization as well as the open wounds of unhealed trauma that present opportunities for predators and abuses to inflict more trauma on past victims.
Trauma informed care can help prevent re-victimization of abuse survivors
Please also review AIHCP’s Trauma Informed Care Program, as well as its Crisis Intervention Certification and other Behavioral Health Certifications for qualified professionals seeking certification.
At Risk Populations
Naturally the marginalized, isolated, and injured populations present opportunistic targets for predators. As a predator in nature monitors the the herd of prey, it looks for members who seem and appear physically weaker or isolated or confused or who are already injured. Likewise, human predators and abusers look for those in society that are an easier target with less chance of fighting back physically or emotionally and as well those who mentally possess low self esteem and emotional disorders. This protects them and lowers the chance for reprisal or being apprehended. This is the nature of an abuser-cowardice and opportunistic.
Some populations that are natural targets for any type of abuse include children, the elderly, emotionally and mentally comprised and those with disabilities (Compton, 2024, p.124). Hence individuals within these categories present excellent targets by the abuser not only for initial abuse but also fall into re-victimization themselves. Counselors and safe-guarders need to be aware of these target populations and look to protect them from potential dangerous environments, especially ones with previous abuse history.
What Makes the Risk Higher for Re-victimization?
Ultimately lack of healing from the initial abuse makes someone a higher risk for re-victimization at the hands of abuser or predator. The lack of healing injures the very soul of the person and prevents them from integrating into society. Many enter into maladaptive coping strategies to numb the pain of the trauma or enter into unhealthy relationships due to low self esteem and again find themselves in the same patterns.
Compton points out that attachment deficits, emotion regulation disruptions and cognitive distortions play key roles in making victims susceptible to future abuse. Compton points out that children and others who have continually experienced abuse have been stripped healthy of attachments that non-abused individuals experience with family and caregivers. Instead of a loving and caring family that promises safety and security, abused individuals live in a world of uncertainty, terror and no safety. This drastically alters their ability to understand normal relations, much less form future healthy attachments with other people. Instead of finding secure bonds, many abused that never find healing, find themselves in the same situation with a different person. The individual ultimately expects abuse as a norm (2024, p. 125-126). Hence when approached or targeted, many abused are familiar with it. While they may seek to escape it or fear it, they do not respond as an un-abused person. Instead many either isolate, feel the re-traumatization, and become unwilling victims not understanding why or how to escape.
Helping stop re-victimization of at risk populations is a key component of trauma informed care. Please also review AIHCP’s Behavioral Health Certifications
Compton also refers to emotional regulation disruptions. Like anyone with PTSD or trauma, unresolved trauma resides in the subconscious. It remains trapped in the emotional part of the brain, not properly filed within the intellectual part. The trauma is dis-fragmented and the horrible nature of the trauma continues to haunt a person. Hence when a person experiences a similar sound, or scent, or visual of the past trauma, the body responds emotionally without rationale into a fight, flight or freeze mode. This is a common state of hyperarousal that many with PTSD or trauma experience. The long term defensive mechanisms for this unhealed trauma results in isolation from other people, as well as numbing through alcohol or other drugs, as well as lashing out at others, Abusers target those who are isolated, friendless, or who are intoxicated or in need of drugs to numb their pain (2024, p. 127-128). in the mind of an abuser, an isolated individual has no-one for support and a drug user is far from reliable as a witness.
Finally, cognitive distortions can persist in the unhealed victim. Without counseling and cognitive therapies to correct incorrect perceptions of self, the abused develops an poor image of self and the value of one’s body. The very design of sexuality and its purpose can also be distorted. Victims reflect low self esteem, misuse of sex as a way to find instant gratification, or allow one’s body to be used by others. This can result in how a victim interacts with others, dresses, or expects to be touched or touches others (Compton, 2024, p. 128-129). These cognitive distortions, views of one’s body, or the misinformed nature of sex, open many unhealed victims to new abusers who can use these distortions to their advantage in luring the victim back into abuse.
Why Not Find Help?
It is easy as non-traumatized individuals to ask this question but if someone is injured through abuse or trauma, the whole self is injured. Until the whole self again finds healing, purpose and meaning and the issues of emotional, cognitive and bonds are corrected, then many never seek help or even report the initial abuse. In addition, those who seek help may feel intimidated, labeled, judged, or felt no-one will believe them.
Some may feel embarrassed over the abuse. During fight, flight or freeze, survivors make a choice in how to respond to the violence. Some individuals may fight, others may try to escape, or others my freeze in utter fear. We see this constantly in horror movies. As we shout at the television screen, for the person to fight back or run, we see some literally freeze. Maybe subconsciously an individual feels if they have a better chance of not fighting back and allowing the abuse to occur in hopes of survival as opposed to being kills in an attempted act of self defense. It is very hard to understand why some individuals fight, flight or freeze, but after traumatic events, the brain thinks back. There is survival guilt for some in war or shootings where the individual re-analyzes their reactions. This can lead to shame, or guilt or regret. Some in abuse, may feel they should have screamed, or fought back, while others lament the fact, that despite the abuse, in some cases, of sex, part of the physical engagement was pleasurable. This is especially true in the case of men who find themselves raped by women abusers. Others who are raped or molested may feel like a “whore” or if a man is assaulted by a man, feel as if their sexuality is now questioned and feel ashamed about being labeled a sexuality that they are not (Compton, 2024, p. 130-131).
Others may feel no-one will believe them and in some cases, authorities do not always believe. Parents may doubt a story of their child about a pastor or coach, or a church member may dismiss a report about a priest, or a police detective may question the details of an abuse story, but when help is not given, re-victimization can occur. One thing to remember, victims of severe trauma have fragmented memories. The brain is protecting the person from the trauma by fogging many of the details. Since the trauma is not properly filed and stored in the intellectual pre-frontal cortex of the brain, the emotional centers of the brain collect the trauma and revisit it through affective disturbances that involve similar sounds, sights, or scents. A similar cologne of an abuser can send a victim into a flash back of the horrible abuse, or a the backfire of a car can send a military veteran back to a war scene. Hence triggers play a key role, as well as intrusive memories, in taking the victim back to the initial trauma, while in regular conscious states, the victim may not recount completely every detail regarding the abuse. The details haunt, but the general story remains the same. This type of lack of detail can sometimes make others doubt a survivor/victim, but a trained professional should see the overwhelming evidence of trauma induced PTSD that reflects far greater evidence of abuse than mere details (Compton, 2024, p. 131-132)
When reporting never occurs, or when authorities do not believe victims, re-victimization usually occurs later in life. It is hence important to prevent future re-victimization to believe the abused. Counselors, pastors, and even friends need to believe and encourage disclosure and when legally required report the incidents to protect the victim. As a safeguarder and protector, one has the unique opportunity to help reconnect to a injured person and help them again find wholeness, meaning and justice (Compton, 2024, p. 133).
Conclusion
Please also review AIHCP’s Trauma Informed Care Program as well as its Behavioral Health Certifications
It is truly sad that anyone is a victim of any type of abuse in this world. It is especially horrific that individuals who find no healing continue to find themselves in a cycle of abuse at the hands of predators and abusers. It is important for behavioral healthcare and health providers, as well as pastoral caregivers, families and friends to recognize the signs the abuse, as well as to understand those who are potential victims for possible future abuse. This involves utilization of trauma informed care practices that encourage disclosure through safe environments, as well as transparency, empathy, trust, and the utilization of therapeutic skills to help the person again find healing and meaning.
Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing in the Church”. Academic
Additional Resources
Marie, S. (2024). “Abuse Survivors Can Be Revictimized — Here’s What You Should Know”. Healthline. Access here
Gillette, H. (2022). “Can Family Members Revictimize Sexual Abuse Survivors?”. PsychCentral. Access here
Patrick, W. (2022), “Why Some Sexual Assault Victims Are Revictimized”. Psychology Today. Access here
Pittenger, S. et al. (2019). “Predicting Sexual Revictimization in Childhood and Adolescence: A Longitudinal Examination Using Ecological Systems Theory”.
Child Maltreat . Author manuscript; available in PMC: 2019 May 1. PubMed. Access here
Trauma Informed Care highlights the reality of trauma as a universal human experience. Whether deeply effected to the point of PTSD, long term effects or no effects at all, traumatic events do occur and leave an imprint on some individuals. Ultimately, the these events occur but it is our experience and how it effects ourselves that determine impairment later in life. Unfortunately, most traumatic cases, especially in abuse, never go reported and individuals live with unresolved trauma that manifests in many maladaptive ways later in life. TIC looks to uproot trauma when identifying various symptoms that point towards it possible existence. Hence, if one is counseling from a TIC perspective, then it is only natural that eventually trauma will re-emerge in a victim/survivor/client.
When someone discloses abuse or trauma, the counselor needs to understand how to listen, and help the victim/survivor heal. Please also review AIHCP’s Behavioral Health Certifications
Obviously basic counseling and advanced counseling skills and techniques all play a key role in helping the individual discuss these difficult events in his/her life, but there are also particular skills key to addressing trauma that are essential. While TIC looks to search for trauma, trauma specific interventions are essential to help the person express and heal from the trauma. In addition, how the trauma is discussed and handled within the counseling room is equally key. In this blog, we will look at trauma, its sources, counselor reaction to the client, discussing trauma itself, and ways to better facilitate the discussions of trauma itself.
Please also review AIHCP’s Trauma Informed Care programs, as well as all of AIHCP’s Behavioral and Mental Health Programs in Grief Counseling, Crisis Intervention, Stress Management, Anger Management and Spiritual Counseling programs.
Trauma Lurks Below
We are well aware that the traumatic events are universal and 70 percent of the population will experience some type of trauma. Of course how the trauma affects the person has numerous subjective factors based upon the person and many surrounding aspects. Ellis points out that individuals in childhood have different levels of exposure to trauma based on their Adverse Childhood Experiences (2022). ACE refers to these adverse childhood experiences and categorizes them as actual events but also deeper seeded social issues that act as roots to the trauma tree and its many branches and fruits. Adverse Community Environments or roots of the problem include multiple negative social issues such as poverty, discrimination, community disruption, lack of economic mobility and opportunity, poor housing and frequent exposure to social violence. These horrible things manifest into various possible traumatic experiences for individuals that will shape them for the rest of their lives. This includes issues that the child might experience at a young age such as maternal depression, emotional, physical and sexual abuse, substance abuse, domestic violence, homelessness, incarceration of self or family members, divorces, physical and emotional neglect and exposure to mental illness (Ellis, 2022).
In turn, later in adolescence and life, fruits of these abuses and traumas will emerge. Behaviors that include drug use, alcoholism, smoking, lack of physical activity and lack of work ethic. In addition, these fruits can manifest in severe obesity, diabetes, depression, suicide attempts, STDs, heart disease, cancer, stroke and various injuries. TIC looks to identify these warning signs and fruits of ACE and acknowledges that not every one’s life was calm, peaceful and loving. This is not to say even the most loving home can face loss and trauma or violent crime, but it does awaken us as a while that people are just much nurture as they are nature in what they become and how their behaviors exhibit themselves. This is why as counselors, we must show empathy even to undesired behaviors. We are not dismissing choice, or condoning bad behaviors or life styles or even later criminal actions, but we are putting a spot light on a great systematic breakdown in society as a whole and how trauma can alter and turn so many people into persons they would never have been. The role of a counselor when facing emerging trauma in counseling is to help the person find peace with the past, cope in the present and find hope in the future.
Shattered but Not Broken
I believe that despite horrible trauma, one can be shattered, but it does not mean one has to be permanently broken. One will always have the scars from that trauma, one will have a far different life due to it as well, but that does not mean it breaks the person. While some may become overwhelmed and lose themselves or become the evil itself that destroyed them, it does not have to be that way.
Individuals who suffer trauma and abuse may be shattered but through a caring counselor and support can find healing and a new self actualization
Trauma can be like the story of the comic hero Batman, who as a child witnessed the murder of his parents, only to turn that trauma and pain into a life long crusade against crime. While a fictional character, I think still, if we look at the story of young Bruce Wayne and his traumatic experience, we can take a lesson from it and see how when trauma is properly processed, while life altering, it can bring out resiliency and growth, and an ability to find meaning.
Outside TIC mindsets, most trauma survivors who are shattered are afraid to bring up the past in counseling and rarely spontaneously disclose their trauma. (Sweeney. A, 2018). It is hence important to understand how to help heal the broken through discussion of trauma and how to facilitate healing. Cochran points out that all human beings are in a state of “becoming” We are constantly changing whether into a traumatic event or out of it, we are never the same but learning how to adjust. Who we are today are not who we were in the past but we are constantly in flux in our experiences and how we interpret them (2021, p. 8). All individuals look however to meet a certain self actualization of self. These self actualizations when molded in a healthy and loving trauma free environment possess healthy concepts of self image and self worth. Trauma and abuse can destroy these images (Cochran, 2021, p. 9-15). Cochran uses the oak tree as an example of self actualization. While the mighty oak is the final concept of what we see as the fullest potential of an acorn, or small sapling, sometimes, those who are victims of abuse or trauma are unable to fulfill their initial abilities or design. Like a young tree that was struck by lightening or partially uprooted, the ideal self actualization has been altered. Unlike a tree though, human beings have far better abilities to recreate image and self actualization. Although shattered, altered and changed, human beings through guidance and support can still grow and meet new goals and fulfill new self actualizations, albeit shatter, but not broken (Cochran, 2021, p. 11-12).
Hence, Cochran points out that as a person develops, like a tree, one can develop and grow without interruption, while others trees may experience difficult times of drought, poor soil, damage, or broken limbs. Each life experience is different and through trauma, individuals develop different self concepts of what is regular or normal as well as what to expect of oneself. Trauma hence can be very damaging. It is important in TIC to find this trauma and to help the shattered find wholeness again and a new way to exist with the past. When trauma is discovered in counseling or finally disclosed, it is hence important to know how to cultivate the discussion and navigate the difficult discussions.
The Calm in the Storm: Counselor Qualities in Trauma Informed Care
Counselors in general need to display certain qualities with their clients but this is especially true in the case of trauma victims or trauma survivors. Karl Rogers approached all counseling in a very client based approach that emphasized complete emotional support via empathy, genuineness and unconditional positive regard. These three qualities not only create a safe environment for disclosure but also helped create a sense of trust between counselor and victim that facilitated healing. Robin Gobbel, LMSW, emphasizes the importance of safety and the necessity of “felt safety” within between the counselor and the victim or survivor or client. Many individuals who are victims of trauma feel chronic “danger, danger” feelings. Due to PTSD, certain triggers can alert the brain to the dangers that are not truly present. The lack of the prefrontal cortex to dismiss the false alarm is not present in trauma survivors. Hence the scent of a cologne similar to a molester, or a car backfiring in a public street can send a trauma survivor into a flight, fright or freeze sense. Helping a person feel safe internally is hence key. In addition to internal issues, “felt safety” also applies to the counseling room itself. In previous blogs, we discussed the importance of agencies creating a environment that promotes a safe feeling for the individual to disclose and discuss the abuse or trauma. They must feel private, secure and free of threat, free of retribution, or even judgement. Physical environment can be helpful in this, but it also must be accompanied with the counselor’s ability to implement basic counseling skills, via word use, tone, body language and facial expressions.
A counselor can supply empathy, genuineness, and unconditional positive regard for the victim.
This is all best implemented through empathetic listening, genuine interest and unconditional positive regard. Empathetic listening is not judgmental but it allows oneself to not feel what one thinks another should feel, but attempts to understand and share what one is feeling and why. Cochran describes empathy as feeling with the client (2021, p. 79). Empathy can be emitted by sharing the same emotions and words that describe those emotions with the client. Empathy does not require one agreeing with the client, their beliefs, choices or actions, but it does involve walking with the client and attempting to understand all the things that make him/her feel the way he/she does.
In addition to empathy, Karl Rogers emphasized the importance of being genuine. Rogers pointed out that the therapist is being him/herself without professional facade of being all knowing or merely a person with letters behind his/her name. Rogers continued that the counselor needs to be genuine in the feelings of the moment and aware of those moments where feelings are expressed. Ultimately, the therapist becomes transparent and down to earth with the client without any ulterior motives but the healing of the client. This helps the client see that the therapist is truly there to help and more willing to open and disclose issues (Cochran, 2021, p. 132). Ultimately, Cochran points out that all counselors if they seek to be genuine need to know oneself and express oneself.
Tying together empathy and genuineness is the key Rogerian concept of Unconditional Positive Regard for a client. This concept is a cornerstone for counseling. It is also sometimes a difficult concept. It does not mean that the counselor again always agrees with beliefs, choices, or actions of a client, but it does entail an unwavering support for the client/victim/survivor that looks not for an agenda or conditional response but a gentle guidance of self development that does not demand but instead listens, nods and recommends without condition. Studies have shown that when conditions are tied to change, change becomes far more difficult. Unconditional Positive Regard retains the autonomy of the client to learn how to change on their own terms.
Rogers listed warmth, acceptance and prizing as three key elements of UPR. Warmth represents the care of the client and genuine empathy. It is the fertile soil that produces a an atmosphere of trust and disclosure. Acceptance is the ability of the counselor without bias to accept the immediate emotions of a person in counseling-whether illogical, angry, hateful, confused or resenting (Cochran, 2021, p. 103). In trauma, many emotions that are sputtered out are helpful in healing. If they are diagnosed, judged or refuted, then this can stunt disclosure. Trauma victims or survivors need a place to express their feelings anytime and anyway without judgement. Acceptance allows the person to express without regret. Many times, the emotions displayed can help the counselor see clues to past incidents, or even help understand the current emotional state of the person. Cochran points out that when a person is allowed to swear, scream, express, or seem illogical without reproach, many times, they will re-evaluate their own reactions in a healthy way (2021, p. 103). Finally, prizing is a concept of UPR that emphasizes the person as a treasure and someone special who is unique and special. Prizing is not an overstatement or infatuation but is a sensitive way of caring and a genuine way of expressing to the client that he/she matters (Cochran, 2021. p. 104). Prizing despite the pain and downfalls, also looks to lift the person up by highlighting the strengths of the person and helps encourage the person to healing and change. Rogers believed that UPR helps clients discover who they truly are. He believed that self-acceptance leads to real change. Through full expression of the spectrum of emotions, one can in a safe environment see the counselor acceptance and hence accept themselves in expressing issues and trauma (Cochran, 2021, p.109-110).
We cannot put agendas, our own judgements, moral beliefs, or expected outcomes upon clients. Some clients in trauma need certain environments to feel safe to heal, or they need to feel that their story has no conditions that must be met. When counselors put agendas on the table, expect outcomes, or think they know better, then their regard becomes conditioned which is detrimental to disclosure and healing (Cochran, 2021, p. 114-116). Many times, well trained analytic minded counselors have a difficult time displaying pragmatic solutions or just letting go of an agenda or idea and instead just listening and being present. Hard to like clients, bad people in the prison system, moral differences, and biased initial thoughts can all play negative roles in how we show unconditional positive regard for a client (Cochran, 2021, p119-121). It is hence important to see each client, no matter who, as a person that is there to be helped and hopefully understood. This does not mean suggestions are guidance are not given, but it does mean, an acknowledgement of the client’s current state and an attempt to understand why. The biggest question should not be “WHAT IS WRONG WITH YOU” but instead “WHAT HAPPNED TO YOU” (Sweeney, A. 2018).
Discussing the Trauma
The concept of trauma can be difficult to discuss. Many clients feel embarrassed, or fear judgement or retaliation if they speak. Others may feel weak if they express traumatic injuries. Others may have in the past attempted to tell but where quickly dismissed. Others may have been difficult ways expressing verbally abuse due to PTSD. Many trauma survivors have a difficult time chronologically making sense of the story but vivid scents, sights, or touches can open the emotional part of the brain. Hence those who experience trauma in many cases fear labeling when discussing trauma (Sweeney, A. 2018).
Learning how to discuss trauma is important in trauma informed care to avoid re-traumatization
Questions about trauma hence need to be done in a safe environment with genuineness and empathy and with a sensitivity about the story. Questions about trauma are usually better during assessment than when in actual crisis. They can be asked within the general psychosocial history of the client to avoid a feeling of purposeful probing. In addition, it is important to preface trauma with a normalizing comment that does not make the person feel like the exception to the rule. The person should feel completely free not to disclose or discuss details that upset him/her (Sweeney, A, 2018).
Sweeney recommends that for those who disclose or are tentative about disclosure that it is s good thing to disclose and that the person is completely safe from the person, judgement, or labeling. If the person does not wish, details should not be dissected from the story. In addition, it is sometimes helpful to help the person slowly enter into the traumatic story by first discussing the initial part of the day prior and then the after feelings before diving deep into the intensity of the story. The counselor should be aware of any changes in the person’s triggers and reactions to re-telling the story. The counselor should discuss if this story has ever been told before and if so, how the other party reacted to the story, as well as how the past trauma affects their current life, especially if maladaptive coping is taking place. When trauma is disclosed, particular trauma specific treatments may be need employed to help healing. In some cases, the counselor or social worker is clinical and can supply those services, but if not, and non-clinical or pastoral in nature, the counselor will need to refer the person to an appropriately licensed, trained and trusted colleague. Finally, following any disclosure, it is critical to check on the person’s emotional state to avoid re-traumatizing the person. This is important because individuals could leave the session feeling less safe and return to maladaptive coping later in the day or even worse, suicidal ideation or attempts. Follow up is key and consistent monitoring. (Sweeney, 2018).
One important note, if the trauma and abuse is current, counselors and social workers, and certain clergy pending on the nature of disclosure and state laws, except within the seal of Catholic/Orthodox confession, have the legal obligation to report abuse.
Facilitating Better Trauma Response
To respond better to the needs of those in trauma due to abuse, it is key to better facilitate responses to individuals who are dealing with past or present trauma, whether in the counseling room, or short term crisis facilities. It is even crucial to better respond to those in trauma who are in longer term facilities, or even correctional facilities.
Individuals who suffer from trauma fear labeling, lack of control in decisions, judgement, retribution and lack of safety. Counselors and facilities need to make them feel safe
A team that responds to victims of trauma with no judgement and empathy is key but this involves dismissing older notions. Notions that dismiss holistic biopsychosocial models for mental distress and only highlight biomedical focus can play a role in impeding healing. Instead of merely prescribing a medication and taking a pill, alternative practices need to be supplementing with many individuals. In addition, agencies need better exposure to social , urban, cultural and historical traumas that underline the person’s makeup. They also need to dismiss notions that treatment involves assessment and conditional parameters for healing that involves an imbalance of power. In these cases, the caregivers have power over the person, make the decisions, and determine the outcomes. In many cases, these same types of lack of control for the abused can cause re-traumatization (Sweeney, 2018). For instance, not granting a person a say in what they do or take, or unnecessarily constraining an individual can all be triggers to the original abuse.
Ultimately, many agencies and facilities do not have a good trauma informed care plan, as we discussed in other blogs. In addition, they are underfunded, staff is stressed and morale may be low and the facility may staff shortages. This leads to stressed, under trained, and confused lower staff members in dealing with patients. In addition, many of the higher staff in counseling are themselves facing burnout, overwhelmed with paperwork or dealing with inconsistent policies or social networking that never follows through (Sweeney, 2018). We can hence see the many challenges that facilities and agencies face but the goal and mission must still remain the same to overcome these pitfalls and introduce real healing strategies for individuals experiencing crisis, trauma and abuse.
Conclusion
When someone discloses trauma or abuse, it is a big moment in that person’s life. Each person with their abuse story is different. Some have other underlying issues. Some may have been mocked or not believed, while others may be maladaptively coping. It is imperative to reach back to each person and give them the security and dignity he/she deserves in disclosing the story. The counselor must be empathetic, genuine and provide as Rogers calls it, Unconditional Positive Regard. Older methods of understanding trauma and assessment and conditional plans need dismissed the counselor needs to help the person validate emotions and find constructive ways to heal. The counselor must be well versed in how to discuss trauma related issues and be careful not only of their own burnout but also in re-traumatizing the client. Facilities also need to reassess their own mission and policies in helping those in abuse find better solutions and healing.
Please also review AIHCP’s Trauma Informed Care programs, as well as its other multiple behavioral health certifications in grief, crisis, anger and stress management
Please also review AIHCP’s Behavioral Health Certifications, especially in Grief Counseling, Crisis Intervention and Trauma Informed Care
Fake people can cause damage professionally, financially, and socially. It is important as a social skill to protect oneself from deceptive individuals and form the proper boundaries to secure oneself against a fake and deceptive person. Please also review AIHCP’s Behavioral Health Certifications and see if they meet your academic and professional goals.
The concept of holistic nursing transcends the mere administration of medical treatments; it embraces the intricate interplay between physical, emotional, and spiritual well-being. In an era where healthcare increasingly emphasizes patient-centered approaches, holistic nursing embodies a philosophy that recognizes the individual as a whole person rather than a set of symptoms. This approach is particularly significant within military healthcare settings, where the integration of creative therapies has enhanced the overall wellness of service members and their families (N/A, 2013). Moreover, understanding spiritual needs and their impact on overall health underscores the necessity for nursing education to incorporate spiritual care competencies (Ali et al., 2015). By cultivating an appreciation for the art of nursing as more than just a science, practitioners can foster healing environments that promote recovery and resilience, thereby redefining the very essence of care in a rapidly evolving healthcare landscape.
Holistic nursing looks to help individuals find also natural ways to supplement their health. Please also review AIHCP’s Holistic Nursing Certification
A. Definition of holistic nursing
Holistic nursing encompasses a comprehensive approach to patient care that transcends traditional medical practices by addressing the physical, emotional, social, and spiritual dimensions of the individuals health. This perspective recognizes that effective healing involves more than merely treating symptoms; it requires understanding the interconnectedness of a persons various life aspects. In Aotearoa New Zealand, the integration of complementary and alternative medicine (CAM) into nursing highlights this approach, as it emphasizes the necessity for nurses to be educated on these modalities to enhance patient wellness and health outcomes (Huia T et al., 2019). Furthermore, spirituality plays a crucial role in holistic care, yet it is often neglected due to challenges in understanding its concept and application within nursing practice. Recognizing spirituality as an integral component allows nurses to cultivate a more compassionate and comprehensive patient care experience, ultimately enhancing both the caregivers and the recipients healing journey (Rogers et al., 2015).
B. Importance of holistic approaches in healthcare
In contemporary healthcare, the importance of holistic approaches cannot be overstated, as they emphasize the integration of physical, emotional, and spiritual well-being in patient care. Such an approach recognizes that effective healing goes beyond merely addressing physical symptoms; it encompasses the patients overall experience and quality of life. Research indicates that spirituality plays a significant role in individuals health perceptions and coping mechanisms, with studies suggesting that spiritual care competencies are still underdeveloped in nursing education (Ali et al., 2015). The incorporation of arts and creative therapies within this framework further illustrates the multifaceted nature of holistic care. These therapies enhance emotional resilience and cognitive functioning, providing an invaluable complement to traditional medical interventions (N/A, 2013). Thus, embracing holistic nursing practices ultimately fosters a more comprehensive understanding of health, paving the way for improved patient outcomes and satisfaction.
C. Overview of the essay’s structure
The structure of this essay on holistic nursing is meticulously designed to guide the reader through the multifaceted nature of this practice. Beginning with an introduction that establishes the importance of holistic approaches in nursing, the essay progresses through clear, thematic sections that explore both theoretical and practical components. Each section integrates evidence from relevant literature, illustrating how holistic nursing transcends traditional medical paradigms to prioritize emotional and spiritual well-being alongside physical health. Notably, the discussion highlights the significance of reflective practice in nursing education, emphasizing its role in nurturing critical-thinking skills and ethical considerations in patient care, as noted in (Foskett et al., 2017). Additionally, the exploration of spiritual care within nursing frameworks elucidates the complexities of addressing patients’ spiritual needs, further reinforced by insights gleaned from (Ali et al., 2015). This well-organized structure facilitates a comprehensive understanding of holistic nursing’s essential role in contemporary healthcare.
II. The Philosophy of Holistic Nursing
Holistic nursing embodies a philosophy that transcends conventional medical practices, emphasizing the interconnectedness of the body, mind, and spirit. This comprehensive approach seeks to address the myriad factors influencing a patients health, including emotional, psychological, and social dimensions, thereby fostering a more profound healing experience. As demonstrated in various healthcare models, such as those integrating complementary and alternative medicine (CAM), holistic nursing incorporates methodologies that consider the individual as a whole (Huia T et al., 2019). Practices like anthroposophic medicine illustrate this philosophy effectively, wherein caregivers focus on nurturing the patient’s innate healing abilities rather than merely alleviating symptoms (Huia T et al., 2018). By prioritizing a patient-centered paradigm, holistic nursing not only enhances the effectiveness of care but also promotes a deeper connection between the caregiver and the patient, ultimately leading to improved health outcomes and patient satisfaction. This artful synthesis of scientific and holistic approaches reflects a growing recognition of the need for a more inclusive understanding of health care.
Holistic nursing is a growing field that gives individuals guidance on nutrition, herbal remedies and other natural alternatives from a trusted healthcare source
A. Historical context and evolution of holistic nursing
The historical context of holistic nursing reveals a significant evolution from traditional medical practices to more comprehensive approaches that consider the whole person—mind, body, and spirit. Rooted in ancient healing traditions, this paradigm began to gain traction in the late 20th century as healthcare professionals recognized the limitations of disease-focused treatments. As the discipline progressed, the necessity for integrating spiritual care within nursing became evident. An exploration of literature between 1993 and 2015 indicates that while spirituality plays a crucial role in individuals experiences of meaning and purpose, the integration of spiritual competencies in nursing education remains under-researched (Ali et al., 2015). Furthermore, both holistic nursing and social work have identified the intersection of spirituality and overall well-being, emphasizing the need for comprehensive frameworks that support this integration (Mathews et al., 2009). This historical trajectory underscores the growing recognition that effective nursing extends beyond mere medical interventions.
B. Core principles of holistic nursing practice
In the realm of holistic nursing practice, the core principles emphasize an integrative approach that prioritizes the patient as a whole individual rather than merely a set of symptoms. This practice involves understanding the interconnectedness of the physical, emotional, spiritual, and social dimensions of health. The significance of spirituality in patient care cannot be overstated; it serves as a crucial element that influences wellness and the sense of purpose in life. However, challenges persist in developing spiritual care competencies within nursing education, as revealed by recent literature which highlights a shortage of studies addressing how these essential skills can be imparted to future nurses (Ali et al., 2015). Moreover, the incorporation of the arts and creative therapies has shown promise in enhancing patient readiness and well-being, offering a remarkable avenue to engage patients at a deeper level (N/A, 2013). Thus, the core principles of holistic nursing practice foster a comprehensive understanding of health that transcends conventional medical models.
C. The role of the nurse as a caregiver and advocate
In the realm of holistic nursing, the role of the nurse as both caregiver and advocate emerges as a critical component in delivering comprehensive patient care. Nurses not only address the immediate health needs of their patients but also recognize the importance of fostering a supportive environment that enhances overall well-being. This advocacy extends beyond the clinical setting; for instance, as the healthcare landscape shifts, the concept of aging in place is becoming increasingly important, particularly for seniors who wish to maintain independence in their homes. (N/A, 2013) highlights that such approaches can significantly reduce healthcare costs and improve life satisfaction among older adults. Furthermore, a deep understanding of cultural influences on health behaviors enables nurses to effectively advocate for marginalized communities, as underscored by (Harper B et al., 2006). This multifaceted role allows nurses to ensure that each patient receives not merely treatment, but holistic care that honors their values and promotes dignity throughout the health journey.
III. Integrative Techniques in Holistic Nursing
In the realm of holistic nursing, integrative techniques are pivotal in bridging the gap between traditional medical practices and complementary health approaches. These techniques often encompass a variety of modalities, including mindfulness, music therapy, and aromatherapy, which collectively aim to address the physical, emotional, and spiritual needs of patients. For instance, the implementation of music interventions has been studied extensively, revealing significant benefits in both chronic and acute medical settings. Unfortunately, the validity and replicability of such findings are often compromised due to inconsistent terminology and inadequate reporting standards within the research community, as highlighted in recent studies (Allison et al., 2018). Moreover, conferences such as the 3rd Java International Nursing Conference emphasize the importance of complementary therapies, encouraging a multidisciplinary approach to nursing that furthers the quality of patient care and fosters interprofessional collaboration (Nurmalia (Editor) et al., 2015). Ultimately, these integrative techniques exemplify the art of holistic nursing, promoting healing beyond mere symptom management.
Holistic Nurses can introduce alternative practices and techniques and other viable options that complement patient health
A. Mind-body connection and its significance
The mind-body connection plays a pivotal role in holistic nursing, emphasizing the intricate relationship between mental, emotional, and physical health. Recognizing this interconnectedness allows healthcare professionals to address the whole person, fostering healing that transcends traditional medical practices. Studies indicate that emotional states can significantly impact physical health, highlighting the necessity for nurses to incorporate assessments of spiritual and emotional well-being into their care paradigms. By embracing concepts such as belief and interconnectedness, which are central to holistic nursing, practitioners can enhance patient outcomes and satisfaction (Wolf et al., 2008). Moreover, the integration of complementary therapies—like mindfulness and yoga—demonstrates how addressing mental and emotional needs can facilitate physical healing (Nurmalia (Editor) et al., 2015). Ultimately, understanding and nurturing the mind-body connection not only enriches nursing practices but also empowers patients to take an active role in their healing journeys.
B. Complementary therapies used in holistic nursing
Holistic nursing is changing, and complementary therapies are now seen as really important for improving patient care, going beyond what traditional medicine offers. These therapies—things like massage, aromatherapy, and mindfulness—focus on treating the whole person, taking care of patients’ physical, mental, and emotional health. Studies suggest that using these therapies can lead to better health results and happier patients, which shows how important they are for more complete nursing care. Massage therapy, for example, can really help improve mental well-being, making it a good and safe addition to treatment (Cavaye et al., 2012). Also, nursing research is moving from just numbers to understanding individual experiences, which shows we’re realizing how complex care can be (Biley et al., 1999). This change highlights that holistic methods are key for making nursing better and focusing on what patients really need.
C. The impact of nutrition and lifestyle on health
Holistic nursing really highlights the importance of looking at the whole person, especially when it comes to how nutrition and lifestyle affect your health. Good nutrition is super important for both your body and mind – a diet full of essential nutrients can really help your immune system and keep your mood steady. Plus, things like exercise and managing stress can make a big difference in dealing with anxiety and depression, which can improve your overall mental and social well-being. Studies have shown that holistic wellness programs, which focus on your mind, body, and spirit, can be really helpful. They’ve been linked to increased mindfulness and lower levels of anxiety and depression (Chopra et al., 2019). This kind of shows why it’s so important for nurses to include advice about lifestyle and nutrition in their care plans, helping patients build both physical health and emotional strength (Nurmalia (Editor) et al., 2015).
IV. Patient-Centered Care in Holistic Nursing
Holistic nursing really revolves around patient-centered care, with a big emphasis on tailoring approaches to each patient’s many different needs. It’s about more than just clinical results; it also takes into account a person’s emotional, spiritual, and psychological state. For example, bringing creative arts therapies into healthcare might help patients get ready for, and bounce back from, treatments – sort of in line with the idea that holistic methods boost both recovery and general health (N/A, 2013). Plus, paying attention to spiritual needs is becoming a recognized, important part of holistic nursing. This means nurses need to consider a patient’s beliefs, values, and how they feel connected to themselves and to others (Wolf et al., 2008). Highlighting all this in patient-centered care allows nurses to connect more deeply with their patients. And this deeper connection should lead to a more effective and kind of caring approach that goes beyond just standard medical care and improves a patient’s overall well-being on multiple levels.
A. Building therapeutic relationships with patients
Nursing isn’t just about knowing the clinical stuff; it’s also seriously about how well you connect with patients. When you build good relationships, you get trust and understanding going, and that makes patients more involved and happier with their care. Good communication and feeling what patients feel are super important in holistic nursing. They help nurses really connect with patients, which makes for a healing atmosphere where everyone’s working together. You know, (Huia T et al., 2019) even suggests that thinking about things like complementary and alternative medicine (CAM) can make these relationships even better because patients often like those holistic health ideas. Plus, there was this study showing that people who took therapeutic classes got better at understanding and feeling empathy, which means learning is a big deal for making relationships better ((Kwaitek et al., 2005)). So, taking care of those therapeutic relationships doesn’t just help patients feel good; it also makes nursing a richer experience, highlighting the real art that’s part of holistic nursing.
Holistic health looks at treating the entire person and considers multiple aspects regarding overall health of a person. Please also review AIHCP’s Holistic Nursing Program
B. Individualized care plans and their importance
Individualized care plans are really important in holistic nursing, because they help make sure each patient gets the best possible care. These plans acknowledge that everyone’s different—they consider things like what each person needs, what they like, and where they come from. This helps nurses build a stronger, more caring connection with patients than you might get with just regular medical treatments. When nurses change treatments to fit each person’s situation, they can get patients more involved in taking care of themselves, which is super important for making sure they stick with the plan and feel good about it. For example, studies have shown that good preparation with a personalized approach before surgery is generally linked to patients doing better (Ablan et al., 2016). Also, programs in military health show how things like art can help with tough feelings and mental health problems, which can really make holistic care work better (N/A, 2013). So, care plans aren’t just about treatment—they’re about helping patients feel strong and in control, which is good for their overall health. They’re a means to empower patients, benefiting their overall health and well-being.
C. The role of communication in holistic nursing
When it comes to holistic nursing, good communication is really important for giving well-rounded care that takes care of patients’ bodies, feelings, and spirits. This complete way helps nurses build trust, which then leads to better relationships with patients. When nurses actively listen and show they care, they can figure out what patients are worried about. This helps them create treatments that not only work well but also mean something to the patient. According to research, using different clinical decision-making methods emphasizes the need for clear communication that acknowledges both the patient’s own situation and bigger things that affect their care (MJ A et al., 2007). Also, dealing with health differences by using culturally sensitive communication makes holistic nursing even better, making sure everyone gets fair treatment and support (Mondi A Mason, 2007). So, communication does more than just share information; it’s a key part of holistic healing.
V. Conclusion
To summarize, holistic nursing moves beyond standard medicine, understanding how deeply connected our physical, emotional, and spiritual selves are. This change in thinking helps patients right away, sure, but it also really helps them get healthier and stronger overall. As (Rogers et al., 2015) points out, when nurses include spiritual care, they can connect better with patients. This leads to a more complete healing that considers parts of being human we often miss. Plus, using art in therapy shows how being creative can help us heal and feel better. Programs like those in (N/A, 2013) prove that art can be a big help in healing, like we see in the military, which is similar to what holistic nursing does. In the end, using these different ways of helping people not only makes patient care better but also builds a kinder, more helpful healthcare system that understands how complex we are as people.
Please also review AIHCP’s Holistic Nursing Certification
Please also review AIHCP’s Holistic Nursing Certification. The program is online and independent study and open to nurses seeking to utilize integrated and holistic care into nursing.
A. Summary of key points discussed
When we consider holistic nursing from various angles, some important ideas come up that show why it’s more than just regular medical stuff. One big thing to talk about is how gut feelings and know-how work together. Benner’s idea about nursing says that using your intuition makes you better at helping patients (Chassy et al., 2007). Also, it’s super important for healthcare folks to learn about spiritual care. Studies show that when they do, they feel more caring, like their jobs more, and don’t stress out as much (Association of Hospice et al., 2005). This means holistic nursing isn’t just about taking care of the body; it’s also about feelings and spiritual needs, which helps patients in a complete way. Because of this, pushing for things like [extractedKnowledge2] integrative methods in nursing programs can really make healthcare better overall. It makes holistic care a strong part of how we help people feel good in today’s nursing world and boosts patient well-being.
B. The future of holistic nursing in healthcare
Holistic nursing’s trajectory, as healthcare progresses, places increasing value on a comprehensive integration of care. This encompasses the physical, emotional, and spiritual facets of a patient’s health. Acknowledging health as more than simply the absence of illness, this approach focuses on a multi-dimensional experience—meaning and purpose in life—which is often vital to patients looking for personalized care that speaks to their individual requirements. Even so, inserting spiritual care abilities into nursing education remains a challenge, indicating a demand for more research in this field (Ali et al., 2015). Creative arts therapies, when included as basic pieces of holistic practice, show the potential for various healing methods to improve care, serving as important tools for healthcare, civilian and military (N/A, 2013). So, holistic nursing’s future should be a vivid interaction between conventional practices and creative methods, promoting a more caring healthcare setting, generally speaking.
C. Final thoughts on the importance of holistic approaches in nursing
To sum up, it’s clear that holistic methods are super important in nursing, especially because they look at health and well-being from all angles. Holistic nursing acknowledges that treating patients goes beyond just medicine; it means understanding how connected we are in body, mind, emotions, and spirit. Bringing spirituality into nursing is really crucial, even though it can be tricky since spirituality is kind of vague, and it sometimes gets pushed aside in hospitals (Rogers et al., 2015). Plus, studies show that nursing students aren’t getting enough training in how to handle spiritual needs (Ali et al., 2015). If we can fix these issues with better education and clear guidelines, nurses will be better equipped to offer care that’s not only more caring but also more effective. This, in turn, can lead to better results for patients and a deeper sense of what health really means, going beyond what medicine typically focuses on.
Other AIHCP Blogs
“The Essential Role of Holistic Nursing in Promoting Holistic Health”. Click here
Additional Resources
Faubion, D. (2025). “What is Holistic Care in Nursing? (With Examples, Principles, & Challenges)”. NursingProcess.org. Click here
“The Importance of Holistic Nursing Care: Enhancing Patient Outcomes and Nurse Well Being” (2024). Nursing Science. Click here
“Holistic nursing: Focusing on the whole person” (2013). American Nurse. Access here
Konuch, C. (2024). “Understanding Holistic Nursing Care”. Nurse.com. Access here
Those who suffer abuse can sometimes fall through the cracks of society. Individuals, organizations, churches, establishments, or others can indirectly or directly be the cause of ignoring abuse and allowing to continue due to internal false notions, or external fears. Those in pastoral care, healthcare or mental health must be the final line of defense in identifying abuse. This may result in identifying initial abuse simply through a medical checkup, or a casual statement to the school counselor, or concerned friend, but sometimes, abuse is discovered years and years later in counseling. This is why it is so critical to make trauma informed care such a critical aspect of all counseling. So many issues emerge in life that are connected to unresolved trauma and it is so important for professionals report it as well as if within the scope of one’s practice to treat it. Counselors and pastors need to see themselves as guardians and watchers for abuse and trauma in all individuals.
Trauma Informed Care experts know how to identify trauma and abuse and how to help others overcome it. Please also review AIHCP’s Behavioral Health Certifications
In this article, we will shortly look at the nature of abuse and the dynamics of power and its role in covering abuse.
Compton and Patterson refer to individuals who protect the innocent from abuse as safeguarders (2024, p. 1). Anyone who wishes to promote a safe environment can be a safeguarder. Whether a observant friend, or those in pastoral ministry, or those within healthcare or mental health agencies. Everyone is called to look out for others whether the person is abused by a stranger, or a friend, or family, or within a religious institution or organization or agency. Compton and Patterson encourage others to be diligent to identify abuse by looking for signs of abuse or possible risks of for potential abuse. They emphasize in addition to looking to also listen to victims with empathy and non-judgmental attitudes that provide a safe place for them to speak. In addition to listening, safeguarding requires equipping the victim/individual/survivor with the tools to heal, build new relationships and find the necessary resources to move forward. Finally, Compton and Patterson emphasize the duty to speak out against abuse, report it and advocate for transparency within organizations that look to hide abuse (2024, p. 2).
Abuse itself is not always physical or sexual in nature, but abuse can also be verbal and emotional and in some cases, these minor forms of abuse can elevate to physical. While physical abuse is constrained to slapping, punching, strangling, burning or restraining and sexual to improper touches, exposure, unconsented recording, or rape itself, verbal and emotional abuse takes far more subtle forms. Emotional and verbal abuse can include guilt tripping, extreme jealousy, constant monitoring, name calling, insulting, sarcasm, threats, ghosting, avoidance and silent treatments (Compton & Patterson, 2024, p. 14). Spiritual abuse at the hand of a partner or even religious leader is common to control and manipulate. Compton and Patterson point out that misuse of scripture can lead to manipulation, especially to donate, or give up possessions, as well as to utilize absolute authority in other’s daily lives. When a religious leader claims undisputed authority from God without checks or balances, that leader is able to order submission to any decisions or actions he or she takes. Ultimately, the person is made to think that their service to the church or religious figure oversteps every other duty in life because the person’s salvation depends upon it (2024, p. 17).
The Power of Authority
Relationships that pend on authority and power of one over another are not partnerships but unequal relationships. When a manager, president, coach, pastor, or priest teaches, speaks, or instructs, there is a sense of power and influence over another (Compton and Patterson, 2024, p. 28). This is not necessarily a structure of evil, but an important part of organization and society, but the inner dynamics of these powers of one over another can lead to evil actions when misused. Rinaldi states, “Abuse flourishes within a system that emphasizes absolute power of leaders, encourages unflinching submission and obedience of followers and avoids meaningful accountability (Compton and Patterson, 2024, p. 26). Authority can easily be corrupted. Authority as a relationship to another carries a huge responsibility. A coach’s responsibility via his/her authority to bring out the best of his/her players, to train them, and teach them and prepare them for games. When this responsibility deviates from these norms, then his/her power is misused and tempted to abuse. Additionally, due to the existence of this relationship, it can easily blur lines and lead to potential misuse of it. Compton and Patterson point out that any leader, pastor, or manager needs to clearly understand the limits and extent of their power, as well as the consequences of misusing that power and the effects of vulnerable individuals under them within this relationship (2024, p. 29).
Many misuse authority. Counselors can help individuals overcome the manipulation.
Those who misuse authority purposely exploit those under their control. To confuse, justify and promote compliance, spiritual leaders will utilize spiritual texts, managers will utilize company goals and professional needs, coaches will use team first mottos or personal goals as ways to contort and confuse the victim. This leads to a grooming phase where those in authority utilize their power to attract the victim outside of the arena of their relationship into other situations. Utilizing scripture, or company goals, or team needs, the perpetrator will work on altering the victim’s conscience and to make them question his/her values. Abusers with authority to cover their crime will look to normalize the abnormal and justify it. For instance, a coach may tell a player that this behavior in the locker room is normal and goes on in all locker rooms across the country. The victim who may be scared to question, or be brainwashed and manipulated into compliance may be in awe of the person, or afraid to lose a job, or a spot on the team. This leads to a cycle of abuse (Compton and Patterson, 2024, p. 31-33). The authority misused also leads to threats later. The abuser who fears accountability or prosecution will use his/her authority to terrify the abused into silence. A priest may tell a young child that no-one will believe them or that if they say anything, they will go to Hell. A politician may tell an intern, that if anything is mentioned, the person will never work in politics again. This disgusting misuse of power and abuse unfortunately happens everyday and it up to those in behavioral health, healthcare and pastoral professionals to uproot it and expose it to the light. This is an important aspect of trauma informed care!
The Dynamics of Authority and Coverup
It is important to realize that many individuals can become complicit in abuse. Some may be more direct, while others are more indirect, but the complicity still remains. Sometimes complicity at even more remote levels protect and shield the most dangerous abuses and keep victims trapped under the spell of dominance. Abusers play a part in abuse by commanding or counseling or consenting to or flattering the perpetrator. They can directly cause it or even participate within it. Others who may not abuse or condone it even play a role in allowing abuse to exist by covering it up, remaining silent, preventing steps to expose, or not openly denouncing it. These individuals in many ways are as dangerous as the abusers. While they may not abuse or have a mental illness to abuse, they care more about image or position or finance than another human being in trauma. Their crimes are an equal problem and a reason why so many institutional abuses continue within many organizations (2024, p. 12-14). Many organizations, churches, schools, or agencies utilize shame, silence, or loyalty above truth. Those who work for schools, universities, sporting teams, church positions, or organizational positions feel the pressure to protect the image of who they associate with, as well as who pays them. In addition, many within cult-like churches will look for the greater good in promoting their silence, or feel as if their salvation is threatened if they question someone of religious authority. This can lead to shame as well to encourage silence and foster the environment for abuse.
Many individuals are pushed into complicity via threats or loss of status when they witness abuse. Individuals must expose the crime at all costs
Compton and Patterson list some key concepts that lead one to complicity and silence. Unity over truth leads those within the organizational structure to silence or dismiss those who call out questionable statements, or patterns or procedures. In this case, the mission of the church or organization overplays the mission to protect individuals. This leads to the greater good motif as well as the needs of the many over the need of the one as a way to justify a crime of abuse. In addition, Compton and Patterson point out that authority over truth leads to the submission of women and children to do without question. If a coach or pastor does something morally questionable, one is told or taught to dismiss it because there is a higher reason for the crime. This leads to diluting the idea that everyone sins or no-one is perfect when comparing it to an actual crime, and then proceeding to forgive the crime as if a minor issue. Others within the organization or church who witness it, then look for reasons to justify the crime of their coach, hero, or pastor. This leads to silence and also internal coverup over an actual crime under the guise of a simple sin that no-one needs to know about and that there must be “good reason” for. In abusive church settings, the congregants are told not to gossip about a potential crime and are pushed to trust their leaders and to also only count on scripture as a source of good counsel over professional resources that would immediately report a crime (2024, p.23)
Trauma informed care probes for these signs of abuse and helps expose it.
Exposing and Preventing Abusive Systems
First, if you feel as a leader in whatever capacity you are over abusing your power and authority beyond its scope and environment, then reel it in and hold oneself accountable. If outside the office, monitor those under your care and limit relationships that are not ethical. Second, if you witness abuse, report it. Do not justify someone’s behavior, normalize it, or belittle a crime.
On a larger scale, trauma informed specialists, mental health and healthcare professionals must become advocates and face organizations that look to hide abuse. This is not only legal and the law but also ethical and moral. Sometimes it may seem whistle blowing is hurting oneself but character and maintaining one’s integrity is far greater than any position. Whistle blowing on a favorite university program may hurt the program, or reporting one’s church may feel as if you endangered the holiness of it, but we need to separate the difference between a crooked and sick individual and our favorite team or church we attend. Instead, we should be enraged that someone would abuse while wearing a collar within our faith, or if a coach would misuse the honor of coaching our favorite team to abuse others or permit abuse under his/her watch. As mentioned earlier, we must be safeguarders and this must be vocational. We are the reformers of our favorite institutions when we do report. We are preserving the future of those institutions by reforming it and removing the scum that has invaded it via reporting it. This is the mindset of a reporter. Criminals must be exposed and removed from society, especially those who misuse power, exploit the vulnerable and emotionally and physically abuse others.
It is important to expose those who hurt the most vulnerable. Please also review AIHCP’s Mental and Behavioral Health programs
Politicians, pastors/priests/bishops, managers/CEOs, and coaches are not above the institution they are in or the people they serve or manage. Their must be complete zero tolerance and complete transparency. The reforms of the Catholic Church, while slow and painful, have produced fruits with more transparency that include not only reporting but also removing the alleged perpetrator with real life consequences. Whether a company, church or university there must clear and unforgiving policies and procedures that let all those who hold authority of the dire consequences that will follow if one is guilty of misuse of power and abuse. This transparency will not taint the view of the organization but actually prove that it cares about the vulnerable and individual over crime. It takes courageous persons in dark times to stand up. Victims are the most courageous by pushing forward and telling their story. Those who report and those who seek to reform institutions are also courageous risking position, status and rejection. Stopping abuse is a community and team effort!
Conclusion
Trauma Informed Care is always looking for signs of past trauma or abuse that may stem across the life span. It looks to expose and challenge any abuser or institution that has committed the crime of abuse or misused authority. As safeguarders, mental health as well as pastoral caregivers must not only help those with trauma and abuse but also be courageous enough to be whistle blowers and advocates for the abused, forcing those who misuse authority to face justice.
Relationships-any relationships, but especially ones with a partner can be difficult. Learning the biggest relationship issues and how to communicate can help others foster mutual respect, understanding and love between couples. This video takes a closer look at counseling tips for improving relationships
In contemporary healthcare, the role of nurse case managers (NCMs) has become increasingly significant in enhancing patient outcomes through coordinated care. These professionals act as essential liaisons between patients and healthcare systems, facilitating communication and ensuring that patients receive comprehensive and tailored care that meets their unique needs. Research indicates that effective care coordination can lead to improved patient adherence and overall satisfaction, as a dedicated contact person is seen as both crucial and beneficial in the process of care management (Baroni et al., 2015). Furthermore, the transformation of primary care practices under healthcare reform necessitates innovative models of service delivery, where nurse case managers can play a pivotal role in implementing and sustaining these new practices (Berenson J et al., 2011). By understanding the structural dynamics of care systems, NCMs help bridge gaps in patient knowledge and engagement, ultimately leading to better health outcomes.
Please also review AIHCP’s Case Management Courses. Please click here
The important role case managers play in coordinated quality care
A. Definition of nurse case management
Nurse case management emerges as a critical framework in healthcare that enhances patient outcomes through systematic coordination of care. It is defined as a collaborative process where nurse case managers assess, plan, implement, and evaluate strategies to promote quality care for patients, particularly those with complex, chronic conditions. This approach is especially beneficial for elderly populations as it ensures that transitions among various healthcare providers and settings are seamless and efficient, reducing the likelihood of fragmented care (Julie A Sochalski et al., 2010). Moreover, the Advancing Care Coordination & Telehealth Deployment (ACT) Programme highlights key organizational processes vital for the effective deployment of care coordination services, emphasizing the importance of a dedicated contact person and the role of engaged staff in fostering patient adherence (Baroni et al., 2015). As such, nurse case management not only bridges healthcare services but also cultivates an environment conducive to improved patient engagement and satisfaction.
B. Importance of coordinated care in healthcare
Effective coordinated care is pivotal in enhancing healthcare delivery, particularly for patients with chronic conditions and the elderly. By integrating services through a structured approach, coordinated care ensures that patients receive continuous attention, aligning their treatment plans across various healthcare providers. This model offers significant advantages, such as improved patient adherence to treatment regimens, which often hinges on the engagement of staff and the establishment of a dedicated contact person for patients. Moreover, successful examples from initiatives like the ACT programme highlight the necessity for organizational structures that synchronize the perceptions of patients, managers, and providers, ultimately leading to better patient outcomes. Additionally, case studies have identified essential elements such as feedback mechanisms and supportive infrastructure, which are vital for the implementation of effective coordinated care strategies. Overall, the integration of these components fosters an environment where patient needs are systematically prioritized.
C. Overview of the impact on patient outcomes
The impact of nurse case managers on patient outcomes is both significant and multifaceted, primarily stemming from their role in facilitating coordinated care. By serving as dedicated contacts in healthcare settings, case managers foster stronger communication between patients, frontline staff, and other healthcare providers, thereby enhancing adherence to treatment plans and improving overall care experiences. The Advancing Care Coordination & Telehealth Deployment (ACT) Programme highlights that successful patient adherence is more likely when staff engage meaningfully with patients, emphasizing the importance of shared responsibilities for health outcomes. Furthermore, incorporating processes such as bedside rounding and interprofessional communication, as exemplified by innovative quality improvement projects, can lead to smoother transitions during critical phases like hospital discharge, ultimately reflecting positively on long-term patient outcomes. Together, these strategies underscore the essential role of nurse case managers in elevating the quality of healthcare delivery and patient satisfaction.
II. Role of Nurse Case Managers
In the context of coordinated care, nurse case managers play a pivotal role in bridging gaps within the healthcare delivery system, ultimately enhancing patient outcomes. Their function extends beyond mere administrative support, as they actively engage with multidisciplinary teams to streamline communication and ensure patients receive comprehensive, continuous care. By serving as dedicated contact persons, case managers foster relationships with patients, empowering them in their healthcare journeys and bolstering adherence to treatment plans. Insights from the Advancing Care Coordination & Telehealth Deployment (ACT) Programme suggest that when staff are engaged, patients show a higher willingness to participate in healthcare programs, emphasizing the importance of a collaborative approach to care (Baroni et al., 2015). Furthermore, addressing systemic issues of care fragmentation through policy recommendations can further optimize the effectiveness of nurse case managers in creating a cohesive care experience (Anne K Gauthier et al., 2008). Thus, their role is integral to achieving better health outcomes.
Case Managers play a crucial role in delivering better patient care and outcomes. Please also review AIHCP’s Case Management Program
A. Responsibilities in patient care coordination
In the realm of patient care coordination, nurse case managers assume critical responsibilities that fundamentally enhance patient outcomes. Central to their role is the facilitation of effective communication among healthcare teams, which ensures a seamless transition of care, particularly during discharge processes. For instance, initiatives such as those outlined in recent studies emphasize the implementation of structured communication strategies, like bedside rounding and shift reports, spearheaded by clinical nurse specialists, to mitigate confusion and enhance clarity in patient care ((Beiler et al., 2019)). Moreover, the adaptability of discharge processes tailored to individual hospital settings demonstrates the responsiveness required in care coordination, as noted in numerous hospital innovations aimed at streamlining transitions from hospital to home care ((Bahr et al., 2015)). By embracing and executing these responsibilities, nurse case managers effectively bridge gaps in care, ultimately leading to improved patient satisfaction and health outcomes.
B. Skills and qualifications required for effective case management
In the realm of nursing, effective case management necessitates a unique blend of skills and qualifications that enable nurse case managers to navigate complex patient needs and coordinate care effectively. Critical thinking and problem-solving abilities are paramount, as these professionals must assess diverse health situations and devise appropriate interventions. Additionally, strong communication skills facilitate collaboration among multidisciplinary teams, ensuring that all stakeholders are aligned with the patients care plan. Knowledge of healthcare systems and policies is equally vital, as evidenced by studies that highlight the importance of restructuring and improving care delivery within small practices ((Berenson J et al., 2011), (Anne K Gauthier et al., 2010)). Familiarity with technology and data management tools enhances case managers ability to monitor patient outcomes and streamline processes. Ultimately, these skills not only empower nurse case managers to advocate for their patients but also contribute significantly to improved health outcomes through coordinated care.
C. The relationship between nurse case managers and healthcare teams
The collaboration between nurse case managers and healthcare teams is pivotal in enhancing patient care through coordinated strategies. Nurse case managers play a critical role in bridging communication gaps among various healthcare providers, which is essential in addressing the complexities of patient needs. For instance, implementing structured communication processes, such as those outlined in the TeamSTEPPS framework, facilitates effective team interactions and improves continuity of care, particularly during transitions like hospital discharge (Beiler et al., 2019). Furthermore, addressing systemic issues in healthcare delivery, such as fragmentation, remains a pressing challenge. Policy reforms that promote care coordination across settings, as suggested in recent analyses, can bolster the effectiveness of nurse case managers in their roles (Anne K Gauthier et al., 2008). Ultimately, these collaborative efforts lead to improved patient outcomes, highlighting the essential role of nurse case managers within healthcare teams.
III. Enhancing Patient Engagement
Enhancing patient engagement is a pivotal aspect of the work conducted by nurse case managers, significantly contributing to improved health outcomes. By fostering open lines of communication and encouraging active participation in care decisions, nurse case managers empower patients to take ownership of their health journeys. This engagement is particularly crucial for individuals with chronic conditions, as evidenced by insights from the Advancing Care Coordination & Telehealth Deployment (ACT) Programme, which indicates that patient perceptions, when aligned with those of healthcare providers, can lead to better adherence and outcomes (Baroni et al., 2015). Moreover, frameworks such as TeamSTEPPS exemplify how structured team communication can bolster patient engagement during critical transitions, such as hospital discharge. By implementing these strategies, nurse case managers not only enhance patient understanding of their care process but also facilitate a collaborative environment where patients feel responsible and capable of managing their health (Beiler et al., 2019).
A. Strategies for improving patient communication
Effective patient communication is paramount in the nursing profession, particularly for nurse case managers who play a critical role in coordinating care. One strategy involves the implementation of structured communication processes, such as bedside rounding and shift reports, which have been shown to enhance information exchange among healthcare providers and patients alike. By utilizing tools like the TeamSTEPPS 10-step action planning guide, as described in (Beiler et al., 2019), nurses can systematically improve dialogue among team members and with patients, ensuring that everyone is aligned on care goals. Furthermore, insights from the Advancing Care Coordination & Telehealth Deployment (ACT) Programme indicate that having a dedicated contact person significantly enhances patient perceptions and experiences, highlighting the importance of clear communication lines ((Baroni et al., 2015)). These strategies not only promote patient adherence but also foster a collaborative environment where patients feel empowered to engage actively in their care, ultimately leading to improved patient outcomes.
Case Managers can play a key role in not only guiding patients but also educating them for better health outcomes
B. Educating patients about their health conditions
Patient education regarding their health conditions is undeniably crucial for better outcomes. Nurse case managers are key to this, making sure patients grasp their diagnoses, treatment choices, and why sticking to care plans matters. Clear communication from these professionals boosts health literacy and lets patients make smart choices about their care. Coordinated efforts to fix the fragmented healthcare system also play a part in a more complete approach, as recent studies show. Strategies like payment reform and infrastructure support, see (Anne K Gauthier et al., 2008), can really help boost these educational efforts, letting nurse case managers build custom plans without dealing with the headaches of disjointed care, generally speaking. And ultimately, well-informed patients tend to be more involved in their treatment, which leads to improvements, as (Anne K Gauthier et al., 2010) emphasizes.
C. Encouraging adherence to treatment plans
One crucial element of coordinated care involves boosting how well patients stick to their treatment plans. Nurse case managers help with this by giving structured support and talking with patients. They serve as a main point of contact, offering key consistency in care. This helps build trust and a personal connection, which makes patients more involved. Studies show that sticking to treatment often depends on healthcare staff being involved (Baroni et al., 2015). It’s really important to focus on patient-provider interactions. Also, the difficulties of changing healthcare systems mean we need new ways to help patients take charge of their health. Nurse case managers help connect the administrative side with the actual care provided (Berenson J et al., 2011). This broad approach encourages patients and providers to share responsibility for following treatment, as patients learn more about what’s happening, which can improve their health and overall well-being as they deal with complicated health issues.
IV. Reducing Healthcare Costs
When we’re talking about cutting healthcare costs, nurse case managers really start to stand out, mostly because they can coordinate care so well. These folks manage ongoing health problems and make sure patients get what they need; this helps keep people out of the hospital and away from the ER when it’s not totally necessary. Studies show that it’s really important to have healthcare setups that let everyone talk to each other easily. This helps create a team atmosphere that’s essential for patients sticking to their treatment and feeling good about the care they’re getting. It’s worth noting that the Advancing Care Coordination & Telehealth Deployment (ACT) Programme found that having a specific person to contact makes a big difference in how patients feel about their experience. What this shows is that having solid support is super important for getting people involved and making sure they follow their doctor’s orders. It’s also key to fix the way healthcare systems are sometimes all over the place. Suggestions for changing how things are paid for and updating the rules can really let nurse case managers do their thing, streamlining care and cutting down on how much healthcare costs overall (Baroni et al., 2015), (Anne K Gauthier et al., 2008).
A. Impact of coordinated care on hospital readmission rates
Coordinated care is now seen as a really important way to lower the number of patients who have to be readmitted to the hospital; it also greatly improves how well patients do overall. It makes sure that those patients are getting the right follow-up and care after they leave the hospital. This is done by making it easier for doctors and other healthcare people to talk to each other. Take the ProvenCare idea, for example. It not only helped use fewer resources but also made patients better. This shows how well it works at keeping readmissions down (McCarthy D et al., 2009). Plus, it’s super important to fix the way healthcare is often split up into different parts, since that lets us make full plans for coordinating care in all sorts of places (Anne K Gauthier et al., 2008). Nurse case managers are key here; they connect everyone, teach patients about what they need to do for their health, and keep an eye on how they’re doing. When all of these things come together, healthcare can be smoother, which stops unneeded readmissions and helps patients stay healthy for longer.
B. Cost-effectiveness of preventive care measures
Considering healthcare reform, the value—specifically the cost-effectiveness—of preventive care really stands out; nurse case managers are pretty important here, as they help coordinate everything. Nurse case managers can really make a difference by putting preventive measures in place, like early screenings and health education. This approach can cut long-term chronic disease costs in a big way. It helps get people the interventions they need when they need them and it lines up with what states are trying to do, which is to revamp how primary and chronic care are delivered. Leadership and payment incentives are key to making this work (Anne K Gauthier et al., 2010). Plus, when you look at case studies, you see that places using models like ProvenCare, which puts a lot of emphasis on prevention, tend to have better clinical results and use fewer resources. This, quite simply, demonstrates good economic sense (McCarthy D et al., 2009). So, you could say investing in preventive care—with nurse case managers coordinating it all—is smart from a financial standpoint and is useful in enhancing patient outcomes; all while taking it easier on healthcare systems.
Case Management is also cost efficient for facilities
C. Financial benefits for healthcare systems and patients
Nurse case managers provide financial advantages to both healthcare systems and patients, largely because they improve care coordination and cut down on needless expenses. By skillfully overseeing patient movement between different care environments, nurse case managers help avoid expensive hospital readmissions and trips to the emergency room. This not only makes patients healthier but also lightens the financial load on healthcare providers. Such coordinated care fits into wider policy suggestions that seek to lessen fragmentation and increase accountability in how healthcare is delivered (Anne K Gauthier et al., 2008). For example, the North Carolina Medicaid program shows how smart care management investments can get the most from limited Medicaid money, boosting health access and tackling urgent inequalities (Rice et al., 2017). When these financial gains are clear, healthcare systems benefit a lot, underscoring the important part nurse case managers play in patient care and financial prudence.
V. Conclusion
To sum up, it’s clear that nurse case managers play a really important part in helping patients get better results by making sure their care is well-organized. They’re good at connecting different healthcare people, which helps patients get care that looks at the whole picture. We can learn from programs like the ACT one that good care coordination needs people to talk to each other clearly and to give patients the exact help they need, especially if they have long-term or complicated health problems (Baroni et al., 2015). Also, case managers use a biopsychosocial way of thinking, which helps them really understand what’s going on with a patient’s health. This makes patients more likely to stick to their treatment plans and feel better overall (Demou et al., 2014). As healthcare keeps changing, it’s going to be important to put money into training case managers and to appreciate what they do. This will help us make a healthcare system that works better together and gives patients the best possible care.
Please also review AIHCP’s Case Management Certification Program
A. Summary of the benefits of nurse case management
Nurse case management, when put into practice, generally shows a marked improvement in how patients fare, thanks to well-rounded and synchronized care approaches. A key advantage is the creation of a specific point of contact for patients. This is really helpful, because its been shown to build trust and makes talking between patients and doctors easier (Baroni et al., 2015). When people feel they can engage this way, it does more than just get them involved in their care, it also helps them stick to their treatment plans and leads to better health overall. Plus, nurse case managers are essential in tackling the scattered nature of healthcare. They steer patients through complicated systems and bring together services from different providers and locations. This is an important aspect, as emphasized in suggestions for healthcare policy changes (Anne K Gauthier et al., 2008). By weaving together these strategies, nurse case management pays attention to both the physical and emotional needs of patients, and this contributes to better care within our healthcare setups.
B. Future implications for healthcare delivery
Looking ahead, as healthcare systems adapt to handle the growing need for well-coordinated care, nurse case managers will almost certainly play a vital part in how healthcare is delivered. These individuals are key to joining together the different parts of the healthcare system, a necessity when dealing with patients who have complicated needs, such as the elderly and those with long-term illnesses. Data from the Advancing Care Coordination & Telehealth Deployment (ACT) program suggests that good outcomes depend on managers, staff, and patients sharing a similar view of the process (Baroni et al., 2015). Plus, new research points out that fixing the fragmented healthcare system means we need changes, like payment updates and better rules, to help healthcare providers work more smoothly together (Anne K Gauthier et al., 2008). Keeping these factors in mind should let nurse case managers improve how patients do, push for customized care, and help make the healthcare system work better overall.
C. Call to action for integrating nurse case managers in care teams
The addition of nurse case managers to healthcare setups is a really important step forward for care that puts the patient first, something we should really jump on. Because healthcare outfits are more and more about joined-up care, nurse case managers are super important for making sure everyone talks to each other and works together well on different teams. This not only makes things easier when patients move from one place to another—like when they leave the hospital—but also sets up a way to get better results for patients by making care plans and support systems that are just right for them. To show you, projects using the TeamSTEPPS model show how structured team talks can improve health results, showing that nurse case managers are good at getting quality improvements in patient care (Beiler et al., 2019). Plus, what we’ve learned from things like the Advancing Care Coordination & Telehealth Deployment Programme shows that it’s vital to have people like nurse case managers to help patients stick to their treatment plans and keep tabs on resources (Baroni et al., 2015).
Other Resources
“The Impact of Case Management on the Healthcare System”. CMSA. Access here
“Understanding the Benefits of Case Management in Healthcare”. Healthcare Resolution Services. Access here
“Healthcare Case Management and Better Patient Outcomes”. AIHCP. Access here
“The Importance of Case Management Roles in Healthcare”. Brundage Group. Access here
Trauma is part of life. As long one exists, trauma can occur. Treating trauma acutely on the scene is important in crisis and mental health, but also recognizing it within a client or patient who has experienced it is key. Being trauma informed and trauma aware can bring day light to many existing problems and prevent many future ones. Mental health professionals must hence be trauma cognizant and alert for clues and possible issues within a client or patient.
Trauma informed care looks to help others that may have fallen through the cracks and never received trauma care. Please also review AIHCP’s Mental and behavioral health certifications
Again, the true reality is everyone grieves and loses someone or something. The chance of one of those incidents to cause trauma at least once to some level in someone’s life is around 80 percent. So understanding the fine line between experiencing something sad, or even bad, and how that translates subjectively to trauma is important since such a high percentage of people within the population will experience some type of traumatic reaction. Identifying and helping individuals who are dealing with trauma can be a beautiful healing moment.
Please also review AIHCP’s Crisis Intervention Program, as well as its Trauma Informed Care Programs in 2026 for both clinical as well as pastoral disciplines. Bear in mind, helping others with trauma and processing it, is not merely a clinical purpose, but it can fall into non clinical and pastoral settings. So, it is important to help individuals face trauma within one’s scope of professional practice. While this may be limiting for some, such as pastors or chaplains within the scope of their mental health training, other licensed professionals in social work, counseling or psychiatric nursing can help treat trauma at a much deeper level. AIHCP’s certifications in behavioral health are aimed at giving professionals within all scopes of mental health additional knowledge and skills to help those in trauma to process and identify it. The idea of recognizing trauma across a life span has only been recently introduced into the DSM-V. This has opened the floodgates for many professionals to become certified within this field or utilize it within their practice.
What is Trauma
A person enters a state of crisis when something overwhelms his/her abilities to cope and handle the situation. It de-stabilizes and disorientates them. Like crisis, trauma is a severe stressful and impactful event in life that imprints itself upon the person. Sometimes it is so horrible, the person is not even able to properly store it within the mind resulting later in PTSD. Different levels of trauma exist. In the article, “Advanced Method-Trauma Informed Framework” from SAMHSA (Substance Abuse and Mental Health Service Administration), the individual who suffers from trauma experiences what is referred to the 3 “E”s of trauma care. The includes the event itself, the experience of it and the effects of it.
Trauma informed care looks to actively identify and recognize trauma in clients and be equipped to help those client heal from trauma across a life span
Within the event, what was the triggering occurrence that caused the initial trauma in a person’s life. This is very subjective in nature. What may negatively impact one person, may not hurt someone else based on numerous subjective, cultural, religious, emotional, mental and social support systems that make up the person’s ability to handle a crisis or horrible situation. While an event may objectively be horrible, some individuals are able to recover and show resiliency to it and trauma is minimal or non existent. Some soldiers can return home from war without trauma, while others cannot escape the trauma. So while the event may be objectively dark, such as a tornado destroying one’s home, an individual may still respond to that event without long term trauma as opposed to someone else.
The experience of event is the second key element. This is far more subjective in nature and determines if the individual will suffer trauma. The experience at the mental, emotional, or physical level is so intense, it overtakes the individual to the point that the persons experience of the event is traumatic acutely as well as long term. This again points back to a person’s emotional and mental build to particular events in life. A person’s history, a person’s interior resiliency, or a person’s support systems can all play key roles in how a person handles a crisis or how a traumatic event imprints upon a person. This in no way dismisses a person who experiences trauma as weaker than others because everyone is susceptible to trauma–it just matters what is one’s tipping point.
The effects of trauma play the third key element. The effects of a traumatic event can be short term or long term. They can be affect all aspects of the person. Effects can include inability to cope with life and everyday stressors, or trust others, social withdraw and issues, or loss of purpose and life meaning, or properly utilize the cognitive process. It can result in maladaptive coping practices, as well as manifest with symptoms associated with PTSD that include hyper vigilance, avoidance, dissociation, nightmares or emotional numbing.
Trauma across a life span and trauma informed care recognizes the imprint of trauma on human life and seeks to see if any trauma still lingers or was never discovered or at least discussed that may be haunting a client throughout his or her life.
SAMHSA and the Four “R”s and Key Assumptions in Trauma and Informed Care
SAMHSA’s article, “Advanced Method-Trauma Informed Framework” gives a detailed account about qualities and key assumptions in presenting a concise commitment to treating trauma across a life span and helping agencies, as well as individual practitioners a better way to proceed forward in creating a practice that gravitates around trauma informed care. The four R’s are essential in addressing trauma within any agency. A program or organization first needs to realize the impact of trauma as a universal human phenomenon that requires treatment in life. Secondly, counselors, or agencies need to recognize the signs and symptoms of trauma that are either acute or manifesting across the span of one’s life time. In many cases, one may have been living with trauma undetected through professional services or lack of visit. Counselors need to be aware that some new clients may have trauma from ages ago that was never treated. The agency or organization then needs to have the ability to respond to the needs of the client via fully integrated knowledge, training, policies and procedures to help the person. Finally, the agency owes to to any client to resist re-traumatization of the person.
Trauma informed care realizes the existence of trauma and looks to recognize the symptoms of it within the population it looks to treat.
A trauma informed approach according to SAMHSA also applies six key principles to its application. First and foremost, safety is key when working with trauma patients. The client must feel safe physically, emotionally and mentally and the environment must facilitate that aura of safety. Second, the agency and counselors or social workers need to present its operations in an open and trustworthy fashion. Third, peer support is a key element in any healing. Peer support or trauma survivors can supply their stories or support to others walking the healing journey. Fourth, the entirety of the agency all plays a role in the healing process. The entire agency has a clear and mutually defined role in application of trauma support. Fifth, both staff and clients are given empowerment. The client is able to share in the process of healing via choice and decisions in plans of action. The staff as well is given empowerment via support of from the administration as well as the tools necessary to do their work. The final principle involves removal of any bias based on culturally, religious or gender issues when dealing with and helping individuals deal with trauma. In doing so, staff recognizes the trauma that can exist within certain groups and how that can manifest within individuals.
SAMHSA and Implementing a Trauma Informed Approach
Trauma informed care is an organizational decision that transforms the organization or agency or individual social worker or counselors paradigm of working with individuals. To be successfully implemented, it takes more than principles and good philosophies but a pragmatic process that involves multiple levels of preparation, policies, training, finances and feed back. SAMHSA lists ten core implementation domains that are essential to help agencies properly support individuals suffering from trauma.
Trauma informed care requires an organizational commitment from the counselor to the administration itself to ensure implementation of it at all levels
First, governance and leadership is essential. There needs to be a conscious choice to implement trauma informed care and establish leadership and management of its implementation to oversee and work with peers and staff in that effort. Second, the agency needs written policies established that outline the new mission as well as a blue print for procedure. Third, the organization needs to create a physical environment that mirrors a safe harbor for the type of work trauma counseling requires. Individuals must feel safe, secure and able to trust without fear of embarrassment, guilt, or repercussion of their story. Fourth, there needs to be within the agency an engagement and involvement across multiple lines of individuals not only between counselor and client, but also within the organization itself and the process of helping individuals through trauma at all levels. In addition, fifth, an agency needs to be equipped with cross sector collaborations with other agencies at the local or state level that can help facilitate healing. Sixth, the agency needs to utilize the best empirically and scientifically proven principles in screening, assessment and treatment. Seventh, training and workforce development is essential to ensure counselors have the education and continuing education necessary in trauma informed care. Education and training workshops are key in maintaining up to date skills and knowledge in helping others. The training, however, is not just shared with counselors and social workers, but also at lower levels within staff in how to deal with trauma and understand the nature of trauma with potential patients who enter the actual facility. Eighth, as with all training, monitoring and quality assurance is essential to confirm that principles, policies, procedures and trainings are carried out properly within the whole of the organization. This involves trauma informed principles that are incorporated into hiring, supervision, evaluation of staff, as well as working with staff and their own vicarious trauma and self care needs. Ninth, agencies obviously need the necessary financial budget to transform the facility to support the need of trauma clients, as well as paying for the necessary trainings. Finally, evaluation and feed back is essential in how the mission is being carried out. This involves evaluation from top to bottom and taking feed back from everyone to ensure the implementation of the program is successful or if needs any adjustments.
Conclusion
Many individuals unfortunately lack proper trauma care. The initial trauma is untreated, or the trauma is allowed to persist without proper care. Individuals feel like they become a number without a real advocate. Many feel the pain of having to re-tell their story over and over without any true treatment. Others feel they labeled and may flee any treatment, while others who seek treatment may not have access to quality care in trauma or not have access to it. Hence many individuals feel as if they are unseen or not heard, or feel unrecognized within their social group and the traumas they collectively face.
Treating trauma is a social issue. Please also review AIHCP’s Behavioral Health Certifications
Trauma informed care looks to acknowledge the reality of trauma in life for individuals within all cultural, social, religious and ethnic groups. It looks to implement mental health plans to help individuals heal from trauma and become healthy members of society. The need for trauma informed care and spotting trauma is essential in our society. So many suffer from trauma and when left untreated, these individuals can become a danger to themselves or others. Recognizing the necessity of trauma informed care is an answer to our mental health crisis itself.
AIHCP recognizes this important issue and offers a variety of mental health certifications, including in 2026, a trauma informed care certification for healthcare professionals. Please review AIHCP’s multiple certifications in behavioral health, as well as its Grief Counseling, Crisis Counseling, Stress Management and Anger Management programs.
