This post discusses Principle 6: Cultural, Historical, & Gender Issues of SAMHSA's six key principles of a trauma-informed approach.
Trauma-informed care (TIC) is an essential approach that acknowledges the pervasive impact of trauma. It includes an understanding of past and current trauma and an awareness of its impact across settings, services, and populations. People that identify as American Indian and Alaskan Native, immigrants, Latinx, Black, African American, lesbian, gay, bisexual, transgender, queer, and other groups who are marginalized are more likely to experience discrimination and microaggressions. In this blog, we will discuss the importance of cultural, historical, and gender issues in delivering effective services. Principle 6 underscores the necessity of moving beyond stereotypes and biases to provide care that truly meets the needs of diverse populations.
Cultural responsiveness in TIC means recognizing, valuing, and respecting the cultural backgrounds of individuals. It involves understanding how cultural values, beliefs, traditions, and practices influence help-seeking behaviors and perceptions of trauma and healing. For example, some cultures may view substance use or depressive symptoms as a sign of weakness or a personal failing, which can discourage individuals from seeking help (SAMHSA, 2014). By incorporating culturally sensitive approaches, providers can create a more welcoming and effective therapeutic environment. One way for providers to get started practicing cultural responsiveness is by acknowledging your own cultural background, values, biases, and stereotypes. Then, you can focus on understanding the client’s individual and cultural strengths and incorporate them into treatment planning.
Historical trauma refers to the collective emotional and psychological injury over the lifespan and across generations. This is particularly relevant for communities such as Native Americans, African Americans, and other groups that are marginalized who have experienced systemic oppression and violence (Brave Heart, 2003). Understanding this context is crucial for providers, as historical trauma can exacerbate the effects of current traumatic experiences.
Gender responsiveness involves understanding how gender-specific experiences and societal expectations can impact an individual's experience of trauma and their path to recovery. For instance, women may experience trauma differently than men due to factors like gender-based violence, caregiving responsibilities, and societal pressures. TIC for women might include offering gender-specific support groups and addressing unique needs related to reproductive health and motherhood. Similarly, recognizing the distinct experiences of men and non-binary individuals is crucial in providing comprehensive care.
The implementation of TIC principles improves clients’ satisfaction and planned discharges. By integrating cultural, historical, and gender-based responsiveness into TIC, providers can offer more effective and compassionate support, helping individuals move beyond their trauma and toward recovery.
Brave Heart, M. Y. H. (2003). The Historical Trauma Response Among Natives and Its Relationship with Substance Abuse: A Lakota Illustration.
Forkey, H., Szilagyi, M., Kelly, E., & Dufee, J. (2021). Trauma-Informed Care. The American Academy of Pediatrics, 148 (2). https://doi.org/10.1542/peds.2021-052580
Hales, T. W., Green, S. A., Bissonette, S., Warden, A., Diebold, J., Koury, S. P., & Nochajski, T. H. (2019). Trauma-Informed Care Outcome Study. Research on Social Work Practice, 29(5), 529-539. https://doi.org/10.1177/1049731518766618
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. https://www.ncbi.nlm.nih.gov/books/NBK207204/#part2_ch1.s11
Read the other posts in this series on SAMHSA's six guiding principles of TIC!
Mark Sanders, LCSW, CADC, is an international speaker in behavioral health whose presentations have reached thousands throughout the United States, England, Canada, Spain, Lithuania, West Indies, and Guam. He is the recipient of five behavioral health lifetime achievement awards, including the prestigious NAADAC Enlightenment Award. He is the founder of The Museum of African American Addictions, Treatment and Recovery, which was honored as the 2023 winner of the Faces and Voices of Recovery Innovations In Recovery Award. He is the author of 5 books on recovery and has enjoyed a 30-year career as a university educator.
Isa Vélez Echevarria, PsyD, is a Puerto Rican clinical psychologist. She is the Ohio State Project Manager for the Great Lakes Addiction, Mental Health, and Prevention Technology Transfer Centers managed by the Center for Health Enhancement Systems Studies at the University of Wisconsin-Madison. During her pre-doctoral internship at Children’s Institute in Los Angeles, CA, she was certified as an Interpersonal Psychotherapy Clinician. She was trained in Trauma-Focused Cognitive Behavioral Therapy and Family Therapy. In addition, she provides telehealth services to communities of color in Massachusetts and Puerto Rico. Her clinical work has focused on culturally tailored and trauma-informed services for Latinx communities.
