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Background and Objectives: Greater lifetime exposure to psychological trauma correlates with a higher number of health comorbidities and negative health outcomes. However, physicians often are not specifically trained in how to care for patients with trauma, especially in acute care settings. Our objective was to identify implemented trauma-informed care (TIC) training protocols for emergency and/or trauma service physicians that have both sufficient detail that they can be adapted and outcome data indicating positive impact.Methods: We conducted a comprehensive literature search in MEDLINE (Ovid), Scopus, PsycInfo, Web of Science, Cochrane Library, Ebsco’s Academic Search Premier, and MedEdPORTAL. Inclusion criteria were EM and trauma service clinicians (medical doctors, physician assistants and nurse practitioners, residents), adult and/or pediatric patients, and training evaluation. Evaluation was based on the Kirkpatrick Model.Results: We screened 2,280 unique articles and identified two different training protocols. Results demonstrated the training included patient-centered communication and interprofessional collaboration. One curriculum demonstrated that targeted outcomes were due to the training (Level 4). Both curricula received overall positive reactions (Level 1) and illustrated behavioral change (Level 3). Neither were found to specifically illustrate learning due to the training (Level 2).Conclusion: Study findings from our review show a paucity of published TIC training protocols that demonstrate positive impact and are described sufficiently to be adopted broadly. Current training protocols demonstrated an increasing comfort level with the TIC approach, integration into current practices, and referrals to trauma intervention specialists.

PurposeMaterials and methodsResultsDiscussionConclusionChildren with behavioral issues in residential care settings have high rates of trauma, with a range of trauma experiences such as abuse and neglect, issues with attachment, and multiple disruptions in placements. Staff in these settings should have an understanding of trauma, its impact, and how to engage in trauma-informed practice.The purpose of this study was to examine whether a trauma-informed training, developed specifically based on the identified needs of a residential group care facility, had an impact on future staff attitudes and behaviors.A 3-h training was delivered by the researchers. Three identical sessions were provided to all 48 staff, regardless of education and role, across a 3-day period. Prior to the training, staff were given a pretest survey measuring components of trauma-informed (TI) practice that indicated how often the staff members engaged in TI practice. Thirty days later, the same participants completed a posttest survey to gauge if the training had an impact on their subsequent attitudes and behavior.There were improvements in many of the trauma-informed practice areas on the posttest survey. T-test analysis revealed five trauma-informed practice areas had improvements that were statistically significant from the pretest survey.The findings present the opportunity for recommendations for trauma-informed training development and delivery, as well as providing implications for the field of social work.This study demonstrates the feasibility of administering a trauma-informed training program and observing relatively rapid improvements in future attitudes and behavior among staff. [ABSTRACT FROM AUTHOR]

Events such as the COVID-19 pandemic and the war in Ukraine have increased people's awareness of mental health issues. Psychological trauma impacts patients in the acute care setting through physical and mental health presentations. Trauma is a public health issue crossing all socioeconomic groups and is related to social determinants of health. Trauma-informed care (TIC) is an evidence-based approach to providing care. TIC is within the scope of nursing practice and improves outcomes for patients. However, there is a lack of standard terms or practices within healthcare. Additionally, there is superficial acknowledgment of the need for TIC at the local or national level regarding policy. Nurses need to adopt TIC into practice and advocate for policy change to improve the health and lives of those seeking care. [ABSTRACT FROM AUTHOR]

Background: Women in the sex trade encounter significant challenges in obtaining reproductive healthcare. Reports of reproductive healthcare for women in the sex trade center on the prevention and termination of pregnancies, yet most women in the sex trade globally experience full term pregnancies and bear children. This study aimed to explore barriers and enabling factors to providing reproductive healthcare for women in the sex trade in Israel. Methods: We conducted a qualitative study utilizing a grounded theory method. Data were collected through semi-structured interviews, conducted between June 2021 and July 2022. Interviews were conducted with practitioners in healthcare settings (n = 20), practitioners in social services settings (n = 15), and women in the sex trade who received reproductive health care-related medical services (n = 13) in Israel. The interviews were audiotaped, transcribed, and thematically analyzed. Results: The findings indicated a multilayered structure of healthcare system-related factors and women-related factors. Stigma was noted as a multidimensional barrier, reflected in service providers' attitude towards women in the sex trade, impairing the patient-provider relationship and impeding women's help-seeking. However, the creation of a relationship of trust between the women and healthcare providers enabled better health outcomes. Conclusions: Based on the findings, we propose recommendations for designing and implementing reproductive healthcare services for women in the sex trade. The recommendations offer to (a) include women with lived experiences in planning and providing reproductive healthcare services, (b) adopt a trauma-informed approach, (c) emphasize nonjudgmental care, (d) train healthcare providers to reduce stigma and bias, and (e) enhance the affordability of health services for women experiencing marginalization. [ABSTRACT FROM AUTHOR]

Recognition that schools should be responsive to children who are impacted by adversity and trauma is burgeoning internationally. However, consensus regarding the necessary components of a trauma-informed school is lacking. This research developed expert-informed and internationally relevant best-practice trauma-informed principles for schools. A four-phase methodology included (i) identification of school-relevant trauma-informed practice programs, (ii) inductive thematic analysis of the main concepts underlying programs, (iii) phrasing of draft Principles and (iv) Principle revision and finalisation via a two-round Delphi survey with international experts. Excellent agreement by experts on the importance of all Principles was achieved (round 1 ≥ 86.4%, 2 ≥ 92.3%). The final 'International Trauma-Informed Practice Principles for Schools' (ITIPPS) include four Overarching (A–D) and 10 Practice Principles (1–10). Summarised, these include that the school: (A) is student focussed; (B) models compassion and generosity; (C) is understanding and responsive; (D) incorporates recognition of their First Nations peoples in the school's ethos: (1) prioritises safety and wellbeing; (2) models positive relationships; (3) provides a positive culture and connects; (4) consults and collaborates; (5) supports vulnerable students; (6) teaches social and emotional learning; (7) provides trauma-informed practice training; (8) is predictable yet flexible; (9) identifies and nurtures strengths and (10) reflects, changes and grows. The ITIPPS provide clear guidance for education sectors, schools and other settings about appropriate learning environments for children and young people impacted by trauma. Research is now underway in Western Australian schools to pilot test the feasibility and impact of using the ITIPPS within a framework (thoughtfulschools.org.au) to establish trauma-informed schools. [ABSTRACT FROM AUTHOR]

AIM This research aimed to uncover elements of a comprehensive, trauma-informed (TI) multidisciplinary health professions simulation framework to improve the delivery of care to traumatized patients. BACKGROUND Trauma is a pervasive public health problem requiring a TI approach. Simulation is an evidence-based teaching strategy that advances knowledge and clinical reasoning. There is a lack of scientifically based simulation education models addressing the delivery of TI care for the health professions. METHOD A Delphi study utilizing a panel of experts was conducted to identify the most critical elements of a simulation framework. RESULTS Phase one identified 10 content areas and 111 subcontent areas. Phase two analysis revealed 99 percent of the 111 subcontent areas achieved expert consensus. CONCLUSION This Delphi study provides the first scientifically based framework to guide the development of a comprehensive, TI, multidisciplinary simulation framework to recognize trauma survivors and subsequently display concern and respect. [ABSTRACT FROM AUTHOR]

Aim: To describe the implementation of a trauma‐informed model of care in the Post COVID Respiratory Clinic of a large tertiary referral centre in NSW. Design: Discussion paper. Data Sources: Evidence gathered from a literature search (2008–2022) was used to develop a framework for management of patients presenting to this Post COVID Respiratory Clinic. This paper outlines the personal reflections of the clinic staff as they developed and implemented this framework. Ethical approval was obtained to report the data collected from patient reviews. Discussion: The literature highlights the high prevalence of trauma in patients following COVID‐19 infection, as well as the larger population both during and after the pandemic. This experience of trauma was observed in patients seen within the clinic, indicating a need for specialized care. In response, a trauma‐informed model of care was implemented. Conclusion: Reconceptualizing COVID‐19 as a 'collective trauma' can help healthcare workers understand the needs of post‐COVID patients and enable them to respond empathetically. A trauma‐informed model is complementary to this cohort as it specifically addresses vulnerable populations, many of whom have been further marginalized by the pandemic. Implications for Nursing and Patient Care: Frontline healthcare workers, particularly nurses, are well positioned to implement trauma‐informed care due to their high‐level of patient contact. Adequate allocation of resources and investment in staff is essential to ensure such care can be provided. Impact: The COVID‐19 pandemic has led to adverse physical and mental health outcomes for many.Trauma‐informed care is a way to promote reengagement with the healthcare system in this group.Post COVID patients globally may benefit from this approach, as it aims to build trust and independence. Patient or Public Contribution: Feedback was sought from a patient representative to ensure this paper adequately reflected the experience of the post‐COVID patient. [ABSTRACT FROM AUTHOR]

Prior trauma exposure significantly increases the risk of developing PTSD following medical stressors and may contribute to the development of medically induced PTSD. However, healthcare systems often overlook the interaction between prior trauma and current medical stressors, contributing to negative psychosocial and health-related outcomes for patients. Integration of both trauma-informed and trauma-focused practices into psychosocial programming in medical settings may be key to effectively addressing the needs of trauma-exposed patients. Yet, there is a lack of practical guidance on how clinical psychologists in medical settings can respond to trauma's effects in routine clinical practice. This paper aims to provide an overview of trauma-focused theory, assessment, and treatment considerations within medical settings, emphasizing the importance of incorporating trauma-focused intervention into integrated psychosocial programming to address prior trauma and its impacts on care in order to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Child maltreatment affects millions globally across all economic levels. Despite its prevalence, comparative research and internationally comparable data are limited due to varied definitions, methodologies, and reporting systems. This narrative review aims to compare child maltreatment trends in the U.S. and Japan, highlighting the roles of sociocultural factors. Through a literature review and analysis of national data since 1990, the study estimates maltreatment and fatality rates in both countries. Findings suggest an increase in Japan's reported maltreatment cases, likely attributable to legislative changes and heightened public awareness, while the U.S. appears to show a decline, potentially linked to improved mental health services and socioeconomic advancements. In both nations, mothers are predominantly identified as perpetrators, with sociocultural factors influencing maltreatment types and rates. Japan faces challenges in accurately measuring maltreatment due to reporting inconsistencies and mental health stigma. Despite a higher victimization rate, Japan reports significantly fewer fatalities than the U.S., with the fatality rate in the U.S. being approximately 9 times higher than in Japan. This contrast underscores the critical role of healthcare access and mental health support. The review advocates for international efforts to standardize maltreatment definitions and reporting, suggesting the adoption of trauma-informed care and comprehensive healthcare access as effective strategies. [ABSTRACT FROM AUTHOR]

Background: There is an intricate relationship between the mind and the body in experiences of health and wellbeing. This can result in complexity of both symptom presentation and experience. Although the contribution of life trauma to illness experience is well described, this is not always fully recognised or addressed in healthcare encounters. Negotiating effective and acceptable trauma-informed conversations can be difficult for clinicians and patients. Aim: To explore the experience of primary care practitioners caring for women through a trauma-informed care lens. Design and setting: Qualitative study in the general practice setting of England, with reflections from representatives of a group with lived experience of trauma. Method: This was a secondary thematic analysis of 46 qualitative interviews conducted online/by telephone to explore primary care practitioners' experiences of supporting women's health needs in general practice, alongside consultation with representatives of a lived-experience group to contextualise the findings. Results: Four themes were constructed: 'you prioritise physical symptoms because you don't want to miss something'; you do not want to alienate people by saying the wrong thing; the system needs to support trauma-informed care; and delivering trauma-informed care takes work that can have an impact on practitioners. Conclusion: Primary care practitioners are aware of the difficulties in discussing the interface between trauma and illness with patients, and request support and guidance in how to negotiate this supportively. Lack of support for practitioners moves the focus of trauma-informed care from a whole-systems approach towards individual clinician–patient interactions. [ABSTRACT FROM AUTHOR]

People in prisons have high levels of trauma exposure throughout their lives. Presentations are often complex, with a high prevalence of PTSD and CPTSD and other mental health comorbidities. Prisons themselves can be stressful and traumatising environments. There are challenges in the delivery of effective treatments for PTSD and CPTSD. There is a need for the development of effective clinical pathways for these conditions that are embedded within trauma-informed organisational approaches. Responding to this need, this report is the result of a multidisciplinary expert consensus meeting and review of the research literature on PTSD, CPTSD, associated comorbidities and optimal approaches to trauma-informed practice. The group consisted of 24 expert representatives from psychology, psychiatry, healthcare, academia, social care and Welsh Government. The meeting commenced with presentations on various aspects of the clinical pathway for PTSD and complex PTSD in prisons, and of applications of trauma-informed practice within prisons. Small sub-groups then provided practical recommendations and solutions relevant to their assigned topic. Findings were presented to all meeting attendees for another round of discussion and debate, until consensus was reached. The resulting recommendations provide guidance to improve identification, treatment and support for people living in prison who have experienced trauma. [ABSTRACT FROM AUTHOR]

The adoption of trauma-informed practices in schools is a significant and growing area of school reform efforts. It has been assumed that professional development aimed at influencing teacher attitudes toward trauma-informed care in schools is an important first step in adopting trauma-informed practices and improving student and school outcomes. However, there are gaps in the literature assessing the impact of trauma-informed professional development on teacher attitudes toward trauma-informed care, and there is little evidence linking changes in teacher attitudes to changes in practices. This exploratory study assessed teacher responses to a year-long pilot program providing intensive professional development and consultation on trauma-informed practices in one urban elementary school in the U.S. Southwest. Findings raise questions about the impact of professional development on teacher attitudes and subsequent changes to practice. [ABSTRACT FROM AUTHOR]

This article discusses the relationship between developmental trauma and violence, arguing that trauma is often overlooked in discussions about violence and mental illness. The authors conducted a literature review and found that early exposure to trauma is a significant risk factor for psychiatric disorders and violence. They propose the reintroduction of developmental trauma disorder (DTD) to better understand the unique implications of childhood trauma. The article emphasizes the need for trauma-informed care and the development of tailored service models for at-risk individuals. It also highlights the potential misdiagnosis of developmental trauma as other conditions and the long-lasting effects it can have on children. The article suggests trauma-informed care, peer support, and digital mental health interventions as potential treatment practices. It concludes by emphasizing the importance of accurate diagnosis and individualized treatment strategies for developmental trauma. [Extracted from the article]

The integration of trauma-informed and ethical frameworks in qualitative research concerning survivors of gender-based violence (GBV) within displaced communities is critical. These individuals often bear the weight of traumatic experiences compounded by displacement and associated hardships. Adopting a trauma-informed approach establishes a safe environment, prioritizing survivors' well-being and respecting their agency and narratives, thereby fostering trust and reducing re-traumatization risks. Ethical considerations ensure the dignity, rights, and cultural sensitivities of participants are upheld, contributing to rigorous and humane research. This integration amplifies survivors' voices and experiences, enhancing understanding and empathy. Trauma-informed approaches acknowledge the likelihood of trauma in individuals' lives and prioritize safety without aiming to treat symptoms. Proficient interviewing skills aim to improve comfort, safety, and recall without avoiding challenging questions. Integration of trauma-informed principles across all interview phases is crucial, particularly for individuals experiencing various traumas simultaneously, such as displacement, violence, and ongoing conflict. Drawing from the authors' experiences and existing literature, this paper advocates for a compassionate and empowering shift in qualitative research methodologies to better engage with survivors of trauma and GBV within displaced communities. [ABSTRACT FROM AUTHOR]

Youth involved in the child welfare system need creative ways to meet their needs. One type of active group intervention, adventure therapy, is currently gaining momentum as an additional support for youth with trauma histories. The Ohio Adventure Therapy Coalition (OATC) developed an implementation model to support youth workers in facilitating adventure therapy groups across the state with a focus on trauma-informed care and involving providers in a parallel process, so they can personally understand the process of adventure therapy. A pilot study collected data from youth, parents and providers looking at overall mental health functioning and trauma symptoms. Overall, youth reported significant improvements in overall mental health functioning, while parents reported significant overall improvements as well as improvements on five subscales as measured by the Youth Outcomes Questionnaire. Providers reported significant decreases in youth trauma symptoms, behavioral and emotional needs and risk behaviors as captured by the CANS. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsIn studies and reports conducted on online sexual exploitation and abuse of children (OSAEC), identified gaps include understanding programmes and services for victim-survivors. In the Philippines, care services consist of a blend of programmes specifically tailored for OSAEC and more generalised therapies for trauma. However, there is a lack of documentation regarding the variety of programmes available and the experiences of service providers during implementation. This qualitative study aims to provide a comprehensive description and critical analysis of these existing programmes and services.Twenty-two in-depth interviews were conducted with key informants from selected government agencies and non-government organisations involved in providing services for the case management of victim-survivors of OSAEC in identified hotspots.A thematic analysis of the interviews revealed that a range of programmes and services are offered to address the needs of the survivors in various aspects of their lives, encompassing psychological, medical, educational, spiritual, and even the recreation of home life. A trauma-informed approach was commonly employed, with care often tailored based on age and gender. Challenges and facilitating factors in providing care were also identified, including limited evaluation of existing programmes and services. The findings carry implications for the ongoing implementation of these programmes, the development of new services and programmes, and the formulation of further policies and laws addressing OSAEC and broader issues concerning child protection and wellbeing. [ABSTRACT FROM AUTHOR]

Autistic children are at an increased risk for both (a) exhibiting problematic eating behaviors such as food selectivity and (b) experiencing potentially traumatic events and correlated posttraumatic stress symptoms. Not only could a history of trauma directly influence the development of food selectivity but may also negatively impact the efficacy and social validity of existing evidence-based interventions. There is currently very little published research on interventions for food selectivity that incorporate commitments and strategies of trauma-informed care. In the current study, we sought to apply a trauma-informed approach to address the food selectivity of an autistic adolescent. Via a combination of single-subject experimental designs, we demonstrated that an intervention package inclusive of multiple trauma-informed care strategies directly contributed to increases in consumption of nonpreferred foods. We describe multiple ways in which we recruited and obtained social validation from the adolescent during his participation. Implications for practitioners and future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Current literature emphasises the importance of resilience in health care. Studies have shown that lack of resilience not only leads to adverse clinical outcomes but is also associated with burnout and long‐term stress in clinicians. Resource‐limited rural settings in the United States often impose unique stressors, and thus, it is critical to examine resilience of health care providers practicing rural medicine. Methods: An anonymous REDCap survey was completed by medical students, residents and attending physicians between 7 April 2021 and 18 May 2022. The primary outcome of resilience was measured by the Connor‐Davidson Resilience Scale 10 (CD‐RISC‐10©). Results: Survey takers scored moderately on the resilience scale (30.64 on a 40‐point scale). The first quartile of respondents scored between 0 and 28; the second quartile scored between 29 and 30; the third quartile scored between 31 and 35; the fourth quartile scored between 36 and 40. Age and years of service were not correlated with resilience. However, survey takers who had been exposed to trauma informed care scored significantly higher on the resilience scale (32.37 vs. 28.85, p = 0.021). The level of resilience when compared by profession was found to be comparable among medical students, residents and attending physicians. Conclusion: Individuals scoring in the first two quartiles of the CD‐RISC‐10© perhaps indicate need for support as they are having difficulty coping with stress. Health care organisations should provide resilience training to support the wellness and mental health of their staff. Moreover, dedicated efforts should be made toward creating trauma‐informed health care organisations as exposure to the topic of trauma informed care had a significant positive impact on resilience. [ABSTRACT FROM AUTHOR]

Purpose: To assess the knowledge, clinical experience, and attitudes of Italian midwives toward perinatal depression (PND) and to explore how these factors impact the quality of care. Methods: We conducted a cross-sectional online survey among 152 midwives employed in public hospitals across Italy. The questionnaire covered a range of topics, including demographic data, professional experience, knowledge of PND symptoms, risk factors, and clinical management, as well as communication skills and personal experiences with PND cases. Results: A concerning 76.3% of midwives displayed inadequate knowledge of PND based on current scientific literature. Those with a more comprehensive understanding were notably more confident in their practice, expressing significantly fewer apprehensions about communicating with mothers (25.8% vs 74.2%) and lesser concerns about the mothers' future well-being (38.9% vs 62.95%). The survey results also emphasised the midwives' call for specialised guidelines and formal training in PND management and underscored the value of communication skills, continuity of care, and family engagement in supporting affected mothers. Conclusion: This inaugural study sheds light on the current state of knowledge and attitudes among Italian midwives regarding PND. It pinpoints crucial areas for educational enhancement and practice improvement, suggesting that elevated levels of midwife expertise in PND could significantly elevate the standard of care and expedite early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Tensions between therapeutic and security needs on forensic wards can create a social climate which is challenging for both mental health nurses and patients. Social climate refers to the physical, social and emotional conditions of a forensic ward which influence how these environments are experienced. For patients with borderline personality disorder (BPD), previous trauma means that the social climate of forensic settings may be experienced as retraumatising, negatively impacting the outcomes and wellbeing of both patients and mental health nurses. Trauma‐informed care (TIC) has been offered as a contemporary framework for mental health nursing in inpatient units which aims to create a therapeutic social climate. In this critical review, we drew widely on literatures examining the social climate in forensic settings, the relationships between patients with BPD and staff (including mental health nurses), and the experiences of patients with BPD in forensic and inpatient settings to draw out the implications of scrutinising these literatures through the lens of TIC. Attending to the physical, social and emotional conditions of social climate in secure settings highlights how forensic wards can mirror trauma experiences for patients with BPD. Implementing TIC in these contexts has the potential to evoke positive shifts in the social climate, thus reducing the risk of retraumatisation and leading to improved outcomes for patients and staff. [ABSTRACT FROM AUTHOR]

Traumatic experiences can impact individuals' oral health and how they experience dental treatment in ways patients and their dental providers may or may not initially anticipate. As approximately half of children and two-thirds of adults in the United States have experienced some type of traumatic event, it is critically important for providers to be aware of patients' trauma histories and to appropriately provide trauma-informed care to their patients when needed. Individuals with a trauma history may experience significant anxiety and distress in the dental setting, even for treatment many providers and patients consider to be "simple," such as a brief intraoral examination, radiographs, or prophylaxis. Such aspects of the dental setting may trigger memories and emotions related to the original trauma and may re-traumatize patients. This short report introduces links between traumatic history, poor oral health, and dental care-related fear and anxiety. Additionally, this paper briefly describes how dental hygienists can provide compassionate trauma-informed care to their patients with the goal of providing whole-person care that considers patients' comfort, health goals, and prior experiences. Specific recommendations for providing trauma-informed care to children and adults within the scope of dental hygiene practice are provided, as is suggested wording for acknowledging a patient's prior trauma and tailoring dental care to accommodate patient experiences and concerns. As dental hygienists are often the oral health providers spending the most time with patients, they are uniquely positioned to provide compassionate effective trauma-informed care to patients with past traumatic experiences. [ABSTRACT FROM AUTHOR]

Trauma-informed care practices are associated with a culture of safety following traumatic experiences, including medical trauma. An interactive, web-based training package ('Responsive CARE') was developed for voluntary uptake by paediatric burns health professionals to increase staff knowledge about trauma-informed practice. This paper reports on a mixed methods process evaluation conducted alongside a preliminary effectiveness study of 'Responsive CARE'. The process evaluation was conducted using The Consolidated Framework for Implementation Research (CFIR) and a logic model, to examine feasibility of both the intervention and implementation strategy. Health practitioners (including senior managers) delivering care to children and caregivers attending an outpatient burns service were eligible to enrol in 'Responsive CARE'. Qualitative interview data and quantitative metadata were used to evaluate the implementation outcomes (adoption, acceptability, fidelity, feasibility and preliminary effectiveness). Children and caregivers attending an outpatient service for change of burn wound dressing or burn scar management during the 3-month control or 3-month intervention period were eligible to enrol in the effectiveness study. The impact on child pain and distress, as well as cost, was investigated using a pretest-posttest design. Thirteen (from anticipated 50 enrolled) health professionals (all female) with mean 10 years (SD=11) of experience with paediatric burns hospital-based outpatient care completed an average of 65% (range 36% to 88%) of available content. Twenty-five semi-structured interviews were completed with health practitioners (21 female) and with 14 caregivers (11 female). Four themes were identified as influencing feasibility and acceptability of the intervention: 1) Keeping a trauma-informed lens; 2) Ways of incorporating trauma-informed care; 3) Working within system constraints; and 4) Being trauma-informed. Preliminary effectiveness data included 177 participants (median age 2 years, and median total body surface area burn 1%). Causal assumptions within the logic model were unable to be fully tested, secondary to lower-than-expected adoption and fidelity. We found no significant difference for pain, distress and per-patient hospital care costs between groups (pre- and post-intervention). Future implementation strategies should include organizational support to keep a trauma-informed lens and to incorporate trauma-informed principles within a medical model of care. Despite efforts to co-design a staff education intervention and implementation approach focused on stakeholder engagement, adaptations are indicated to both the intervention and implementation strategies to promote uptake highlighting the complexity of changing clinician behaviours. ● The Consolidated Framework for Implementation Research was a good fit for study purpose. ● Strategies targeting stakeholder engagement were insufficient for optimal uptake. ● Assessing readiness and capacity for change may be central to successful implementation. [ABSTRACT FROM AUTHOR]

The COVID pandemic has necessitated mask-wearing by inpatient providers; however, the impact of masks on the acute care surgeon-patient relationship is unknown. We hypothesized that mask-wearing, while necessary, has a negative impact by acting as a barrier to communication, empathy, and trust between patients and surgeons. A cross-sectional study was performed by administering a written survey in English or Spanish to trauma, emergency general surgery, burn, and surgical critical care inpatients aged ≥18 y at a University Level 1 Trauma Center between January 2023 and June 2023. Patients were asked seven questions about their perception of mask effect on interactions with their surgery providers. Responses were scored on a five-point Likert scale and binarized for multivariable logistic regression. There were 188 patients who completed the survey. The patients were 68% male, 44% Hispanic, and 17% Spanish speaking, with a median age of 45-54 y. A third of patients agreed that surgeon mask-wearing made it harder to understand the details of their surgical procedure and made them less comfortable in giving consent. Twenty three percent agreed that it was harder to trust their provider; increasing age was associated with lower levels of trust, odds ratio 1.36 (confidence interval 1.10-1.71, P = 0.006). Findings were consistent among patients of different sex, race/ethnicity, language, and pre-COVID hospital experience. Mask-wearing, while important, has a negative impact on the patient-surgeon relationship in trauma and acute care surgery. Providers must be conscious of this effect while wearing masks and strive to optimize communication with patients to ensure high-quality trauma-informed care. [ABSTRACT FROM AUTHOR]

BACKGROUND: The oncology care environment includes a wide range of traumatic physical and emotional experiences that can be challenging for patients and healthcare providers. OBJECTIVES: This article aims to establish a knowledge base about the trauma-informed care (TIC) approach in oncology care. METHODS: This article provides a literature-based overview of TIC as a model of care for patients with cancer, informed by definitions of trauma, post-traumatic stress disorder, and adverse childhood experiences. This review is based on clinical studies, expertise, and evidence-based guidelines. FINDINGS: Based on a foundation of care for patients with cancer, nurses can apply TIC to clinical oncology practice. To illustrate TIC in practice, this article includes a case study, nursing approaches, implications, the TIC model of care, and resources. When applied to care, TIC benefits patients, staff, and organizations. [ABSTRACT FROM AUTHOR]

ABSTRACT Trauma negatively impacts on the ability of children in out‐of‐home care to experience safety in their relationships. Trauma rearousal can continue to occur even when children are living in a safe and stable setting due to environmental triggers. Carers who are emotionally regulated themselves can model and support emotional regulation (known as coregulation) when their child becomes dysregulated. To do this, carers need agencies to provide trauma‐informed and therapeutic models of care, so they in turn can offer an emotionally secure experience for their child. This article reports on participatory action research with caseworkers from two nongovernment and one government organisation who supported foster and kinship carers to coregulate with children in long‐term care. Reflective practice meetings were held over an eight‐month period to capture the perspectives and experiences of 16 caseworkers who trialled practice changes for coregulation. An inductive analysis approach was used to elicit themes. Findings revealed a three‐phase process took place for caseworkers and carers to (1) acknowledge the presence of trauma and stress, (2) become aware of their own emotional capacity and (3) apply coregulation strategies. This process was possible when organisations promoted trauma awareness and relational safety, thereby creating a ‘holding environment’ for their caseworkers and allowing coregulation to be experienced by carers and their children. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsDiscussionTraumatic experiences are ubiquitous and associated with negative impacts on health and wellbeing in patients, students, and clinicians. Trauma-informed care (TIC) is a harm reduction framework that aims to minimize re-traumatization and the negative health impacts of trauma. TIC is increasingly being incorporated into undergraduate medical education (UME) curricula; however, to date, there is no standardized curriculum to support faculty in precepting TIC clinical skills.We created a series of five educational modules in an asynchronous online format to support faculty in the instruction and precepting of TIC clinical skills in UME. The modules instruct on trauma epidemiology, trauma-informed clinical skills, trauma-informed precepting, and trauma-informed self-care (TISC). The modules are interactive and utilize multimedia content.Fifty-three faculty members of the primary care clerkship participated in the modules. After the modules, faculty demonstrated increased knowledge of TIC, though their comfort in applying principles with patients and students was unchanged.We present a novel, standardized curriculum to support faculty in the practice and precepting of TIC clinical skills. The intervention is shown to promote knowledge surrounding TIC. In the future, pairing these asynchronous modules with in-person training may be necessary to improve comfort with the application of these skills. [ABSTRACT FROM AUTHOR]

This qualitative thematic study aimed to examine the placement of unaccompanied asylum-seeking minors in compulsory institutional care in Sweden, to expand knowledge regarding their care and treatment. The dataset comprised Social documents and anonymized journal documents from personnel detailing the experiences of twenty-five unaccompanied asylum-seeking minors in compulsory institutional care organized by the Swedish National Board of Institutional Care in 2015. The study identified three main themes: traumatic life events and mental health, alignment between needs, goals, and treatment, and language diculties. The findings revealed a high prevalence of severe traumatic experiences among the asylum-seeking minors, with half having endured significant psychological and physical trauma. Mental health issues were inconsistently addressed, and prior traumas were often overlooked in care planning. The majority exhibited various mental health problems, underscoring the need for tailored interventions. The study highlights challenges in aligning unaccompanied asylum-seeking minors’ individual needs, treatment goals, and provided care. Language barriers emerged as a critical concern, impeding e [ABSTRACT FROM AUTHOR]

ABSTRACT Kinship care is increasingly recognised as an important care option within the Australian out‐of‐home care (OOHC) system. However, kinship carers face multifaceted challenges that set them apart from other carers within the system and internationally. Through the lens of kinship carer advocates, this research explores factors that contribute to placement stability in kinship care. Advocates offer a unique perspective on the interface between the child protection system and the carers that has not been explored before. Semistructured interviews were conducted with 10 South Australian kinship carer advocates to gain insights into their perspectives. Findings of this research highlight the need to recognise kinship care as a unique alternative within OOHC, engaging with three overarching themes: stability in an ecological system of care, bridging support gaps to achieve placement stability, and recognising instability in kinship care. In the context of these three themes, advocates emphasised priority to implement trauma‐informed, whole of family support frameworks to further promote stability within kinship placements. However, the concept of stability, often framed as uninterrupted continuity of care arrangement, came under examination and scrutiny in light of these research findings, encouraging further research in this area. [ABSTRACT FROM AUTHOR]

For decades, thousands of active-duty service members have sought treatment for trauma exposure. Stellate ganglion block (SGB) is a fast-acting nerve block documented in medical literature for nearly a century that has shown promise as a potentially life-altering treatment for post-traumatic stress (PTS).This review aims to answer the practical questions of those who support individuals suffering from trauma: (1) SGB’s safety profile (2) efficacy data (3) potential advantages and limitations, (4) a cross-cultural application example, (5) and the use of SGB in combination with talk therapy to optimize clinical outcomes.The current body of literature, to include several large case series, meta-analyses, and a sufficiently powered randomized controlled trial, were reviewed, and presented to describe the history of SGB for emotional trauma symptoms and address the objectives of this review.Critical consideration is given to the safety and efficacy data on SGB and the evolution in safety-related technologies. Advantages such as decreased barriers to care, rapid onset, and decreased dropout and limitations such as treatment non-response, potential adverse effects, and misconceptions about the treatment are then described. Finally, the cross-cultural application of SGB is explored based on the deployment of SGB in Israel.SGB is associated with level 1B evidence and a reassuring safety profile. Evolving the model of care through the combined use of effective biological treatments like SGB with trauma informed talk therapy offers a hopeful path forward for supporting those who suffer from post-traumatic stress. [ABSTRACT FROM AUTHOR]

AbstractThe delivery of high-quality case work is central to efforts to reform youth justice systems around the world. Youth justice practitioners can be the most effective agents of change when the focus of their casework practice is on listening to justice-involved young people, helping them to feel safe and to avoid re-traumatization, and working in ways that promote positive childhood experiences. It is argued that developing ‘practice-based evidence’ in this way can help to unite the field, to close the policy implementation gap, and simultaneously contribute to the personal wellbeing of young people and the broader agenda of public safety. [ABSTRACT FROM AUTHOR]

Student mental health needs continue to rise across the United States and many students and families rely on schools to provide services to meet these needs. Yet, an overwhelming number of available frameworks and approaches to school mental health (SMH) and overlapping terminology surrounding SMH supports like trauma‐informed (TI) approaches, social and emotional learning (SEL), and others can lead to confusion and potentially less effective implementation of services and supports for students. In this paper, we aim to mitigate this confusion and offer a solution that integrates several of these approaches into a single complementary model with a special emphasis on the role of SEL. We first present an overview of commonly used SMH frameworks. Next, we present the Trauma‐Informed Multi‐Tiered Systems of Support Model (TI‐SEL MTSS)–an adaptation of the TITI‐SEL MTSS–to include and emphasize the specific role of SEL as a critical foundational layer within a multi‐tiered system of support. The proposed adapted model maintains the key structure of a MTSS while highlighting the importance of embedding SEL pedagogy in daily teaching practices and all aspects of school life. A case study is used to illustrate how the proposed model adaptations can be used in practice and in tandem with TI and SMH services without being conflated as the same service as SEL. Practical implications for implementation are discussed. Practitioner points: Social and emotional learning, school mental health, and trauma‐informed approaches have become synonymous and may cause confusion in school response to students' needs.With a clearer conceptualization of social and emotional learning, schools stakeholders can be more equipped to respond and prevent the need for more intensive interventions.School stakeholders, particularly teachers, play an important role in embedding social and emotional learning in regular teaching practices. [ABSTRACT FROM AUTHOR]

Introduction A substantial number of trauma-exposed veterans seen in primary care report significant symptoms of PTSD and depression. While primary care mental health integration (PCMHI) providers have been successful in delivering brief mental health treatments in primary care, few studies have evaluated interventions that combine mobile health resources with PCMHI groups. This pilot study assessed the potential benefits of webSTAIR, a 10-module transdiagnostic treatment for trauma-exposed individuals, supported by 5 biweekly group sessions delivered via telehealth. The transdiagnostic and mobile health nature of the treatment, as well as the therapist and peer support provided through group sessions, may offer an innovative approach to increasing access to patient-centered and trauma-informed treatment in primary care settings. Materials and Methods Thirty-nine male and female veterans with trauma-related symptoms (i.e. PTSD and/or depression) participated in group webSTAIR. Mixed effects analyses were conducted to assess changes in PTSD and depression at pre-, mid-, and post-treatment. Baseline symptom severity was assessed as a predictor of module completion and group attendance. The project was part of a VHA quality improvement project, and IRB approval was waived by the affiliated university. Results Analyses revealed significant pre-to-post improvement in both PTSD and depression outcomes with a large effect size for PTSD (Hedges' gav  = 0.88) and medium to large for depression (Hedges' gav  = 0.73). Of participants who completed the baseline assessment, 90% began webSTAIR; of those, 71% completed the program. Baseline symptoms of PTSD and depression did not predict group attendance or module completion. Conclusions Good outcomes and a satisfactory retention rate suggest that group webSTAIR may provide easily accessible, high-quality, and effective treatment for patients presenting with trauma-related problems without increasing therapist or system burdens. The results suggest the value of conducting a randomized controlled trial to test the effectiveness of group webSTAIR relative to PCMHI usual care or other evidence-based, disorder-specific (e.g. PTSD) treatments for trauma-exposed individuals in PCMHI. [ABSTRACT FROM AUTHOR]

Rates of exposure to traumatic events are up to two times higher among people with substance use disorders (SUDs) compared to the US general population. Overdoses (OD) and overdose fatalities have continued to increase nationally and in Kentucky and are associated with elevated trauma symptoms. This paper examines the impacts of witnessing and experiencing OD among people who inject drugs (PWIDs) in Kentucky. Study participants were recruited via Respondent-Driven Sampling techniques supplemented with direct community outreach. Our findings showed that participants reporting past year severe mental health distress and lifetime violence exposure had higher odds of both witnessing and experiencing OD. Additionally, participants who reported early abuse had higher odds of both witnessing and experiencing OD as did participants with early onset injection drug use. The study findings suggest the need for incorporating knowledge about trauma into policies, procedures, and practices in treating SUD among PWID. [ABSTRACT FROM AUTHOR]

LGBTQ + individuals experience disproportionately high rates of mental health disorders. Subpopulations of this community experience unique risk factors and barriers to accessing care. This study analyzes chart review data of patients (n = 49) of an LGBTQ+-specific, student-run, free mental health clinic in NYC between March 2019 and July 2021. Most common diagnoses were mood disorders (55%) and anxiety disorders (53%). Eighty-eight percent of patients reported experiencing lifetime traumatic events; 20% of patients met criteria for PTSD. Further research is needed to characterize vulnerable subpopulations to create equitable, accessible, and competent mental health care resources for the LGBTQ + community. [ABSTRACT FROM AUTHOR]

2SLGBTQ+ people are more likely than their heterosexual and/or cisgender peers to experience violence and/or trauma in their lifetime. Many 2SLGBTQ+ people may need support related to experiences of violence and/or trauma. Yet, research has shown that a lack of 2SLGBTQ+ competence and capacity from service providers has resulted in barriers for 2SLGBTQ+ people accessing health and social services. This intervention seeks to fill an important gap by integrating the approaches and principles of trauma-informed care and 2SLGBTQ+ competence. The intervention was developed by a team of researchers in consultation with an Indigenous Elder and an advisory committee of service providers. The 2SLGBTQ+ competent trauma-informed care intervention was developed and implemented based on the following principles: centering intersectional perspectives; foregrounding Indigenous perspectives; modeling trauma-informed care; and anti-ableism and accessibility as the rule, rather than exception. The training reached a total of 295 participants, and 116 institutions and services across Ontario, Canada. A 2SLGBTQ+ competent trauma-informed care intervention has the potential to increase capacity for service providers in healthcare, mental health, and social services to avoid re-traumatization and meet the needs of 2SLGBTQ+ people who have experienced violence and/or trauma. [ABSTRACT FROM AUTHOR]

Injecting drug use is a risk factor for severe bacterial infection, but there is limited high-quality evidence to guide clinicians providing care to people who inject drugs. Management can be complicated by mistrust, stigma, and competing patient priorities. To review the management of severe infections in people who inject drugs, using an illustrative clinical scenario of complicated Staphylococcus aureus bloodstream infection. The discussion is based on recent literature searches of relevant topics. Very few randomized clinical trials have focussed specifically on the management of severe bacterial infections among people who inject drugs. Most recommendations are, therefore, based on observational studies, extrapolation from other patient groups, and the experience and opinions of the authors. We discuss evidence and options regarding the following management issues for severe bacterial infections among people who inject drugs: initial management of sepsis; indications for surgical management; assessment and management of substance dependence; approaches to antibiotic administration following clinical stability; opportunistic health promotion; and secondary prevention of bacterial infections. Throughout, we highlight the importance of harm reduction and strategies to optimize patient engagement in care through a patient-centred approach. We advocate for a multi-disciplinary trauma-informed approach to the management of severe bacterial infection among people who inject drugs. We emphasize the need for pragmatic trials to inform management guidelines, including those that are co-designed with the community. In particular, research is needed to establish the comparative effectiveness, safety, and cost-effectiveness of inpatient intravenous antibiotics vs. early oral antibiotic switch, outpatient parenteral therapy, and long-acting lipoglycopeptide antibiotics in this scenario. [ABSTRACT FROM AUTHOR]

Recently, there have been reports of children without placement (CWOP) in foster care, often resulting in youth sleeping in hotels or child protective service offices. This study explored perspectives of the current crisis among child welfare practitioners who managed CWOP cases. We conducted interviews with 11 child welfare practitioners who had graduated from two universities in a Southern state. Themes aligned with the trauma-informed framework and highlighted challenges related to organizational climate, workforce development, and trauma-informed services. Implications include strategies for cross-sector collaboration, specific training, and continued research to support a healthy, trauma-informed workforce that can better meet youth needs. [ABSTRACT FROM AUTHOR]

Previous literature increasingly recognizes the prevalence of childhood trauma (CT) history in forensic settings. Patients in forensic settings are likely to engage in self-harm, violence, and encounter multiple hospital admissions. We aimed to investigate CT history in a low secure forensic population and examine associations between specific types of CTs and three clinical outcomes: self-harm, in-hospital violence, and number of hospital admissions. A retrospective case file review was employed. A data capture sheet was developed using items from two Childhood Trauma Questionnaires. Data was collected from case files of male patients within a low secure forensic setting (n = 93). CTs were documented if they occurred before the age of 18 years old. Associations were examined between CT and the clinical outcomes using a series of logistic regression analyses. Eighty-five percent of patients had experienced CT and 60.3% had been exposed to two or more types of CT. There were no significant associations between CT and the clinical outcomes. Findings expose the high prevalence of CT experienced by patients in a low secure hospital. Additionally, high rates of CT with low rates of PTSD also suggest potential diagnostic overshadowing. Findings are discussed with reference to trauma-informed care treatment approaches in forensic settings. [ABSTRACT FROM AUTHOR]

People in secure psychiatric services experience high levels of exposure to early psychological trauma, are often diagnosed with severe mental illness (SMI) and have increased risk for obesity. Developmental trauma, SMI and obesity are associated with poor physical health outcomes and early death. This study aimed to assess the predictive power of Adverse Childhood Experiences (ACEs), self-harm and psychiatric diagnosis for secure inpatient weight gain and obesity. Data for 248 Welsh patients accommodated in low, medium, and high secure hospitals throughout England and Wales was analyzed. Patient admission bodyweight (in kilograms), bodyweight at the time of audit, and patient BMI at the time of audit was collected. Sex, psychiatric diagnosis, length of current admission, number of ACEs, and frequency of self-harm were also examined. Patients gained significant amounts of weight between admission until the time of the audit (median period = 1 – 2 years) and showed high levels of obesity. Self-harm frequency significantly predicted weight difference. Number of ACEs and diagnosis of schizophrenia significantly predicted patient BMI at the time of audit. The study findings indicate that psychological trauma and the nature of mental illness are important factors driving weight gain and excess morbidity in this vulnerable group. [ABSTRACT FROM AUTHOR]

Introduction: The on‐going substance use crisis has led to unprecedented rates of hepatitis C virus (HCV) in Canada, with increasing positivity among women who use drugs (WWUD). Despite efforts to reduce barriers to HCV testing and treatment, follow‐up remains a major issue. Methods: In this quality improvement project (QIP), we partnered with a short‐stay trauma‐informed residential drug treatment facility specifically for WWUD, to provide an engaging peer‐led HCV education session, followed by low‐barrier nurse and peer‐led testing and treatment. We sought to evaluate these interventions, as well as determine what factors could improve engagement after women leave. Results: The session was attended by 217 participants, 130 completed the survey and 153 opted into testing. Survey results indicated that participants were highly motivated to access general care as well as HCV testing and treatment. The most frequently reported barriers to testing and treatment were a previous negative test and being asymptomatic, respectively. Follow‐up facilitators included a non‐judgmental provider (88%), monetary incentives (67%), follow‐up phone calls (77%), e‐mails (66%) and text messages (58%). Of those who were RNA positive, 5 of 13 initiated treatment on‐site. By using the results of the QIP in real‐time, 6 of 13 were started after leaving the centre (one pending and one lost to follow‐up). Discussion and Conclusions: The implementation of co‐localised peer‐led testing and treatment for HCV, along with persistent follow‐up efforts, led to increases in linkage to care and treatment. Co‐localisation of testing and care with substance‐use services, especially if residential, is a viable, low‐barrier strategy for increasing linkage to care among WWUD. [ABSTRACT FROM AUTHOR]

Background: Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals. Methods: We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes. Results: We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals. Interpretation: Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities are at increased risk of dental anxiety and poor oral health. In addition, people with intellectual disabilities are at increased risk of potentially traumatic experiences, such as violence and sexual abuse, and appear to be more vulnerable to developing trauma‐related disorders following such experiences. While psychological trauma is associated with poor oral health and dental anxiety in the general population, the potential link between dental anxiety, poor oral health and psychological trauma is yet to be explored in people with intellectual disabilities. In this conceptual paper, we provide an overview of recent findings concerning the relationships between oral health and intellectual disabilities, psychological trauma and intellectual disabilities, as well as between psychological trauma and oral health, and discuss the relevance of these findings related to dental care for people with intellectual disabilities. We conclude that psychological trauma is likely to contribute to dental anxiety and poor oral health also in people with intellectual disabilities. Implications include an urgent need for research exploring how trauma affects oral health and experiences of dental care for people with intellectual disabilities, as well as the importance of individualized and trauma‐informed dental care for these individuals. [ABSTRACT FROM AUTHOR]

In Volume 30(3) we welcome a new Publishing Partner representative from Monmouth University and a new Co-Editor from the University of Minnesota to our Practice Section, along with grateful appreciation for the dedicated people who contribute their time and expertise to making Reflections possible. We introduce the idea of Reflections as a “way station” for authors and readers on an increasingly rapid journey of professional helping where making the space to reflect is absolutely critical, and yet, actually grasping the time and savoring the moment is challenging. We are excited to highlight eight articles that offer insights about self-care and strategies for facilitating opportunities for change in practice and educational arenas as well as remind us of the importance of balancing the multiple and many demand in our lives. [ABSTRACT FROM AUTHOR]

Children removed from their biological families because of abuse, neglect, and/or violence have increased healthcare needs and are susceptible to poor health outcomes compared with children who are not in the child welfare system. Developmental delays occur in about 75% of children in foster care. Up to 80% of children entering out-of-home care have at least one physical health problem and more than 40% experience educational challenges. In most US states, newly removed children are required to have a medical evaluation shortly after placement in a foster or kinship family. The initial evaluation is important for identifying urgent concerns and developing a rapport with children who may not have had regular medical care. In addition, the child's complete social, trauma, and medical history may be unknown because of system barriers such as inconsistent medical care by biological parents, privacy laws protecting records, and unavailability of birth histories and biological parents' medical and psychosocial histories. As a result, a series of visits is required to fully evaluate the child's development and healthcare needs. This article provides guidance for physician associates/assistants who provide care to children in foster care. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this discussion paper is to summarize the 2022 updates to the American Psychiatric Nurses Association's (APNA) Seclusion and Restraint Position Statement and Seclusion and Restraint Standards of Practice. Method: Both documents were the work of the APNA 2022 Seclusion and Restraint Task Force that consisted of APNA nurses with expertise in the use of Seclusion and Restraint, who practice across a wide range of clinical settings. Results: The 2022 Updates to the APNA Position Statement and Standards were guided by evidence-based information found in the review of seclusion and restraint literature and clinical expertise from the 2022 Seclusion and Restraint Task Force. Conclusions: Updates were evidence-based and in line with APNA's core values and initiatives in diversity, equity, and inclusion. [ABSTRACT FROM AUTHOR]

Given the potential for retraumatization among survivors of sexual violence engaged in research, we aimed to provide pertinent knowledge and exemplification of the integration of trauma-informed practice to research with survivors. Grounded in trauma-informed care, we discuss the need for trauma-informed research, drawing upon experiences and data from a longitudinal case-control study on sexual violence. Through trauma-informed research settings, we can improve research experiences for survivors of sexual violence, as demonstrated by positive experiences of participants in The THRIVE Study. By meeting the needs of survivors, researchers can increase participation while maximizing the research quality and advancement of research.