Part 2: Creating a Survivor Friendly Practice

Why is a trauma lens important to healthcare professionals?

For the trauma survivor to have the best experience in a healthcare office, both you and your office staff needs to be trauma-informed. Your staff must understand the emotional issues, expectations, and special needs that a trauma survivor may require in a health care setting. Anxious feelings about appointments may be amplified for a trauma survivor. A simple office visit may trigger memories of past abuse; generating overwhelming feelings of helplessness and fear of physical harm. Think of what we do as pelvic health therapists in our assessment and treatment sessions. Our patients need to undress and are placed in positions that may feel very vulnerable (legs open). We may be introducing something into their body (instruments or a finger); we touch them and are in close proximity to some very intimate areas of their body.

 

How do you create a survivor friendly office?[i]

  • Offer a calm and soothing office environment.
  • Provide a relaxed and unhurried attention to the patient.
  • Talk over concerns and procedures before asking the patient to disrobe.
  • Give your patient as much control and choice as possible about what happens and when (wearing their coat, listening to music, leaving door open/closed/ajar during the exam).
  • Validate any concerns your patient may have as understandable and normal.
  • Be flexible about having a support person in the room with them.
  • Explain each procedure and obtain consent.
  • Ask if they are ready for you to begin.
  • Be clear that they can pause or end the exam at any time.
  • Encourage questions.
  • Maintain a personable and friendly manner.
  • Be straightforward and generous with information.
  • Talk to your patient throughout to let them know what you are doing and why.

 

We are part of our patient’s emotional healing process. When we provide a positive medical experience, we support healing from past trauma. These patients have often never had any control, learnt to say no or been listened to. When we provide them this control, it empowers them to counteract the helplessness they have always experienced.

 

What about our own emotional wellbeing when working with trauma patients?

 

Patients may open up and share intimate details about their lives and you may not know how to deal with this information. What impact does that have on you as a therapist? What if you are yourself a survivor of trauma? Working with a survivor of trauma can be a very draining experience as a physiotherapist. I have found that when I have a few trauma survivors scheduled in the same day, I finished the day exhausted.

 

You may encounter a few symptoms such as compassion stress, compassion fatigue or experience vicarious trauma where you may begin to see changes within yourself especially if you are a highly empathic, sensitive individual.

 

Self-care is necessary and I have to say, was my personal challenge. Are you sleeping well? Are you eating well? Do you need to ensure that you exercise daily, go for a good walk or run and get some fresh air? Do you need to do some restorative exercises such as yoga and meditation? If you are a survivor yourself and become triggered by working with a patient, do you have a plan to help you manage your own symptoms?

 

Shouldn’t learning to treat with a trauma lens be introduced at the University level for all professions that are involved in the healing arts? It’s not just about pelvic health! All physiotherapists, occupational therapists, physicians, nurses, massage therapists touch their patients. When we look at the statistics, it seems nonsensical that we are not better prepared to address the needs of trauma survivors.   A basic understanding of recognizing the signs of trauma and knowing when to refer to the appropriate professionals should be part of our toolkit as therapists.   A trauma course will teach you these basic skills as well as provide you with an understanding of how to respond if your patient has been triggered and how to best manage your own self-care. It was a game changing course for me both for my professional growth but also for my personal growth.

 

 

“Be there for others, but never leave yourself behind”

– Dodinsky

 

 

Written by:

Marie-Josée Forget
Assistant Instructor

 

[i] Course notes – Trauma and the Pelvic Floor, Lisa Aldworth, MSW, RSW, Trauma Therapist, 2016