A trauma-informed social work framework for the abortion seeking experience

Understanding Trauma-Informed Care in the PALTC Setting

A trauma-informed, thematic analysis that identified stress-related themes evident in 39 personal abortion narratives from the Tennessee Stories Project in the United States is presented in this paper. Using the Braun and Clarke model of thematic analysis, guided by the trauma-informed social work framework, researchers examined these narratives to identify stress related themes. Findings An overall theme of stress and traumatic stress was found to be present throughout the abortion narratives. These themes were categorized into subthemes, including: (a) existing life stressors preceding the abortion experience, (b) stressors while trying to access abortion services, (c) stressors while obtaining abortion services, and (d) stressors arising after the procedure. Applications These results suggest that stress and traumatic stress were reflected in these abortion narratives throughout the abortion seeking experience. This finding supports the need for social work practice responses that are designed to address and eliminate stress during the process of seeking and obtaining an abortion in the United States. A trauma-informed framework is recommended for guiding social work education about abortion, social worker interactions with clients who are seeking abortions, and the development of abortion policy in the United States in order to better align the abortion seeking experience with the principles of trauma-informed care.

Trauma informed care has been taken up across healthcare as a way of delivering care. With evolving understandings of what it means to be trauma informed, and in response to some limitations with trauma informed care, trauma and violence informed care has been proposed as an alternative. There is currently a lack of clarity around what the concept of trauma and violence informed care means, why it is needed, what it encompasses and who it will benefit. This review uses a concept analysis method to systematically explore and refine the concept of trauma and violence informed care, with a particular focus on the implications of the concept for mental health nurses.

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Statement of purposeTo evaluate baseline attitudes and confidence related to providing Trauma Informed Care (TIC) and quality of professional life of Emergency Department (ED) Staff at a Level I PTC,...

Trauma-informed attitudes in residential treatment settings: Staff, child and youth factors predicting adoption, maintenance and change over time

Olivia, a 13-year-old neurologically intact patient with cerebral palsy, arrived from a routine abdominal procedure screaming in pain. The medical team was baffled as to why she experienced such agony despite receiving copious doses of morphine. We spoke with her adoptive parents to obtain more history. They revealed long-standing physical and sexual abuse before Olivia’s adoption 6 years ago and noted extreme distress to all medical procedures and prolonged surgical healing time. Although her parents hoped to give her a better life and ensure she received appropriate care for her condition, they felt helpless that Olivia was at risk for retraumatization (reexperiencing posttraumatic symptoms from her original traumas) each time she came to the hospital. The amplification of pain and delayed medical recovery secondary to a history of psychological trauma and adverse childhood experiences (ACEs) is well recognized.1–3 Health care institutions are aware of the need for the integration of trauma-informed care into practice, yet they struggle to find the right approach. Although screening for ACEs has been widely adopted as a trauma-informed practice, there are multiple concerns with ACEs screening, including operating from a deficit- versus strength-based model, risk for traumatization from screening, and limited follow-up resources.4 ACEs scores also do not fully capture trauma and posttraumatic stress symptoms, which may be better predictors of negative outcomes than ACEs alone. Many organizations have now implemented the Substance Abuse and Mental Health Services Administration guidelines of educating clinicians on realizing …

Although abortion is common in the United States, women who have abortions report significant social stigma. Currently, there is no standard measure for individual-level abortion stigma, and little is known about the social and demographic characteristics associated with it. To create a measure of abortion stigma, an initial item pool was generated using abortion story content analysis and refined using cognitive interviews. In 2011, the final item pool was used to assess individual-level abortion stigma among 627 women at 13 U.S. Planned Parenthood health centers who reported a previous abortion. Factor analysis was conducted on the survey responses to reduce the number of items and to establish scale validity and reliability. Differences in level of reported abortion stigma were examined with multivariable linear regression. Factor analysis revealed a four-factor model for individual-level abortion stigma: worries about judgment, isolation, self-judgment and community condemnation (Cronbach's alphas, 0.8-0.9). Catholic and Protestant women experienced higher levels of stigma than nonreligious women (coefficients, 0.23 and 0.18, respectively). On the subscales, women with the strongest religious beliefs had higher levels of self-judgment and greater perception of community condemnation than only somewhat religious women. Additional differences were found by race, age, education, religiosity and motherhood status on the subscales. This valid and reliable scale can be used in research examining abortion stigma and related outcomes (e.g., women's health, relationships and behavior). The scale can also be used to evaluate programs and interventions that aim to reduce the stigma experienced by women who have abortions.

INTRODUCTION: This research investigates what knowledge and training social workers have in preparation for working alongside survivors of trauma. Including what support social workers receive to ensure they keep themselves safe and how comfortable they feel about accessing support to promote their self-care and emotional resilience. METHOD: Using an exploratory research design, qualitative data has been collated through semi-structured interviews with four care and protection social workers, capturing their stories in a narrative format and comparing the data to academic research on trauma-informed practice and care. FINDINGS/ IMPLICATIONS: While social workers have sound knowledge on trauma and its impact on individuals and their behaviours, the implementation of trauma-informed practice and care can often be confusing and underutilised. Additionally, the consideration of the impact on practitioners can often be overlooked, falling on the practitioner to manage themselves rather than a collaborative approach alongside the organisation they work in.

Trauma-informed care is an emerging concept that acknowledges the lasting effects of trauma. Nurses are uniquely positioned to play an integral role in the advancement of trauma-informed care. However, knowledge related to trauma-informed care in nursing practice remains limited. The purpose of this article is to present the results of a qualitative study which explored nurses’ understandings and experiences related to trauma-informed care. Seven semistructured interviews were conducted with nurses and four categories emerged from the analysis: (a) Conceptualizing Trauma and Trauma-Informed Care, (b) Nursing Care and Trauma, (c) Context of Trauma-Informed Care, and (d) Dynamics of the Nurse–Patient Relationship in the Face of Trauma. These findings highlight important considerations for trauma-informed care including the complex dynamics of trauma that affect care, the need to push knowledge about trauma beyond mental health care, and noteworthy parallels between nursing care and trauma-informed care.

The social work role in nursing facilities is a valuable resource in the lives of residents, families, and staff. Whether the nursing facility is called a nursing home, a long-term care center, or a subacute or a rehabilitation center, the social worker is an essential, vital member of the healthcare team. As in other settings, social workers in nursing home settings use professional casework skills to help people in particular times of crisis and stress. As a contributing member of the interdisciplinary team, the social worker provides an opportunity for residents and families to examine problems, mobilize existing resources and/or refer to resources that are more appropriate, and develop positive resolutions. This third revised edition of <italic>A Guide for Nursing Home Social Workers</italic> provides the knowledge and information that social workers, regardless of their education and experience, need in the performance of their role in nursing home settings. The book is divided into six parts to help categorize the content: Social Work in Nursing Facilities; The Interdisciplinary Team; Nursing Facilities and Governing Oversights; Diagnosis, Treatment, and Care Issues; Ethics; and Community Liaisons. The first part presents key informational topics that social workers may utilize in their day-to-day work, such as assessments, care planning, and documentation. The second part contains information about team meetings, room changes, staff training and in-services, and social work consultation. The third part addresses a range of topics including Omnibus Budget Reconciliation Act (<abbrev>OBRA</abbrev>) and the Minimum Data Set 3.0, as well as state surveys and facility policies. The fourth part provides current information about care topics such as neurocognitive disorders, mood disorders, medication, and pain in older adults, as well as groups, families, and diversity within the nursing facility. The fifth part contains chapters on social work ethics, legal representation, abuse, neglect, mistreatment, and confidentiality. The final part includes chapters on resident finances, transfer and discharge, community resources, funeral arrangements, pandemics and disaster planning, and trauma-informed care and adverse childhood experiences. The goal of this guide is to provide some of the necessary supports and assistance needed by social workers in this field as they pursue their profession of helping residents, families, and others involved in long-term care.

This chapter highlights the different ways mothers engage in storytelling to resist stigma, while also rejecting the idea that they are “bad” mothers. The prevailing story told about what makes a “good” mother relies on the construction of an ideal mother parenting within a specific vision of the nuclear family. Mothers who do not live up to this ideal construction of motherhood are punished through various forms of stigma such as sexual stigma and abortion stigma. This chapter considers the impact of stigma on two groups of women: lesbian mothers and mothers who have had abortions. Mothers from both communities who have faced stigma are finding ways to rewrite the script about how to mother without shame. Some of the forms of resistance these mothers have engaged in include abortion speak-outs, online storytelling through blogs and videos, and storytelling through art. The chapter also explores how community-based initiatives informed by the principles of reproductive justice make possible new narratives of maternity and as well as visions for a future for mothering without stigma.

Adversity in childhood negatively impacts health and wellness across the life span. Infants across all gestational ages requiring newborn intensive care are exposed to a myriad of early adverse experiences ranging from painful and stressful procedures to sleep fragmentation, social isolation, and maternal separation. For the family, neonatal intensive care unit hospitalization has been described as a traumatic event that shatters hopes, dreams, and expectations for parenthood. Acknowledging the nature of traumatic experiences endured by infants, families, and clinicians within the setting of intensive critical care assists in identifying and developing strategies aimed at reducing traumatization and re-traumatization while creating effective compassionate caring encounters. Trauma-informed developmental care invites practitioners to move past procedure-driven practices and create a culture of care that focuses on the human experience. This requires a shift in mindset, intention, and language.

It has long been recognized that there is a high prevalence of trauma exposure in client populations served by social workers. The recent (current) pandemic underscores the universality of trauma exposure, not only for clients but for generalist practice social workers. Experiencing trauma impacts the client-worker relationship and client outcomes, which makes it critical to address at an early point in social workers’ education. Implementing a trauma-informed care (TIC) model is becoming the standard of care, despite many social workers not receiving comprehensive, explicit education about trauma until reaching their master’s level education courses. By equipping the baccalaureate level social worker with trauma-specific education, they are better equipped to respond to clients and to be prepared for the impact of their clients’ trauma on their own lives. Offering trauma-courses at the baccalaureate level for social work students offers them opportunity to better serve their clients, recognize organizational practices that support trauma-informed care, and manage their own self care practice. In this paper, the author examines the rationale for, and outlines the creation and implementation of three trauma-specific courses at the baccalaureate social work education level.

Introduction. HIV treatment and prevention have seen significant advancements over the past four decades, with antiretroviral therapy (ART) enabling people living with HIV to achieve viral suppression and live long, healthy lives. However, disparities persist among Hispanic/Latino populations in the southern United States. In the Deep South region of the U.S., young Latino men face potential intersecting stigmas related to HIV status, sexual orientation, ethnicity, and immigration status. Stigma is an established barrier to healthcare access and optimal health outcomes. This study explored how HIV clinicians in the Deep South perceive the impact of intersectional stigma on shared decision-making (SDM) and antiretroviral therapy adherence for young Latino men living with HIV. Methods. This qualitative study employed semi-structured, virtual interviews with 11 HIV clinicians practicing in the Deep South. Data were analyzed using the Framework Method. Results. Clinicians identified cultural norms, religious beliefs, language barriers, and immigration-related fears as major contributors to intersectional stigma, which often led to non-disclosure of HIV status and reluctance to engage in care. They emphasized that building trust is essential but challenging, as patients’ guardedness is shaped by anticipated stigma. To foster stronger relationships, clinicians reported using neutral language and patient-centered approaches; however, shared decision-making was inconsistently practiced. Structural barriers, including bureaucratic processes and transportation challenges, further constrained consistent access to medication. Resources such as bilingual staff, on-site pharmacies, medication samples, and support from case managers or social workers were considered vital for improving ART adherence. Although clinicians demonstrated empathy and awareness of their patients’ intersectional challenges, they acknowledged gaps in consistently translating this understanding into practice. Conclusions. HIV clinicians in the Deep South recognize the influence of intersectional stigma on young Latino men living with HIV. While many clinicians employ patient- centered strategies to mitigate the impact of stigma on SDM and ART adherence, systemic barriers persist. Addressing these challenges requires both clinic-level interventions and broader policy-level reforms to reduce stigma. This study underscores the need for tailored interventions that bridge clinicians and systems to actionable practices to improve health outcomes for this population.