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About Trauma and Trauma-Informed Care

What is Trauma?

Psychological trauma is an occurrence which is outside the scope of everyday human experience and which would be notably distressing to almost anyone (American Psychiatric Association, 1987).

It is not the event that determines whether something is traumatic to someone but the individual's experience of the event.

Listen to our MSW students Jennifer Jeziorski, Monica Walter, and Kathryn Leavitt as they discuss 'what is trauma' and how trauma does not discriminate.

The Adverse Childhood Experiences (ACE) Study

Robert Anda, MD, MS, with The Center for Disease Control and Vincent J. Felitti, MD, with Kaiser Permanente were the co-principal investigators of the ACE study. The study was conducted over an eight year period including over 17,000 patients. Their research continues to examine the negative impacts of traumatic experiences (Academy on Violence and Abuse, 2012).

ACE Score

The ACE Questionnaire looks to examine exposure to significant and potentially traumatic childhood experiences. There are a total of 10 questions. Every "Yes" answer is given a score of "1". The higher the ACE score, the more adverse childhood experiences one has been exposed to. More exposure to adverse childhood experiences indicates a greater risk of developing trauma-related mental and behavioral health issues.

How is Our Community Affected by Trauma?

  • The High School graduation rate in 2012 in Buffalo was 47 percent (Tan, 2014).
  • Nearly half of children in Buffalo live in poverty (Williams, 2013).
  • Up to 81 percent of men and women in psychiatric hospitals have experienced physical or sexual abuse (Bryer et al., 2006).
  • 27.8 percent of kids felt sad or hopeless every day for 2 or more weeks in the 12 months prior to the survey (Results of the "Youth Risk Behavior Survey" in Buffalo Public High Schools).
  • 97 percent of homeless women with mental illness experienced severe physical and/or sexual abuse (Goodman, et al., 1997).
  • More than half of women seeking substance abuse treatment report experiencing one or more traumas (Najavits et al., 1997).

What Can Be Done About Trauma?

Trauma-Informed Care

It is essential to understand the consequences of trauma in order to promote prevention and recovery as a community (CDCP, 2014). Trauma-Informed care shifts from asking "What is wrong with a person?" and starts asking "What has happened to this person?" (Harris & Fallot, 2001). Trauma-Informed Care understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatize.

Trauma-Informed Care is anchored in the Principles of:

  • Safety.
  • Trust.
  • Choice.
  • Collaboration.
  • Empowerment.

The principles of trauma-informed care relate not only to one's work with clients but includes an organizational commitment to working with staff in a way that understands the complex nature and effects of trauma. Trauma-informed care is both about a personal commitment and an organizational change process.

"Trauma-informed systems and services are those that have thoroughly incorporated an understanding of trauma, including its consequences and the conditions that enhance healing, in all aspects of service delivery. Any human service program, regardless of its primary task, can become trauma-informed by making specific administrative and service-level modifications in practices, activities, and settings in order to be responsive to the needs and strengths of people with lived experience of trauma" (Harris & Fallot, 2008).

Trauma-Informed Care Infographic


American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.; DSM-III-R). Washington, DC: American Psychiatric Publishing.

Bryer, J. B., Nelson, B., Miller, J. B., & Krol, P. (November 1987). Childhood sexual and physical abuse as factors in adult psychiatric illness. Am J Psychiatry, 144:1426-1430.

Fallot, R. & Harris, M. (2008). Trauma-informed approaches to systems of care. Trauma Psychology Newsletter, Division 56 of the American Psychological Association, 3(1), 6-7.

Goodman, L., Dutton, M., & Harris, m. (1997). The relationship between violence dimensions and symptom severity among homeless, mentally ill women. Journal of Traumatic Stress, 10 (1), 51-70.

Harris, M., & Fallot, R. (Eds.). (2001). Using trauma theory to design service systems: New directions for mental health services. San Francisco, CA: Jossey-Bass.

Najavits L., Weiss R., Shaw S. (1997). The link between substance abuse and post-traumatic stress disorder in women: A research review. American Journal on Addictions, 6, 273–283.

Tan, S. (2014 March 5). Buffalo schools see leap in college enrollment. Buffalo News. Retrieved from:

Terr, L. (1990). Too scared to cry: How trauma affects children and ultimately us all. New York, NY: Basic Books.

Williams, D. (2013 June 28). Buffalo kids living in poverty. The Buffalo News. Retrieved from: