New Commentary in Women’s Health Issues Recommends Steps for Providers to Inquire about and Respond to Trauma

WASHINGTON, DC (Jan. 10, 2019) — The growing recognition of the role of trauma in physical and behavioral health conditions leaves many healthcare providers and practices eager for guidance on how to offer trauma-informed care. In a new commentary in Women’s Health Issues, Edward L. Machtinger, MD, director of the Women's HIV Program and the Center to Advance Trauma-informed Health Care at the University of California, San Francisco, and his co-authors recommend ways for providers and practices “to inquire about and respond to recent and past trauma as a way of more effectively addressing many common health problems.” The authors are trauma experts from multiple medical disciplines and public health sectors, including academia, government, community organizations, and people with lived experience of trauma.

Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, based in the Department of Health Policy and Management at the George Washington University Milken Institute School of Public Health (Milken Institute SPH).

The commentary recommends key preparatory steps that providers and practices can take to lay the foundation for trauma inquiry and response, ways to inquire about past trauma, and both immediate and longer-term steps to help patient who disclose trauma experiences. Machtinger and his colleagues offer multiple options for inquiry, including assuming a history of trauma instead of asking and screening for the impacts of past trauma instead of for the trauma itself, and suggest language providers can use to respond to trauma disclosures.

“Providers and clinics that adopt a trauma-informed approach, inquire about trauma, and provide linkages to trauma-specific services will offer new pathways to support more satisfying and effective relationships for both patients and providers,” the authors write.

This commentary builds on a 2015 commentary by the same group of authors, also published in Women’s Health Issues, that provided a conceptual framework for trauma-informed primary care. Since then, the authors note, it has become clear that trauma affects the experiences and outcomes of care in specialties as well as in primary care, and so the newest publication refers to “trauma-informed care” and can be used in specialties such as obstetrics and gynecology, rheumatology, neurology, infectious disease, geriatrics, and palliative care. 

“Given high rates of childhood and adult trauma among women, improving provision of trauma-informed care has the potential to greatly improve women’s health and reduce health disparities both in the short term and throughout the life course,” said Women’s Health Issues Editor-in-Chief Amita Vyas, PhD, MHS, an Associate Professor of Prevention and Community Health at Milken Institute SPH. “This commentary makes an important contribution to a rapidly evolving field by offering concrete guidance for providers and practices.”

The commentary “From Treatment to Healing: Inquiry and Response to Recent and Past Trauma in Adult Health Care” was published online January 1 and will appear in the March/April issue of Women’s Health Issues