Everyone has things from their past they wish they could forget. For some it might be something as accidental as practically chocking on a candy and now you can’t even look at the candy without having flashbacks. For others it might be something a little more serious and personal. Trauma can manifest itself in a lot of different ways. Some members will be upfront about previous trauma while others might choose to hide it. The Comprehensive Assessment is not the only time when a conversation might trigger someone’s mind to wander to traumatic memories. In order to see the whole picture, having uncomfortable and difficult conversations with members’ about their past can bring up a reaction a Care Manager might not have otherwise been expecting.

In “Talking about Trauma” The Blue Knot Foundation’s guide to having difficult conversations, it discusses the five trauma-informed care principles: safety, trust, choice, collaboration, and empowerment. Using these principles and having a conversation with the member early on about boundaries is going to help lay down a foundation with the member. The safer a member feels and the more trust they have with their Care Manager the more likely they are to choose to share their experience(s). The principles also create an atmosphere that makes it less likely for the member to become re-traumatized because they are more likely to feel empowered by the relationship and foundation that has been built.

Identifying Stress

While the ultimate goal is to prevent members from being re-traumatized there is always a chance a member could be triggered. There are different ways to identify if a member is experiencing stress related to trauma or simply feeling uncomfortable. If the member becomes withdrawn, shut off, has increased rates of breathing, or a disturbance of energy levels, these are all signs the member could be in distress due to a conversation that is currently or has just taken place.

De-Stressing Tips

The guide provides tips that can help members feel more comfortable and ultimately reduce stress. In the moment allowing the member to express their current needs without feeling forced can help them relax. Being conscious of proximity with the member is another way to allow the member to feel empowered, safe, and trust you. If you know being too close to the member makes them uncomfortable then give a little space or conversely if being too far is disconcerting then close some of the gap. Using the five senses to help the member bring themselves back to the current moment will allow the member to feel centered. Physically having a member plant their feet firmly on the ground and/or stretching can help a member feel grounded and release tension.

Extra resources

The foundation’s guide also covers a variety of “what if” questions that address different scenarios that could arise and how one might choose to combat those issues. To review the foundation’s tips on questions that could arise, please visit “Talking about Trauma.” The tips for having difficult conversations in regards to trauma can also be applied to other types of difficult conversations with members.