Trauma-informed approaches have become increasingly recognised as essential in education, health, and social care settings, particularly when supporting children and adolescents whose development, relationships, and behaviour may be shaped by adversity. These approaches are grounded in evidence developed over decades, and are increasingly cited in policy and practice as effective frameworks for supporting those affected by trauma. Rather than asking 'What is wrong with this person?', trauma-informed practice shifts the focus to 'What has happened to this person?' - acknowledging that past experiences can influence how someone learns, behaves, and interacts with the world.
For teachers, support workers, allied health professionals, and families, this perspective is not simply about acquiring knowledge of trauma, but about integrating this understanding into everyday interactions. Trauma-informed care is guided by principles of safety, trust, collaboration, empowerment, and sensitivity to cultural and individual differences. The Substance Abuse and Mental Health Services Administration (SAMHSA), a leading mental health services administration, has defined and guided trauma-informed practice, providing a recognised framework for implementation. It provides a foundation for environments where individuals feel respected, understood, and emotionally secure.
Trauma is often the result of a traumatic event - an occurrence that can overwhelm an individual's ability to cope. Such events may be potentially traumatic or even life threatening, and can have lasting impacts on mental and physical health. Trauma experiences can affect an individual's neurological development and overall health, influencing brain function, stress response, and behaviour. Trauma can lead to persistent fear, hyperarousal, diminished executive functioning, and complicated social interactions. Responses to traumatic experiences are shaped by genetic, epigenetic, and non-genetic factors, an individual's developmental level at the time of trauma, and the presence or absence of social support.
As research continues to highlight the widespread impact of trauma on mental health, executive functioning, emotional regulation, and social development, trauma-informed approaches offer practical pathways to reduce re-traumatisation, enhance wellbeing, and improve long-term outcomes. This is especially relevant for children and adolescents with behavioural conditions such as autism or ADHD, where unmet sensory, communication, or cognitive needs can overlap with trauma responses, leading to misunderstood behaviour and escalating support needs. In trauma-informed environments, seeking support is encouraged and facilitated, helping individuals access the help they need without stigma.
In this article, we will explore the key principles of trauma-informed practice, how these approaches are applied in education and care environments, and why a trauma-informed lens is essential for effective, compassionate support. The Office for Health Improvement and Disparities has also created guidance for professionals working in Health and Care regarding trauma-informed practice.
Positive Behaviour Support (PBS) Strategies for Children and Adolescents Impacted by Trauma is an online course provided by Behaviour Help in which you will learn how trauma affects the developing brain, how survival responses (fight, flight, freeze, fawn) show up as behaviours of concern, and how to create emotionally safe, predictable environments that reduce triggers and strengthen regulation. You will also learn how to use Positive Behaviour Support (PBS) to assess behaviour, prevent escalation, and respond in ways that build trust, connection, and long-term healing for those that have experienced trauma.
Introduction to Trauma Informed Practice
Trauma-informed practice is an approach built on recognising how traumatic experiences can profoundly shape a person's physical health, mental health, and overall life outcomes. Trauma may stem from adverse childhood experiences, chronic stress, abuse, neglect, violence, displacement, or other overwhelming events that exceed a person's ability to cope. For many trauma survivors, the effects of these experiences persist long after the event itself - impacting emotional regulation, learning, relationships, behaviour, and engagement with support services. Trauma also creates a barrier that delays or prevents people from seeking help.
See our article 'What is Trauma? A Guide to Trauma in Children and Adolescents'.
At its core, trauma-informed practice focuses on creating environments that feel physically safe, emotionally safe, and genuinely supportive. This not only applies to clinical and mental health services, but increasingly to schools, social care, disability services, and justice settings. By acknowledging the widespread impact of trauma on the brain, nervous system, and behaviour, professionals can better understand why certain individuals may present with fear, mistrust, hypervigilance, or avoidance when interacting with healthcare or support systems.
The shift towards trauma-informed approaches has been driven by growing research evidence and government policy highlighting how trauma contributes to poor long-term health outcomes - including increased risk of chronic disease, depression, anxiety, and harmful coping strategies. As a result, trauma-informed frameworks are now being adopted across sectors to reduce re-traumatisation, promote recovery, and improve both mental and physical health outcomes. Re-traumatisation is generally triggered by reminders of a person's past traumatic experiences, causing individuals to re-experience distressing thoughts, feelings, or sensations.
A key purpose of trauma-informed practice is to support trauma survivors without inadvertently triggering distress or reinforcing powerlessness. It encourages sensitivity to cultural and individual differences, recognising that trauma does not affect all communities equally and that historical or systemic trauma can further shape a person's sense of safety. Importantly, it raises awareness of how trauma affects trust - especially trust in professionals, institutions, and helping services - and why people who have experienced trauma may disengage or struggle to ask for support.
Understanding trauma is therefore essential for anyone working in education, health, disability, or care environments. When we appreciate the hidden role trauma can play in behaviour, communication, emotional expression, or learning, we can respond with compassion rather than judgement, and offer pathways to healing rather than further harm.
According to SAMHSA, trauma-informed principles are especially critical in areas such as substance abuse, where trauma and mental health are closely intertwined. Trauma-informed practice does not aim to directly treat trauma related difficulties, but rather to recognize trauma's impact and reduce barriers to care, leaving specialized treatment to trauma professionals.
Key Principles of Trauma Informed Care
Trauma-informed care is guided by a set of core principles designed to create environments where individuals feel safe, respected, and able to participate actively in their own healing. There are 6 principles of trauma-informed practice: safety, trust, choice, collaboration, empowerment, and cultural consideration. While models can vary slightly across agencies and frameworks, the most widely recognised principles include safety, trust, choice, collaboration, empowerment, and cultural awareness. These principles are not abstract ideals; they form the practical foundation for trauma-informed practice across mental health, education, disability, and social care settings.
Safety is the first priority - ensuring that both service users and staff experience physical, psychological, and emotional safety. Safety in trauma-informed care involves ensuring physical, emotional, and psychological safety for everyone. Many trauma survivors carry heightened sensitivity to threat, so environments must be predictable, calm, and transparent. Emotional safety is particularly important, as shame, fear, or distrust can quickly derail engagement and progress if not recognised and supported.
Trust and transparency underpin all interactions. Trauma-informed care acknowledges that trauma can erode a person's ability to trust others, especially professionals, institutions, or systems that hold power. Clear boundaries, consistent communication, reliability, and honesty help rebuild a sense of safety and credibility over time.
Choice and collaboration are equally central. Trauma-informed services actively involve individuals in decision-making about their goals, treatment, support strategies, and day-to-day interactions. Supporting choice service users is fundamental, ensuring that service users are empowered to participate in shared decision-making, goal setting, and determining their personalised plans for healing and progress. This sense of agency counters the powerlessness that often accompanies traumatic experiences. Choice may include how information is shared, what interventions are used, who is present, or how a service is accessed - seemingly small details that can significantly reduce anxiety and increase engagement.
Empowerment focuses on recognising strengths and building on them. Trauma-informed care seeks not only to avoid re-traumatisation - such as through unexpected physical contact, coercion, or reminders of past trauma - but also to promote resilience, self-efficacy, and hope. For some individuals, specialist trauma services may be necessary to process traumatic memories or trauma-related difficulties, while trauma-informed everyday practice helps create the supportive context in which this healing can occur.
Finally, cultural awareness and gender responsiveness are essential to ethical trauma-informed care. Trauma does not occur in a vacuum; it is shaped by cultural identity, historical context, gender, and social experiences. Trauma-informed frameworks therefore challenge cultural stereotypes, avoid discriminatory assumptions, and provide services that are attuned to the lived realities of different communities.
Together, these principles provide a roadmap for supporting trauma survivors with dignity and compassion, helping ensure that services do not inadvertently reproduce the conditions that caused harm, but instead foster connection, safety, and long-term wellbeing.
Trauma Informed Approaches in Education
Trauma-informed approaches in education are grounded in understanding how traumatic experiences can affect a young person's development, emotional regulation, learning, behaviour, and relationships. When a trauma informed school adopts trauma-informed practices, the goal is to create safe, predictable, and inclusive learning environments that acknowledge the role of trauma and actively support healing, rather than unintentionally reinforcing fear, shame, or mistrust. A trauma informed school implements whole-school culture change, incorporates policies and training to support students affected by trauma, and fosters a systematic, school-wide approach to understanding trauma's impact on behaviour.
Whole-school training and structured development plans play a crucial role in embedding trauma-informed approaches. Whole-system training ensures that all staff recognize signs of trauma and respond with compassion. These plans help teaching and support staff build a shared understanding of how trauma and adverse childhood experiences can impact a student's ability to concentrate, regulate emotions, feel safe, or trust adults. For many students affected by trauma, traditional behavioural responses - such as avoidance, withdrawal, aggression, or defiance - may be protective survival strategies rather than intentional misbehaviour. Trauma-informed approaches reframe these behaviours through a compassionate lens, enabling staff to respond supportively rather than punitively. Becoming a trauma-informed school requires a commitment to culture change and ongoing policy and practice development, alongside training and a CPD programme.
In practice, trauma-informed education prioritises emotional safety and consistency across classrooms, playgrounds, and pastoral systems. A trauma informed way incorporates six key principles - safety, trustworthiness, choice, collaboration, empowerment, and cultural consideration - to foster a supportive and non-harmful environment for individuals affected by trauma. Creating predictable routines and clear expectations helps restore a sense of control for students who may otherwise feel overwhelmed by uncertainty. Teachers can create safe spaces for students through methods like morning meetings to establish a sense of belonging. Small adjustments - such as calm transitions, structured seating, sensory supports, or quiet spaces - can significantly reduce anxiety and improve engagement in learning. Creating cognitive distractions in the classroom can also help students regulate emotions, providing an alternative to relying solely on calming chairs. When students feel physically and emotionally safe, they are more able to focus, participate, and benefit from the school environment.
Trauma-informed schools also recognise the importance of relationships. Warm, reliable and attuned relationships with trusted adults help counteract trauma's disruption to attachment, trust, and self-worth. Staff are encouraged to use de-escalation strategies, collaborative problem-solving, and strengths-based approaches to communication, supporting emotional stability and preventing further distress. By prioritising these relational elements, trauma-informed practice in education promotes mental health, fosters resilience, and supports long-term academic progress.
Ultimately, trauma-informed approaches in education are not a temporary initiative, but a cultural shift. They help ensure that students with trauma are understood, supported, and empowered, allowing schools to become environments where healing is possible and learning can flourish.
The Widespread Impact of Trauma on Mental Health
Trauma can have a profound and lasting adverse effect on a person's emotional, physical, social, and mental well-being. Research increasingly shows that traumatic experiences - whether acute, chronic, or complex - can alter stress responses, disrupt the nervous system, affect brain development, and influence behaviour, relationships, and health across the lifespan. These impacts may limit daily functioning, contribute to mental health challenges, and increase engagement with health and care services.
Trauma-informed practice acknowledges the significant difference that trauma can make in an individual's life. Rather than minimising or overlooking the effects of trauma, it seeks to validate feelings, recognise coping strategies, and support mental health through understanding rather than judgement. For many people affected by trauma, simply having their experiences recognised and believed can be an essential first step towards healing.
Importantly, trauma does not impact only individuals - it can affect families, groups, and entire communities. Collective trauma resulting from war, displacement, natural disasters, intergenerational trauma, or systemic discrimination can shape cultural narratives, community mental health, and patterns of trust in services. This broader perspective highlights why trauma-informed care is not confined to specialist therapy; it is increasingly required across general health, education, disability support, social care, and justice sectors.
One of the most significant effects of trauma on mental health is its influence on a person's sense of safety and trust. Trauma-informed approaches therefore pay careful attention to how services are delivered, acknowledging that traditional clinical or institutional environments can sometimes feel threatening or invalidating for trauma survivors. A trauma-informed model works to reduce these barriers by promoting choice, transparency, cultural consideration, and respect for lived experience.
Cultural sensitivity is central to this work. Trauma-informed practice recognises that cultural identity shapes how trauma is experienced, expressed, and treated, and that some communities may have historical reasons for mistrusting health systems or mental health services. Consequently, trauma-informed care focuses on creating services that are emotionally and culturally safe, consistent, and responsive, so people are more likely to engage and receive the support they need.
By understanding the widespread impact of trauma and approaching mental health care through this lens, professionals are better equipped to improve wellbeing, enhance engagement, and reduce the risk of re-traumatisation for those seeking help.
Principles of Trauma Informed Care in Action
Putting trauma-informed care into action means translating core principles into everyday practice - within organisations, health and care systems, education settings, and community services. It begins with prioritising physical, psychological, and emotional safety for both service users and staff. Safety is not limited to preventing harm; it involves creating environments that feel predictable, respectful, and validating so that individuals are more able to engage, trust, and participate in their own care. When emotional safety is upheld, wellbeing naturally improves.
Operational transparency is another essential feature of trauma-informed care in practice. Clear communication around organisational policies, procedures, and decision-making processes helps build trust among staff, service users, and the wider community. Transparency and trust within an organisation's policies and procedures are crucial for building trust and fostering a supportive environment for everyone involved. Trauma-informed organisations recognise that many people who seek support may have lived through situations where information was withheld or used as a form of control, and therefore transparency is a way of restoring agency and respect. Cultural consideration is also woven throughout this work, ensuring that services are sensitive to cultural identity, community context, and systemic barriers that may influence a person's access to care.
Choice, collaboration, and shared decision-making are key components of trauma-informed care in action. Rather than prescribing interventions or treatment plans without consultation, trauma-informed approaches involve service users in setting goals, identifying needs, and shaping the direction of their healing. This collaborative style not only promotes autonomy, but also strengthens motivation, engagement, and long-term outcomes by respecting the individual's own knowledge and experience.
Trauma-informed systems also recognise the value of lived experience - both from service users and from staff who may have their own trauma histories. Instead of viewing lived experience as a barrier, it is understood as an asset that can inform service design, improve communication, and strengthen mental health and wellbeing. The experience of staff and service users is vital in overcoming challenges and driving improvements in trauma-informed practice, ensuring that obstacles are addressed collaboratively for better support. Organisations that adopt this mindset often see improvements in service quality, staff morale, and community trust.
Finally, empowerment is central to trauma-informed care in action. Empowerment involves giving individuals a strong voice in decisions that affect them, whether at the level of personal care, organisational planning, or system-wide policy. When service users and staff are empowered and included, health and care systems become more adaptable, compassionate, and effective. Staff wellness in trauma-informed care acknowledges vicarious trauma and provides support to prevent burnout, helping to sustain a healthy and effective workforce. Trauma-informed care in practice therefore moves beyond awareness and into structural change - reshaping services so that healing, dignity, and health improvement are prioritised at every level.
Implementing Trauma Informed Approaches in Organizations
Implementing trauma informed practice at the organisational level is a transformative process that goes beyond individual interactions - it requires a commitment to embedding the key principles of trauma informed care into every aspect of an organisation's culture, policies, and daily operations. Whether in health and care services, mental health services, education, or social support agencies, organizations that adopt trauma informed approaches create environments where both service users and staff feel safe, respected, and empowered.
A trauma informed organisation begins by prioritising safety - ensuring that physical spaces are welcoming and that emotional safety is actively promoted. This means developing clear safeguarding arrangements, transparent communication, and predictable routines that help reduce anxiety for trauma survivors. Trust is built through consistency, honesty, and reliability, while choice and collaboration are fostered by involving service users in decision making about their care and support.
Empowerment is another cornerstone of trauma informed practice. Organizations can empower both staff and service users by recognizing strengths, providing opportunities for feedback, and supporting professional development in trauma informed strategies. Actively involving service users listening to their experiences and needs, and adapting services accordingly, helps ensure that interventions are relevant and effective.
Cultural consideration is essential throughout this process. Trauma does not affect everyone in the same way, and past cultural stereotypes or exclusionary practices can create additional barriers to accessing health and care interventions. Organizations must be proactive in creating culturally sensitive and gender responsive services, challenging assumptions, and ensuring that policies and practices are inclusive of all backgrounds, sexual orientations, and identities.
Implementing trauma informed approaches also means supporting staff wellbeing, recognizing the risk of vicarious trauma, and providing access to supervision, peer support, and training. By embedding the principles of trauma informed care at both the individual and organisational level, organizations can make a huge difference in the service user experience, improve health outcomes, and foster a culture of healing and resilience.
Trauma Informed Approach in Community Settings
A trauma informed approach in community settings is vital for reaching individuals who may not access formal health or mental health services, but who still carry the effects of trauma in their daily lives. Community environments - such as schools, youth clubs, faith groups, and local health and care services - are uniquely positioned to provide informal peer support, foster positive relationships, and create safe spaces for healing.
Trauma informed practice in community settings starts with recognizing the widespread impact of trauma and understanding that many people may be experiencing trauma or living with the effects of previous trauma, even if they have never sought formal help. By adopting a trauma informed approach, community organizations can reduce stigma, validate feelings, and encourage individuals to seek support when needed.
Key to this approach is creating environments that are emotionally safe, inclusive, and responsive to the diverse needs of community members. This includes being mindful of cultural consideration, respecting traditional cultural connections, and avoiding practices that may inadvertently trigger distress or reinforce past harm. Community leaders and staff can benefit from whole school training or community-wide education on trauma informed strategies, helping everyone to recognize signs of trauma exposure and respond in a supportive, non-judgmental way.
In addition, trauma informed community settings can play a crucial role in prevention and early intervention - identifying individuals at risk, providing access to trauma specialist services, and supporting mental health and spiritual well being. By building networks of mutual self help and informal support, communities can help individuals overcome challenges, reduce isolation, and achieve mental and physical health improvement.
Ultimately, a trauma informed approach in community settings strengthens the fabric of support available to trauma survivors, making it easier for people affected by such experiences to access help, build resilience, and move towards healing in a way that honours their unique histories and needs.
Trauma in Children and Adolescents with Behavioural Conditions such as Autism and ADHD
Many children and adolescents with behavioural conditions such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) experience heightened vulnerability to stress, anxiety, and sensory overwhelm. For some, these challenges are compounded by trauma, whether through adverse childhood experiences, sudden life changes, bullying, exclusion, repeated behavioural misunderstandings, or difficulties accessing appropriate support. Trauma-informed practice and Positive Behaviour Support (PBS) therefore intersect powerfully in supporting this group, helping to reduce distress and promote wellbeing and learning.
Trauma-informed approaches emphasise safety, predictability, and emotional regulation - needs that are often essential for autistic children and young people with ADHD. Many children with ASD may already struggle with communication differences, sensory sensitivities, or difficulties in interpreting social cues. In these circumstances, trauma responses may not always present in obvious ways. Instead, trauma can manifest through heightened anxiety, shutdowns, meltdowns, avoidance, reduced tolerance for uncertainty, or defensive behaviours that are sometimes misinterpreted as 'non-compliance'. Trauma-informed practice encourages adults to view these behaviours as signals of unmet needs rather than wilful defiance.
For children with ADHD, trauma can further complicate difficulties with attention, impulse control, and emotional regulation. Young people who are impulsive or energetic may be more likely to encounter environments where discipline is emphasised over understanding, which can inadvertently reinforce feelings of shame or rejection. Trauma-informed PBS shifts the focus from punishment to understanding the function of behaviour, and to building skills that support self-regulation, communication, and confidence.
A key consideration in trauma-informed PBS is the recognition that young people need environments that feel safe, calm, and predictable. Predictable routines, clear expectations, visual supports, sensory adjustments, and structured transitions all reduce anxiety and give children a greater sense of control. When children feel secure, they are better able to engage in learning, participate socially, and build trusting relationships with adults.
Another essential factor is partnership and collaboration with families. Parents and carers often hold critical insight into the child's sensory profile, communication needs, triggers, and strengths. Trauma-informed PBS values this expertise, incorporating lived experience into planning and decision-making, and ensuring that strategies are consistent across home, school, and community settings.
Positive Behaviour Support aligns closely with trauma-informed approaches because both are built on respect, dignity, and a commitment to understanding behaviour in context. PBS avoids coercive or punitive practices, instead identifying what the child is trying to communicate, and proactively teaching new skills and coping strategies. This strengths-based approach helps rebuild a sense of agency and confidence - particularly important for children who may already feel misunderstood, excluded, or unsafe.
By combining trauma-informed principles with PBS, educators and practitioners are better equipped to differentiate between behaviours driven by sensory needs, developmental differences, and trauma responses. This integrated approach supports the whole child, promoting emotional wellbeing, encouraging positive relationships, and enabling meaningful participation at school and beyond.
Conclusion
Trauma-informed approaches provide a compassionate and evidence-informed framework for supporting children, adolescents, and adults whose behaviour, development, and wellbeing have been shaped by adversity. By shifting the focus from blame to understanding, trauma-informed practice helps professionals recognise the deeper factors influencing behaviour, emotional regulation, learning, and relationships. Crucially, these approaches emphasise safety, trust, collaboration, empowerment, and cultural awareness - principles that not only improve engagement with services, but also create the conditions in which long-term healing and resilience can thrive.
Across education, health, disability, and social care settings, trauma-informed approaches have moved from specialised practice to essential practice. They acknowledge that trauma can affect entire communities, that it profoundly influences mental health and physical health, and that traditional punitive or compliance-based responses can unintentionally re-traumatise individuals who already feel unsafe or misunderstood. When schools and services adopt trauma-informed principles, they become places where children and young people are able to learn, trust, regulate, and connect.
For children and adolescents with behavioural conditions such as autism or ADHD, trauma-informed practice intersects naturally with Positive Behaviour Support. Both approaches seek to understand behaviour in context, avoid coercive or harmful responses, and build the skills, supports, and environments that allow young people to flourish. Together, they offer a powerful alternative to reactive behaviour management - one grounded in dignity, collaboration, and respect for lived experience.
Becoming a trauma-informed practitioner or trauma-informed organisation is an ongoing journey rather than a single intervention. It involves curiosity, reflection, training, and system-wide change. However, the benefits are significant: reduced anxiety, better engagement, stronger relationships, improved mental health, and environments where children, families, and staff feel safe and valued.
As awareness of trauma continues to grow, trauma-informed approaches will remain central to high-quality care and education. By embedding these principles into everyday interactions, we strengthen the protective factors that support healing and reduce the barriers that prevent children and young people from accessing the help they need. In doing so, we take a meaningful step towards providing better care, better outcomes, and better futures for the individuals and communities we serve.