Quick Overview: When a therapy setting says it seeks to avoid repeating harmful experiences, it may be referring to a trauma-informed approach. SAMHSA describes this approach for programs, organizations, and systems: it recognizes trauma’s effects, integrates knowledge about trauma into policies, procedures, and practices, and seeks to actively resist retraumatization. SAMHSA also identifies safety, trustworthiness and transparency, collaboration and mutuality, and empowerment, voice, and choice as principles. These principles do not determine whether a particular therapy relationship will feel right for any one person.
What the Phrase Means in a Trauma-Informed Context
The phrase “seeks to avoid repeating harmful experiences” should be understood carefully. SAMHSA uses the term retraumatization when describing trauma-informed approaches. Its description is directed toward a program, organization, or system rather than defining exactly how every individual therapy setting or therapist will work.
According to SAMHSA, a trauma-informed approach realizes the widespread impact of trauma, recognizes signs and symptoms of trauma in people involved with a system, and responds by integrating knowledge about trauma into policies, procedures, and practices. It also seeks to actively resist retraumatization.
The word seeks matters. It describes an aim of an approach, not a guarantee about any person’s experience. The available sources do not establish how a particular therapy setting will feel, whether it will fit a specific person, or what result a person will have.
Principles Named by SAMHSA
SAMHSA identifies several principles for trauma-informed approaches. These principles can offer language for learning about the term without assuming that every service uses the same structure or practices.
Safety
SAMHSA describes safety as an environment in which participants and staff feel physically and psychologically safe. This principle names safety as a consideration within a trauma-informed approach. It does not establish that a particular person will feel safe in every setting or at every point in therapy.
A person considering therapy may wish to ask how a prospective therapist describes their general approach. NIMH notes that a preliminary conversation can help someone understand how treatment will proceed and assess comfort with the therapist.
Trustworthiness and Transparency
SAMHSA states that organizational decisions are conducted with the goal of building and maintaining trust. It identifies trustworthiness and transparency as a trauma-informed principle.
NIMH separately states that rapport and trust are essential in psychotherapy. NIMH also notes that a preliminary conversation can help a person understand an approach and assess comfort. The sources do not say that trust will develop in a particular way, on a particular timeline, or within any specific service.
Collaboration and Mutuality
SAMHSA describes collaboration and mutuality as placing importance on partnering and leveling power differences between staff and service participants. This is an organization-level principle in SAMHSA’s description.
For someone exploring therapy, this principle can provide a topic for a direct question: how does the therapist describe the approach being considered? NIMH includes questions about the approach a therapist will use, the rationale and evidence base for that approach, goals of therapy, and how progress will be assessed.
Empowerment, Voice, and Choice
SAMHSA identifies empowerment, voice, and choice as another principle. Its description says that organizations foster a belief in the primacy of the people they serve to heal and promote recovery from trauma.
This principle does not tell a reader what choices will be available in a specific therapy service. It also does not establish what a person should choose. A preliminary conversation may help a person gather information about an approach and consider comfort before deciding whether to begin.
What a Trauma-Informed Label Does Not Establish
A trauma-informed label can communicate an orientation toward recognizing trauma’s effects and seeking to avoid retraumatization. It can also point to the principles SAMHSA names.
By itself, however, the label does not establish the exact structure of therapy, the topics that will be discussed, the number of sessions, or the pace of a particular process. It does not predict comfort, fit, or clinical outcomes for an individual reader.
NIMH explains that therapists may use one primary approach or incorporate elements from multiple approaches depending on their training, the disorder being treated, and the needs of the person receiving treatment. The available information does not support assuming that all therapy settings use the same approach.
Reflection Questions for Considering an Approach
These questions are not a test of readiness or a way to judge a therapist. They can help identify information you may want to understand during a preliminary conversation.
| Question to consider | What it may help you explore |
|---|---|
| What do I want to understand about the approach before deciding? | How treatment may proceed |
| What would help me assess my comfort in a preliminary conversation? | Whether to continue exploring fit |
| Which SAMHSA principle matters most to me right now: safety, transparency, collaboration, or voice and choice? | Language for asking a question |
| What do I want to know about the goals of therapy? | The purpose of the approach being discussed |
| How would I want progress to be assessed? | A question NIMH suggests discussing |
Questions to Bring to a Consultation
NIMH notes that a preliminary conversation can help a person understand treatment and assess comfort. Questions may include:
- What approach will you use in therapy?
- What is the rationale and evidence base for that approach?
- What are the goals of therapy?
- Do you recommend a specific time frame or number of sessions?
- How will progress be assessed?
- What happens if it seems that I am not improving?
Practice Note: Rooted Integrative Therapy offers individual therapy, couples therapy, group therapy, and therapy intensives. Alina Hovsoyan, LCSW, provides in-person therapy near Orem and Provo, with virtual therapy across Utah. The practice’s FAQs describe a consultation call as a first step for asking questions and considering fit.
FAQs
Is a trauma-informed therapy setting the same as a guarantee of safety?
No. SAMHSA identifies safety as a principle of trauma-informed approaches, but the available sources do not guarantee how a particular person will experience a particular setting.
Does trauma-informed mean therapy will never be difficult?
The available sources do not make that claim. SAMHSA describes an approach that seeks to actively resist retraumatization; it does not predict an individual experience.
Can a preliminary conversation help with deciding about therapy?
NIMH states that a preliminary conversation can help a person understand how treatment will proceed and assess comfort with the therapist.
Does the label explain exactly what therapy will involve?
No. The label does not establish a specific structure, number of sessions, or approach for an individual service. Asking direct questions can provide information about the approach being considered.
Sources and Further Reading
Sources used for this article:
- Substance Abuse and Mental Health Services Administration: Trauma-Informed Approaches and Programs
- National Institute of Mental Health: Psychotherapies
A Grounded Next Step
If you would like to ask about Rooted Integrative Therapy or request an appointment, the practice’s Connect page provides contact details and a form for inquiries and appointment requests. Its FAQs describe scheduling a consultation call as a first step, with an opportunity to ask questions and consider fit.
Please do not include urgent or highly sensitive clinical information in a general inquiry.
This article is for general education only. It is not a diagnosis, treatment plan, or substitute for individualized mental-health care. A qualified mental-health professional can help you consider what fits your circumstances.