As a health care provider, you have an opportunity, and many of the basic skills, to make a difference in how children and their families experience illness, injury, and the medical care they receive.

Opportunities to help patients by using trauma-informed care arise at each phase of medical treatment – from new diagnosis or emergent treatment through ongoing treatment of chronic illness or sequelae of injury. However, not every child and family will require the same level of care. Similar to a public health prevention model, trauma-informed care can be grouped into three distinct levels, each with differing implications for intervention.:

• UNIVERSAL CARE: Research shows that the majority of ill or injured child are families are distressed but resilient. Many simply need information, comfort, and support in mobilizing their own resources. The D-E-F Protocol (below) is an excellent guide to helping children and families help themselves after medical trauma.


• TARGETED CARE: A smaller number of children and families with acute distress may need to be monitored and may require interventions that focus on reducing symptoms of traumatic stress or promoting adjustment or adherence to medical treatment.


• CLINICAL CARE / TREATMENT: Only a small minority of children and families will experience distress severe enough to impede active medical treatment. These families may require intensified psychosocial services and/or mental health treatment.

Many health care professional can provide UNIVERSAL trauma-informed care as part of everyday clinical treatment. Some of the key elements of UNIVERSAL care include:

• Minimize potentially traumatic aspects of medical care and procedures
• Provide child and family with basic support and information
• Address distress (pain, fear, loss)
• Identify family strengths and resources (help parents and family help the child)
• Screen to determine which children and families might need more support, and make appropriate referrals
• Provide anticipatory guidance about adaptive ways of coping

The D-E-F Protocol for Trauma-Informed Pediatric Care

Health care providers are experts in treating illness, restoring functioning, and saving lives.

"A-B-C" orients providers to the crucial first steps to save a life (Airway, Breathing, Circulation).

The D-E-F Protocol can help providers remember the key steps to guiding and promoting children's emotional recovery from illness or injury.


Read more about the D-E-F Protocol.