framework traumatic informed care_public health prevention model

In providing trauma-informed care, not every child and family will need the same level of support. The majority will benefit from psychoeducation, comfort, and basic assistance. A smaller number with acute distress will need interventions that promote medical adjustment or adherence. Only a few families with severe distress will need mental health treatment.

Providing Psychosocial Care as a Healthcare Provider

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 and psychosocial care they receive.

Opportunities to provide psychosocial care to 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 psychosocial 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 PSYCHOSOCIAL 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 PSYCHOSOCIAL 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 PSYCHOSOCIAL 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.

Respond by Providing Psychosocial Care in Each Phase of Children's Illness and Injury Experiences

The experience of an injury or illness unfolds in phases that can help pinpoint targets for prevention and intervention.

Phase I: Peri-trauma Providers caring for children as the initial events are still unfolding (in the midst of emergency care, giving a new and frightening diagnosis, carrying out procedures that may be painful or distressing) have the opportunity to reduce traumatic aspects of the experience for the child and family.

Phase II: Early (Evolving) Responses In the days and weeks that follow, the focus of intervention is addressing immediate emotional distress, promoting adaptive coping by the child and family (supporting existing strengths), and screening to determine who might need more support.

Phase III: Long-term Providers in many settings have the chance to care for children over the long haul – and can be instrumental in continuing to support adaptive coping, detecting persistent traumatic stress reactions or other emotional sequelae, and referring children and families for psychosocial assessment and treatment.

Providing Universal Psychosocial Care as a Part of Clinical Care

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