Tips for Creating Emotionally Safe Environments in Therapy Using Trauma Informed Care

By Imani Thompson
MFP Technical Assistant, The MayaTech Corporation


Creating emotionally safe environments in therapy is essential for effective healing and growth, particularly for clients dealing with trauma and substance abuse issues.1 Establishing such environments requires therapists to employ a variety of strategies aimed at cultivating trust, empathy, and empowerment while honoring cultural differences. A primary goal for therapists is fostering a space where clients feel valued, understood, and free to express their thoughts and emotions without fear of judgment. This commitment requires a nuanced understanding of clients' needs and experiences, particularly for those who have faced trauma. Using trauma-informed care (TIC) is pivotal in this process. TIC emphasizes physical, psychological, and emotional safety for both clients and therapists, and helps survivors rebuild a sense of control and empowerment. To implement an emotionally safe environment effectively, consider the following strategies:2

  • Establish Clear Boundaries: Clearly defining and respecting boundaries within the therapeutic relationship is crucial for creating a predictable and safe space for clients to explore their thoughts and emotions without fear of judgment. This involves establishing boundaries and ensuring that clients understand and respect these boundaries.
  • Practice Active Listening: Demonstrating genuine interest and concern through active listening is vital for validating clients' feelings and experiences. By actively engaging with clients and acknowledging their emotions, therapists can help foster a sense of safety and trust within the therapeutic relationship.
  • Cultivate Empathy and Compassion: Empathy and compassion are foundational in building a strong therapeutic alliance. By empathizing with clients' experiences and demonstrating compassion for their struggles, therapists can help clients feel seen, heard, and understood, thereby creating an emotionally supportive environment for healing.
  • Honor Cultural Differences: Recognizing and respecting cultural differences is essential for creating an inclusive and culturally sensitive therapeutic environment. Therapists should strive to understand the cultural backgrounds and values of their clients, acknowledging the unique perspectives and experiences that shape their worldview. By honoring cultural differences, therapists can validate clients' identities and promote a sense of belonging and acceptance
  • Empower Clients: Recognizing and affirming clients' strengths, supporting their autonomy, and encouraging their active participation in the therapy process are essential for empowering clients to take control of their recovery journey. Empowerment reinforces clients' sense of agency and self-efficacy, contributing to their overall sense of well-being and growth.
  • Incorporate Client Feedback: Regularly soliciting and integrating client feedback into the therapy process is crucial for ensuring that therapy remains responsive to clients' evolving needs and preferences. By actively involving clients in decision-making and treatment planning, therapists can foster a collaborative and empowering therapeutic environment.

Understanding Trauma-Informed Care

TIC is an approach that acknowledges the widespread impact of trauma and seeks to understand potential paths for recovery. The TIC-trained therapist recognizes the signs and symptoms of trauma in clients, families, staff, and others involved in the system. TIC is more than just a set of techniques; it's a philosophy that reshapes how therapists engage with their clients. By recognizing the prevalence of trauma and its profound effects on individuals, therapists adopt an approach rooted in empathy, collaboration, and sensitivity. Therapists trained in TIC practices are prepared to integrate this knowledge into all aspects of treatment delivery. Through this lens, therapy becomes a collaborative journey, with the therapist serving as a guide who navigates the complexities of trauma with compassion and understanding.

Guiding Principles of Trauma-Informed Care

TIC encompasses six principles that serve as a guide for therapists: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues.3

1. safety 2. trustworthiness 3. peer support 4. collaboration & mutuality 5. empowerment voice & choice 6. cultural, historical, and gender issues

TIC also involves seeking to actively resist re-traumatization of clients. Therapists are encouraged to:

  • Ensure that the therapeutic environment is safe and welcoming.
  • Maintain transparency in the therapeutic process to build and sustain trust.
  • Utilize peer support and mutual self-help groups to facilitate recovery.
  • Work collaboratively with clients, empowering them to have a voice and choice in their treatment.

For those looking to delve deeper into the principles and application of trauma-informed care, SAMHSA provides extensive resources and guidance. Please view SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach, which offers a comprehensive framework for organizations and therapists aiming to implement trauma-informed principles in their practice.4 As well as SAMHSA's Trauma-Informed Care in Behavioral Health Services Manual, which provides an overview of trauma, its impact on individuals, and the principles of trauma-informed care.5 Additionally, the National Child Traumatic Stress Network (NCTSN) provides valuable information on trauma types and trauma-informed care interventions, which underscores the importance of understanding trauma's impact and the benefits of a trauma-informed approach in therapy.6

Creating emotionally safe environments in therapy requires a multifaceted approach that integrates sensitivity, knowledge, and a commitment to trauma-informed principles while honoring cultural differences. By fostering safety, trust, empathy, and empowerment, therapists can support their clients' healing and growth in profound ways. As the field continues to evolve, it is essential for therapists to engage in ongoing education and reflection to continually refine their practice and meet the complex needs of their clients effectively. By implementing trauma-informed care, therapists can not only enhance therapeutic relationships but also contribute to the broader mental health field by promoting resilience and recovery.

References
  1. https://www.acesaware.org/ace-fundamentals/principles-of-trauma-informed-care/
  2. https://www.discovercounselingcollective.com/blog/2023/2/5/emotional-safety-what-it-is-and-how-to-develop-it
  3. https://www.cdc.gov/orr/infographics/6_principles_trauma_info.htm
  4. Substance Abuse and Mental Health Services Administration. SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
  5. Substance Abuse and Mental Health Services Administration. SAMHSA's Trauma Informed Care for Behavioral Health Services-KAP Keys for Clinicians (Based on TIP 57). HHS Publication No. (SMA) 15-4420. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.
  6. https://www.nctsn.org/what-is-child-trauma/trauma-types