Compassion Connections
This resource has been co-created by:
Dr. Sharuna Verghis and
Dr. Xavier Vincent Pereira
COMPASSIONATE CONNECTIONS: A Trauma Informed Approach to Community Engagement © 2023 by Sharuna Verghis and Xavier V Pereira for Health Equity Initiatives is licensed under CC BY-NC-ND 4.0
For inquiries regarding the utilization of these resources in training programs, please contact Health Equity Initiatives for permission at: admin@healthequityinitiatives.com
Dr. Sharuna Verghis and
Dr. Xavier Vincent Pereira
COMPASSIONATE CONNECTIONS: A Trauma Informed Approach to Community Engagement © 2023 by Sharuna Verghis and Xavier V Pereira for Health Equity Initiatives is licensed under CC BY-NC-ND 4.0
For inquiries regarding the utilization of these resources in training programs, please contact Health Equity Initiatives for permission at: admin@healthequityinitiatives.com
LEARNING OUTCOMES
After participating in this session, participants should be able to:
1. Define stress, describe the stress response and how stress affects the body and mind.
2. Explain the key differences between stress and traumatic stress.
3. Outline the physical and physiological, psychological, behavioral, and social consequences of traumatic events.
4. Identify the core principles of a trauma-informed approach to community engagement
1. Define stress, describe the stress response and how stress affects the body and mind.
2. Explain the key differences between stress and traumatic stress.
3. Outline the physical and physiological, psychological, behavioral, and social consequences of traumatic events.
4. Identify the core principles of a trauma-informed approach to community engagement
introductioN
Welcome to this module on a trauma informed approach to community engagement!
The trauma informed approach is becoming increasingly vital in a range of professional and community settings. It offers a framework that acknowledges and addresses the widespread impact of trauma on individuals’ lives. This approach is also crucial in general community engagement as it ensures that individuals who have experienced psychological trauma are provided with the compassionate and sensitive support they need to heal, participate, and thrive in their communities.
A trauma-informed approach recognizes that trauma is common, that it can affect how people respond to services and relationships, and that community engagement should be organized in ways that promote safety, dignity, trust, and participation rather than inadvertently causing further harm.
This module is designed for individuals interested in volunteering with organizations that assist people who
The trauma informed approach is becoming increasingly vital in a range of professional and community settings. It offers a framework that acknowledges and addresses the widespread impact of trauma on individuals’ lives. This approach is also crucial in general community engagement as it ensures that individuals who have experienced psychological trauma are provided with the compassionate and sensitive support they need to heal, participate, and thrive in their communities.
A trauma-informed approach recognizes that trauma is common, that it can affect how people respond to services and relationships, and that community engagement should be organized in ways that promote safety, dignity, trust, and participation rather than inadvertently causing further harm.
This module is designed for individuals interested in volunteering with organizations that assist people who
have experienced psychological trauma. You don’t have to be a mental health professional to practice trauma-informed care. Anyone can be trauma informed.
It has been intended as an introductory guide for non-mental health professionals, aiming to offer a foundational yet thorough understanding of trauma, its extensive impacts, and practical insights for integrating a trauma-informed approach into both community and institutional settings.
We hope that this module will enhance your understanding of trauma and trauma-informed care, enriching your knowledge and capabilities for active participation and effective contribution within your community.
Whether your intention is to volunteer with organizations devoted to supporting individuals who have experienced psychological trauma or within communities of such individuals, we hope that this module to prepare you for a compassionate and empathetic journey in volunteerism.
It has been intended as an introductory guide for non-mental health professionals, aiming to offer a foundational yet thorough understanding of trauma, its extensive impacts, and practical insights for integrating a trauma-informed approach into both community and institutional settings.
We hope that this module will enhance your understanding of trauma and trauma-informed care, enriching your knowledge and capabilities for active participation and effective contribution within your community.
Whether your intention is to volunteer with organizations devoted to supporting individuals who have experienced psychological trauma or within communities of such individuals, we hope that this module to prepare you for a compassionate and empathetic journey in volunteerism.
EXPLORING STRESS
Let's start by exploring Stress.
Stress is a normal part of life and has become almost ubiquitous in our vocabulary. Phrases like "I’m stressed out," "stressful situation," or "stress relief" are common. Students talk about "exam stress," and "academic stress”. Terms like "stress management," "stress response," and "chronic stress" are regularly used in mental health. Phrases like "stress-induced illnesses" or "stress hormones" such as cortisol are frequently mentioned in medicine. In human resource management we cite "workplace stress," "stress leave," or "job-related stress".
Stress is a normal part of life and has become almost ubiquitous in our vocabulary. Phrases like "I’m stressed out," "stressful situation," or "stress relief" are common. Students talk about "exam stress," and "academic stress”. Terms like "stress management," "stress response," and "chronic stress" are regularly used in mental health. Phrases like "stress-induced illnesses" or "stress hormones" such as cortisol are frequently mentioned in medicine. In human resource management we cite "workplace stress," "stress leave," or "job-related stress".
EXPLORING THE STRESS RESPONSE
We will now delve into one of the most fundamental aspects of human physiology and psychology: the fight, flight, and freeze responses, a crucial part of how we, as humans, react to perceived threats and stress.
TRAUMATIC EVENTS AND TRAUMATIC STRESS
We have examined bodily stress, stress responses, and the impact of stress. Our focus will now shift to exploring traumatic stress, an extreme form of stress caused by traumatic events.
Exploring the Consequences of Traumatic Events
A key aspect of traumatic events is their overwhelming nature. They overwhelm an individual's ability to cope, leading to feelings of helplessness. These events often threaten the individual's sense of safety and can shatter their sense of normality (Herman, 1992).
The impact of a traumatic event can be immediate as well as long-term, affecting an individual's physical, emotional, and mental health. Common immediate reactions include shock, denial, unpredictable emotions, flashbacks, and strained relationships. Long-term effects can include post-traumatic stress disorder (PTSD), depression, and anxiety (American Psychiatric Association, 2013).
Swipe the deck of slides below to explore the many outcomes of trauma.
The impact of a traumatic event can be immediate as well as long-term, affecting an individual's physical, emotional, and mental health. Common immediate reactions include shock, denial, unpredictable emotions, flashbacks, and strained relationships. Long-term effects can include post-traumatic stress disorder (PTSD), depression, and anxiety (American Psychiatric Association, 2013).
Swipe the deck of slides below to explore the many outcomes of trauma.
FACTORS THAT SHAPE THE IMPACT OF TRAUMA ON INDIVIDUALS
In this section, we explore the intricate web of factors that shape the impact of trauma on individuals. Recognizing the profound interplay of these factors is crucial in fostering empathy and providing effective support for trauma survivors on their path to healing and recovery.
Firstly, it is important to understand that trauma is subjective. What might be traumatic for one person may not be for another. This subjectivity is influenced by a variety of factors, including an individual's past experiences, resilience, and available support systems (Rothschild, 2000)
• The type and severity of the traumatic event significantly influences its impact. Events that are intentional (such as assault) typically have a more severe impact than those that are not (like natural disasters). The duration and frequency of exposure to trauma also matter – chronic and repeated exposure, as seen in cases of domestic violence or war, can lead to more severe outcomes (Center for Substance Abuse Treatment, 2014).
• Resilience is the ability to adapt well in the face of adversity. It plays a crucial role in how individuals respond to trauma. Those with higher resilience may recover more
quickly and effectively from traumatic events. Resilience is not an innate trait but can be developed and strengthened over time through supportive relationships, positive coping skills, and effective problem-solving abilities (Southwick et al., 2014).
• The developmental stage also influences the impact of trauma at the time of the event. Trauma experienced during critical developmental periods, such as childhood, can have profound and lasting effects on emotional and psychological development. For example, early-life trauma can disrupt attachment, cognitive development, and emotional regulation (Van der Kolk, 2005). Studies have demonstrated that individuals who have experience childhood trauma may be at a higher risk of developing enduring health issues, such as diabetes and heart disease, and facing a reduced lifespan (Felitti et al., 1998; Anda et al., 2006). Additionally, traumatic stress can result in heightened utilization of healthcare and mental health services, as well as greater interaction with child welfare and juvenile justice systems (Kerker et al., 2015; Putnam-Hornstein et al., 2018).
• Social support is a key factor in trauma recovery. The presence of a supportive network can provide emotional comfort, practical help, and a sense of belonging and security. Studies have shown that individuals with strong social support are more resilient to the effects of trauma and are less likely to develop PTSD (Brewin et al., 2000).
• Several other factors can influence the impact of trauma
such as:
Firstly, it is important to understand that trauma is subjective. What might be traumatic for one person may not be for another. This subjectivity is influenced by a variety of factors, including an individual's past experiences, resilience, and available support systems (Rothschild, 2000)
• The type and severity of the traumatic event significantly influences its impact. Events that are intentional (such as assault) typically have a more severe impact than those that are not (like natural disasters). The duration and frequency of exposure to trauma also matter – chronic and repeated exposure, as seen in cases of domestic violence or war, can lead to more severe outcomes (Center for Substance Abuse Treatment, 2014).
• Resilience is the ability to adapt well in the face of adversity. It plays a crucial role in how individuals respond to trauma. Those with higher resilience may recover more
quickly and effectively from traumatic events. Resilience is not an innate trait but can be developed and strengthened over time through supportive relationships, positive coping skills, and effective problem-solving abilities (Southwick et al., 2014).
• The developmental stage also influences the impact of trauma at the time of the event. Trauma experienced during critical developmental periods, such as childhood, can have profound and lasting effects on emotional and psychological development. For example, early-life trauma can disrupt attachment, cognitive development, and emotional regulation (Van der Kolk, 2005). Studies have demonstrated that individuals who have experience childhood trauma may be at a higher risk of developing enduring health issues, such as diabetes and heart disease, and facing a reduced lifespan (Felitti et al., 1998; Anda et al., 2006). Additionally, traumatic stress can result in heightened utilization of healthcare and mental health services, as well as greater interaction with child welfare and juvenile justice systems (Kerker et al., 2015; Putnam-Hornstein et al., 2018).
• Social support is a key factor in trauma recovery. The presence of a supportive network can provide emotional comfort, practical help, and a sense of belonging and security. Studies have shown that individuals with strong social support are more resilient to the effects of trauma and are less likely to develop PTSD (Brewin et al., 2000).
• Several other factors can influence the impact of trauma
such as:
o Prior Trauma Exposure: Previous exposure to trauma can increase vulnerability to future traumatic events.
o Mental Health History: Pre-existing mental health conditions can exacerbate the impact of trauma.
o Cultural and Societal Factors: Cultural beliefs and
societal attitudes towards trauma can affect how individuals process and cope with traumatic events (Benjet et al., 2016).
In conclusion, the impact of trauma is pervasive and can affect every aspect of an individual's life. A complex interplay of various factors, including individual resilience, the nature of the traumatic event, social support, developmental stages, and more determines it. Understanding what a traumatic event is involves recognizing its complexity and subjectivity. This knowledge is crucial in fostering empathy and support for those who have experienced trauma and providing effective support and treatment for trauma survivors.
What is important to remember is that trauma itself is not just about the events that occur; it's about the individual's emotional experience of these events and recovery flows from the capacity to integrate and move on from those traumatic events (Herman, 2015).
What is important to remember is that trauma itself is not just about the events that occur; it's about the individual's emotional experience of these events and recovery flows from the capacity to integrate and move on from those traumatic events (Herman, 2015).
As we continue to advance in our understanding of trauma, we are better equipped to develop effective interventions and support strategies for trauma survivors that address its multifaceted nature, helping individuals on their journey towards healing and recovery.
References
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci, 256(3), 174-186. https://doi.org/10.1007/s00406-005-0624-4
Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., Shahly, V., Stein, D. J., Petukhova, M., Hill, E., Alonso, J., Atwoli, L., Bunting, B., Bruffaerts, R., Caldas-de-Almeida, J. M., de Girolamo, G., Florescu, S., Gureje, O., Huang, Y., . . . Koenen, K. C. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med, 46(2), 327-343. https://doi.org/https://doi.org/10.1017/S0033291715001981
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol, 68(5), 748-766. https://doi.org/10.1037//0022-006x.68.5.748
Center for Substance Abuse Treatment (US). (2014). Trauma-informed care in behavioral health services. Treatment Improvement Protocol (TIP) Series, No. 57 https://www.ncbi.nlm.nih.gov/books/NBK207201/). Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK207201/
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8
Herman, J. L. (2015). Trauma and recovery. Basic Books. https://books.google.com.my/books?id=1VfetwEACAAJ
Kerker, B. D., Zhang, J., Nadeem, E., Stein, R. E. K., Hurlburt, M. S., Heneghan, A., Landsverk, J., & McCue Horwitz, S. (2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics, 15(5), 510-517. https://doi.org/https://doi.org/10.1016/j.acap.2015.05.005
Putnam-Hornstein, E., Needell, B., King, B., & Johnson-Motoyama, M. (2013). Racial and ethnic disparities: A population-based examination of risk factors for involvement with child protective services. Child Abuse & Neglect, 37(1), 33-46. https://doi.org/https://doi.org/10.1016/j.chiabu.2012.08.005
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York: W. W. Norton & Company.
Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol, 5. https://doi.org/10.3402/ejpt.v5.25338
van der Kolk Bessel, A. (2005). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408. https://doi.org/10.3928/00485713-20050501-06.
Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., Shahly, V., Stein, D. J., Petukhova, M., Hill, E., Alonso, J., Atwoli, L., Bunting, B., Bruffaerts, R., Caldas-de-Almeida, J. M., de Girolamo, G., Florescu, S., Gureje, O., Huang, Y., . . . Koenen, K. C. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med, 46(2), 327-343. https://doi.org/https://doi.org/10.1017/S0033291715001981
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol, 68(5), 748-766. https://doi.org/10.1037//0022-006x.68.5.748
Center for Substance Abuse Treatment (US). (2014). Trauma-informed care in behavioral health services. Treatment Improvement Protocol (TIP) Series, No. 57 https://www.ncbi.nlm.nih.gov/books/NBK207201/). Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK207201/
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8
Herman, J. L. (2015). Trauma and recovery. Basic Books. https://books.google.com.my/books?id=1VfetwEACAAJ
Kerker, B. D., Zhang, J., Nadeem, E., Stein, R. E. K., Hurlburt, M. S., Heneghan, A., Landsverk, J., & McCue Horwitz, S. (2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics, 15(5), 510-517. https://doi.org/https://doi.org/10.1016/j.acap.2015.05.005
Putnam-Hornstein, E., Needell, B., King, B., & Johnson-Motoyama, M. (2013). Racial and ethnic disparities: A population-based examination of risk factors for involvement with child protective services. Child Abuse & Neglect, 37(1), 33-46. https://doi.org/https://doi.org/10.1016/j.chiabu.2012.08.005
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York: W. W. Norton & Company.
Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol, 5. https://doi.org/10.3402/ejpt.v5.25338
van der Kolk Bessel, A. (2005). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408. https://doi.org/10.3928/00485713-20050501-06.
RESPONSE TO TRAUMA: TRAUMA-FOCUSED TREATMENT AND TRAUMA-INFORMED CARE
Having explored traumatic stress in quite some detail, in this section, we will explore two approaches to supporting individuals who have experienced trauma – namely trauma-focused treatment and trauma-informed care.
Swipe the deck of slides below to view the two videos.
Trauma-informed practice begins with the recognition that
trauma is widespread and that traditional forms of service delivery may
unintentionally intensify distress or trigger past traumatic experiences. It is
therefore not only about what support is offered, but also about how support is
provided.
A trauma-informed approach seeks to create environments and relationships that are safe, respectful, collaborative, and empowering for people who have experienced trauma.
Trauma-informed practice is often described using the 4
Rs: realizing the prevalence and impact of trauma, recognizing the signs
and symptoms of trauma, responding by integrating trauma-informed knowledge
into practice, and resisting re-traumatization.
In this module, the key principles of a trauma-informed approach include:
-Safety – creating physically and emotionally safe environments, while actively working to avoid re-traumatisation.
-Trustworthiness and transparency – building trust through clear communication, consistency, confidentiality, and predictable interactions.
-Peer support and mutual self-help – recognizing the importance of shared experience, connection, and community-based support in healing and recovery.
-Collaboration and mutuality – reducing power imbalances and working in partnership with individuals and communities rather than acting on their behalf.
-Empowerment, voice and choice – supporting autonomy, informed decision-making, and the strengths and capacities of those receiving care or support.
-Cultural, historical and gender sensitivity – acknowledging how trauma is shaped by identity, history, displacement, oppression, and social context, and responding with cultural humility.
-Strengths and resilience – focusing not only on distress and deficits, but also on coping, resilience, and the resources people already bring to recovery.
A trauma-informed approach to community engagement therefore asks us to pay close attention not only to people’s needs, but also to the quality of our interactions, the power relations within those interactions, and the wider environments in which engagement takes place.Swipe the deck of slides below to view the two videos.
Dos And Don'ts for Volunteers
For student volunteers, these principles mean listening with empathy,
explaining clearly, respecting boundaries, avoiding intrusive or
unnecessary questioning, being mindful of cultural and gender
differences, and working in ways that support dignity, choice, and
safety.
In closing, practicing trauma informed care in community settings requires sensitivity, respect, and a deep understanding of the principles of a trauma informed approach. For volunteers, it’s about listening, learning, and supporting without imposing, ensuring that interactions are empowering and respectful.
We hope this presentation equips you with the knowledge and understanding to make a positive impact in your community work.
In closing, practicing trauma informed care in community settings requires sensitivity, respect, and a deep understanding of the principles of a trauma informed approach. For volunteers, it’s about listening, learning, and supporting without imposing, ensuring that interactions are empowering and respectful.
We hope this presentation equips you with the knowledge and understanding to make a positive impact in your community work.