Trauma-Informed Care

Trauma-informed care (TIC) is an approach that recognizes and responds to the effects of psychological injury on individuals. It aims to create environments where people feel safe, supported, and empowered. I run a trauma-informed practice, believing that healing begins with safety, choice, and connection. Whether you’re navigating the aftermath of a difficult experience, struggling with relationships, or simply trying to make sense of your feelings, my role is to work at your pace, without judgment. I’ll use trauma-informed therapy techniques that build skills for grounding, self-compassion, and reconnecting with parts of yourself that may feel lost or distant. You can see a bit about my work as a trauma-informed psychologist in the case examples at the end of this post.

What is Trauma-Informed Care?

Key Principles of a Trauma-Informed Psychologist

1. Safety – A trauma-informed practice ensures physical, emotional, and psychological safety. This includes creating spaces where individuals feel secure and respected.
2. Trustworthiness and Transparency – A trauma-informed psychologist builds trust by being clear, consistent, and honest about what will happen and why.
3. Peer Support – Encouraging support networks and relationships among peers with similar experiences to promote healing.
4. Collaboration and Mutuality – Avoiding power imbalances between a trauma-informed psychologist and you means working together and valuing your input.
5. Empowerment, Voice, and Choice – A trauma-informed psychologist empowers you by emphasizing your strengths and allowing you to choose your care or support.
6. Cultural, Historical, and Gender Awareness – A trauma-informed psychologist recognizes the impact of cultural, historical, and systemic emotional pain (such as racism, oppression, or discrimination) and ensures care is sensitive and responsive to these factors.

Why Is Trauma-Informed Care Important?

• Painful wounds can impact individuals’ engagement with services or systems, such as healthcare, education, or therapy. Trauma-informed therapy recognizes and responds to that.
• People who have experienced this type of emotional pain may struggle with trust, boundaries, or certain triggers.
• By understanding the effects, a trauma-informed psychologist can promote healing and recovery.

How Trauma-Informed Care Looks in Various Fields

• Healthcare: Doctors and nurses with trauma-informed practice might ask about a patient’s comfort and provide clear explanations before procedures.
• Education: Teachers may use trauma-informed practice techniques such as calming spaces or avoidance of punishment that could trigger certain responses.
• Social Services: Caseworkers may use trauma-informed practice to focus on collaboration and offer choices to avoid making individuals feel powerless.

My Role as a Trauma-Informed Psychologist

I center my work around safety, trust, and empowerment while being deeply aware of how psychological wounds can impact a person’s mental health, behavior, and relationships. I aim to support a person’s healing and resilience actively. Here are some ways I implement trauma-informed care in my practice.

Basic Tenets of a Trauma-informed Practice

Creating Emotional Safety

• Emotional safety means fostering a space where clients feel accepted, not judged, and in control.
• A trauma-informed practice validates their experiences without minimizing them.
• I remain mindful of how power dynamics play out (especially if the client has experienced abuse or control in the past).
• Letting clients know they can pause sessions, take breaks, or step outside if they feel overwhelmed.

Prioritizing Trust and Transparency

• Explaining everything: I explain the trauma-informed therapy process, confidentiality, and what to expect, reducing the client’s uncertainty.
• Predictability: Start and end sessions on time, maintain clear boundaries, and follow through on promises.
• Transparency about treatment: Being clear about trauma-informed therapy methods and why they’re used and giving the client the option to opt out or modify.

Trauma-informed Therapy Example:

“Today I’m thinking of using a grounding exercise to help with anxiety — how does that sound to you?”
“I’ll always check with you before trying anything new in therapy.”

Empowerment, Choice, and Control

These wounds often leave people feeling powerless. A trauma-informed practice gives control back to the client in any way possible.

• Offering choices in trauma-informed therapy sessions, like:
  • “Do you want to discuss what happened today or focus on grounding techniques?”
  • “You can stop or pause at any time.”
• Encouraging self-advocacy by asking the client to identify their own needs or goals in individual therapy.

Understanding Responses and Triggers

A trauma-informed practice recognizes how the effects appear in behavior, cognition, and emotions. This means:

• Recognizing fight, flight, freeze, or fawn responses during trauma-informed therapy sessions.
• Understanding that “difficult” behaviors (like avoidance, dissociation, emotional shutdown, or anger) are responses and not “bad behavior.”
• Responding with compassion rather than frustration when clients seem disengaged, avoidant, or reactive.

Trauma-informed practice example:

If a client suddenly disconnects, I might say: “I noticed you seem really distant right now. Would you like to take a break or do a grounding exercise?”

A Trauma-informed Psychologist Avoids Re-traumatization

This happens when a client feels powerless, invalidated, or out of control — similar to their original experience.

• A trauma-informed psychologist avoids forcing you to talk about anything if you’re not ready.
• I never use confrontational language like “You need to face this head-on” or “You have to talk about this eventually.”
• I avoid using terms that imply blame or judgment (e.g., “Why did you do that?”).
• The client always has the option to leave or pause trauma-informed therapy sessions if overwhelmed.

Trauma-informed Practice Example:
“We don’t have to go there today — it’s totally up to you.”
“I’ll follow your lead.”

Recognizing the Impact of Historical, Cultural, and Systemic Factors

Deeply negative feelings can come from systemic oppression, discrimination, and cultural violence (such as racism, sexism, homophobia, etc.). A trauma-informed psychologist:

• Is aware of systemic oppression and validates how those experiences impact mental health.
• Avoids making assumptions about a client’s identity or background.
• Affirms cultural identity as a source of strength.

Trauma-informed practice example:

• • If a client experiences racial injustice, I might say: “It makes sense that you feel anxious in certain spaces. Racism is emotionally scarring — and your feelings are valid.”

Using Trauma-Informed Therapy Approaches

A trauma-informed psychologist might choose therapeutic approaches designed for recovery, such as:

• Somatic Therapy – Helping clients connect with their bodies and calm the nervous system.
• Trauma-Focused CBT (TF-CBT) – Trauma-informed care through cognitive restructuring without pushing the client too fast.
• Internal Family Systems (IFS) – Helping the client understand different “parts” of themselves (such as the inner critic, wounded child, protector, etc.) in a non-shaming way.

The key to a trauma-informed practice is to move at the client’s pace and never rush processing.

Supporting Resilience and Growth

A trauma-informed psychologist doesn’t just focus on the negative — we also focus on strengths, resilience, and growth.

• Helping the client see their strengths and how they’ve survived.
• Encouraging the client to build a support network.
• Helping them find meaning or purpose, if appropriate.

Trauma-informed practice example:

“I see a lot of strength in the way you’ve protected yourself.”
“You’ve already come so far — I’m wondering what’s been helping you get through this.”

Summary of a Trauma-Informed Care Practice

Avoiding Common Pitfalls

I avoid:

• Pathologizing responses. Instead of “You’re being avoidant,” I say, “Your nervous system is protecting you.”
• I push clients to share details. Processing is not about reliving something—it’s about regaining control and safety.
• Ignoring the body. Painful feelings are stored in the body, so grounding, movement, and sensory interventions can be key to healing.

Trauma-informed Therapy Techniques

Here’s how trauma-informed care (TIC) can be applied within each of the therapeutic modalities I commonly use:

1. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Goal: Change unhelpful thought patterns and reduce distress.

How TF-CBT Differs:

Traditional CBT often focuses on changing negative thoughts, but in TF-CBT:

• I normalize responses (instead of pathologizing them).
• Focus shifts from “What’s wrong with you?” to “What happened to you?”.
• Pacing is slow to avoid triggering an unnecessary response.

Techniques in TF-CBT:

• Psychoeducation:
  • Teach the client how emotions affect the brain (fight/flight/freeze response).
  • Normalize their symptoms as adaptive survival responses, not personal failures.
    • “Your brain did exactly what it needed to do to keep you safe.”
• Cognitive Restructuring (but gently):
  • Instead of pushing for cognitive shifts too quickly, I might say:
    • “What’s a small shift you’d feel comfortable making today?”
    • “Can we find a kinder story to tell yourself about what happened?”
• Grounding Techniques:
  • Teach body-based strategies like 5-4-3-2-1 grounding, paced breathing, or movement to help regulate the nervous system.
  • Encourage physical safety first, cognitive work second.
• Window of Tolerance:
  • Educate the client about hyperarousal (fight/flight) and hypoarousal (freeze/dissociation).
  • Help them build skills to stay within their “window of tolerance” (the state where they feel safe and connected).

2. Trauma-informed Care with Acceptance and Commitment Therapy (ACT)

Goal: Help the client accept difficult emotions and build a life aligned with their values.

How Trauma-Informed Care with ACT Differs:

• Emotional scarring often creates rigid avoidance of painful emotions, sensations, and memories.
• In TIC-ACT, the focus is on making space for those experiences without overwhelming them.
• I avoid pushing clients to accept pain too quickly — safety comes first.

Techniques in TI ACT:

1. Safe Exposure to Emotions:
   • Use metaphors like “You can carry this pain without letting it control you.”
   • Small, gradual exposures to difficult memories if the client consents.
2. Self-Compassion Work:
   • Help the client develop a more compassionate inner voice.
   • Example: “Can you speak to yourself like you would speak to a friend?”
3. Grounding in Values:
   • Increase awareness of meaning and purpose.
   • Help clients reconnect with their values (relationships, creativity, safety).
   • Example: “Even when the emotions are present, what’s one small thing you can do that aligns with your values?”
4. Consent-Based Defusion:
   • Instead of pushing the client to detach from painful thoughts, invite them to consent.
   • Example: “Would it be okay if we gently looked at that thought together?”
   • This re-establishes a sense of choice, crucial for trauma survivors.

3. Narrative Trauma-Informed Therapy

Goal: Help the client reclaim control over their story and identity.

How TI Narrative Therapy Differs:

• Trauma often fragments a person’s sense of self (identity, worth, agency).
• TIC-Narrative therapy helps clients re-author their stories to emphasize strength, survival, and agency.

Techniques in TI Narrative Therapy:

1. Externalizing:
   • Separate the client from their emotional pain.
   • Example: “What happened isn’t you — it’s something that happened to you.”
   • Name the response: “It sounds like your nervous system is still in survival mode.”
2. Reclaiming Power:
   • Help the client highlight acts of resistance.
   • Example: “Even though you felt powerless, you found a way to survive — how did you do that?”
   • Shift the story from victim to survivor.
3. Post-Traumatic Growth Narrative:
   • Help the client write a new story about themselves.
   • Example: “What do you want your life to look like now, despite what happened?”
4. Slow Storytelling:
   • Never force the client to tell their story if they’re not ready.
   • Instead, say: “You can share as much or as little as you want. Your story belongs to you.”

4. Schema Trauma-Informed Therapy

Goal: Identify and heal early maladaptive schemas.

How TI Schema Therapy Differs:

• Trauma (especially in childhood) creates core schemas like:
  • “I am unlovable.”
  • “I can’t trust anyone.”
• Instead of challenging these schemas directly, a trauma-informed care approach seeks to validate why the schema exists and gently offers an alternative.

Techniques in TI Schema Therapy:

1. Limited Reparenting:
   • Act as a secure, validating presence.
   • Example: “It makes sense that your brain created this belief to protect you.”
   • Offer small corrective experiences during sessions.
2. Mode Work:
   • These early experiences often split people into different “modes” (child, protector, critic).
   • Help the client differentiate between:
     • Vulnerable Child (wounded, scared part).
     • Protective Mode (shutdown, dissociate, avoid).
     • Healthy Adult (grounded, compassionate).
   • Build  a connection between Healthy Adult and Vulnerable Child.
3. Imagery Rescripting:
   • Guide the client in visualizing a painful memory — but change the ending.
   • Example: “Imagine someone stepping in to protect you — what would you want them to do?”
   • This helps reprocess memories without re-traumatizing them.

5. Trauma-Informed Practice of Gestalt Therapy

Goal: Help the client stay present and process unresolved trauma stuck in the body.

How TI Gestalt Differs:

• Trauma disconnects people from their bodies and emotions.
• TIC-Gestalt focuses on reconnecting to the body without overwhelming the client.

Techniques in TI Gestalt Therapy:

1. Body Awareness Work:
   • Gently ask: “Where do you feel that in your body?”
   • Help the client describe the sensation (tightness, heat, heaviness).
   • Avoid pushing if the client seems dissociated.
2. Two-Chair Work (modified):
   • Use two-chair work if the client has inner conflict (like shame vs. worth).
   • Modify it to avoid overwhelm:
     “Would it feel okay to speak to that part of yourself today?”
     “We can stop anytime.”
3. Regulating the Nervous System:
   • Before processing trauma, always bring the body into a regulated state.
   • Use grounding (breath, touch, movement) to build safety in the body.

Key Trauma-Informed Care Adjustments (for all modalities):

Trauma-informed Care Example: Adolescent with Childhood Trauma

• Name: Sarah
• Age: 15
• Presenting Issue: Severe anxiety, difficulty trusting adults, emotional numbness, dissociation during conflict.
• History: Sarah experienced physical neglect and emotional abuse from ages 5-10. She was often blamed for her parents’ fights and learned to stay invisible to avoid conflict.

Building Safety and Externalizing (Narrative Therapy + CBT)

Me (or any trauma-informed psychologist): “I know this can feel scary, but you don’t have to tell me everything right now. We’ll go slow, and you can decide what you’re ready to share. I’ll follow your lead.”

Why This Works:

• I prioritize choice and safety, preventing re-traumatization.
• Sarah begins to regain control by deciding the pace.

Grounding Exercise: I teach Sarah a 5-4-3-2-1 grounding technique to help when she dissociates.

Naming the Protective Parts (Schema Therapy)

Me: “I wonder if there’s a part of you that’s really good at shutting off your feelings when things get scary. Do you think that part was trying to protect you back then?”

Sarah: “…Maybe. It’s like I just go numb so I don’t get hurt.”

Intervention:

• I validate the protector part rather than framing it as a “problem.”
• I say: “That part of you was really smart — it kept you safe.”
• This reduces shame and builds self-compassion.

Re-authoring Her Story (Narrative Therapy + Cognitive Restructuring)

Me: “What would you say to that little girl if you could go back?”

Sarah (crying): “I’d tell her it wasn’t her fault.”

Me: “Can we write that down? Like a letter to your younger self?”

Intervention:

• Sarah writes a letter to her younger self, reclaiming power and self-compassion.
• This slowly shifts her core schema from “I am bad” to “I was a child in a bad situation.”

Outcome:

• Sarah begins experiencing fewer dissociative episodes.
• Her new internal narrative shifts from “I’m broken” to “I survived something really hard.”
• I continually offer control, choice, and empowerment.

Trauma-Informed Care Example 2: Adult with Relational Trauma

• Name: Alex
• Age: 32
• Presenting Issue: Relationship conflict, fear of abandonment, over-apologizing, avoiding confrontation.
• Trauma History: Grew up in a household where expressing anger or needs resulted in punishment or rejection. Partner often says, “You never tell me what you need.”

Building Safety (ACT + Gestalt Trauma-Informed Therapy)

Me (or any trauma-informed psychologist): “When conflict comes up, do you notice anything happening in your body?”

Alex: “My stomach feels tight, and I just want to leave.”

Me: “Your body is trying to protect you from something it learned long ago.”

Intervention:

• Body awareness is used to help Alex stay present.
• The therapist doesn’t push for cognitive reframing yet — safety comes first.

Naming the Schema (Schema Therapy)

Me: “It sounds like when your partner’s upset, this voice shows up that says, ‘You’ll be abandoned if you mess up.’ Do you know that voice?”

Alex: “Yes! It’s like, if I don’t keep everyone happy, I’ll lose them.”

Intervention:

• I gently identify the Abandonment Schema.
• Instead of challenging it, they validate why it exists.

Me: “That belief kept you safe as a kid. It’s not your fault you still feel that way.”

Externalizing the Schema (ACT + Schema Trauma-Informed Therapy)

Me: “Can we give that voice a name? Like ‘The People Pleaser’?”

Alex: “Yeah… it’s like a scared little kid.”

Me: “Exactly. So when your partner gets upset, it’s not you — it’s that scared little kid reacting. Would it feel okay to talk to that part of you?”

Intervention:

• Alex imagines speaking to the scared inner child.
• This creates distance from the schema and reduces shame.

Defusing from the Response (ACT + Gestalt Trauma-Informed Therapy)

Scenario: Alex’s partner expressed frustration, and Alex immediately shut down.

Me: “What did you notice happening in your body during that moment?”

Alex: “My stomach flipped, and I just froze.”

Me: “That’s your nervous system going into ‘freeze mode.’ Would it be okay if we practiced grounding first before analyzing it?”

Intervention:

• I use a grounding exercise (cold water on hands, deep breathing).
• I never rush Alex to analyze the trauma response until the body is regulated.

Reclaiming Power (Schema + ACT Trauma-Informed Therapy)

Me: “What would it be like to ask your partner for something, even if it’s small?”

Alex: “…Terrifying.”

Me: “That makes sense. Your brain learned that asking for things leads to rejection. But what if we tried just one small thing?”

Intervention:

• Alex practices asking their partner to do something small (e.g., “Can you make me coffee today?”).
• Each time Alex asks without over-apologizing, they challenge the Abandonment Schema.
• I repeatedly emphasize choice, safety, and pacing.

Outcome:

• Alex slowly learns to stay grounded during conflict.
• His schema shifts from “I’ll be abandoned if I mess up” to “I’m allowed to take up space in this relationship.”
• Alex’s relationship improves, and their trauma response diminishes.

Summary and My Work

I believe deeply in your capacity to heal, not because I am the expert on your life but because you have already survived the hardest parts. Now, it’s about learning how to live and grow beyond survival. Together, we will work toward helping you feel more grounded, connected, and empowered in your life. You may have days where you feel strong and hopeful and others where you feel stuck or overwhelmed. Both are valid. Both are part of healing.

I am a trauma-informed psychologist, providing trauma-informed care in everything I do. Sometimes, this care is a central part of why clients come in; others, it is a secondary issue to a current challenge or barrier during life transition therapy, for example. It can also be a backdrop in couples therapy or family therapy.

Please contact me or schedule a consultation to hear more about these approaches and how they might benefit you or a loved one.

Dr. Alan Jacobson Founder and President

Dr. Jacobson is a licensed clinical psychologist providing individual, couples, and family therapy for over 20 years. He uses an integrative approach. choosing from a variety of proven and powerful therapeutic methods.

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