Is Your Therapist Trauma-Informed? (Part 2) + Free Questions to Ask
(Summary) Trauma-informed therapy is built on eight core principles that prioritize client safety, trust, and healing. In Part 1, I explained the first four: safety, trustworthiness, client autonomy, and cultural sensitivity. In this post, I’ll cover the remaining four—avoiding re-traumatization, knowledge of common trauma outcomes, coordination of care, and therapist self-care. These principles work together to create a safe therapeutic environment where trauma survivors, including those with DID and OSDD, can build trust, reduce shame, and begin to heal without being pushed beyond their readiness.
Have you ever heard the term trauma-informed therapy and wondered what it really means? Many people assume all therapists are trained to recognize and treat trauma—but surprisingly, that’s not the case. Trauma-informed therapy goes beyond basic counseling skills. It emphasizes safety, transparency, client choice, and cultural awareness to ensure survivors aren’t re-traumatized in treatment. For people with dissociative identity disorder (DID), OSDD, or complex PTSD, finding a trauma-informed therapist can make the difference between feeling judged and unsafe—or truly supported in healing.
In part 1, I talked about the first four of eight important principles of trauma-informed care. They are:
- Client safety
- Trustworthiness and transparency
- Prioritizing client autonomy (client’s ability to make decisions for themselves)
- Cultural sensitivity
Today, I’m going to cover the other 4 principles.
5. Avoiding Re-traumatization. Another aspect of safety in trauma-informed therapy is making efforts to avoid a client becoming re-traumatized as a result of therapy. This can happen, for instance, when a client is treated under the old paradigm of needing to tell the story of their trauma and re-experience all the horrors and emotions again. In my practice, I try to keep talk about specific trauma at a very high level, what I call the 30,000-foot flyover level. I might ask, “If you trauma was a book, what would the title be?” That’s as specific as I’d want to get initially. My intake paperwork lists various types of trauma and asks clients to mark any they’ve experienced, but I do not ask for any details at that time. I also tell clients that if anything in my intake paperwork is triggering for them, they should skip it or write “not now” on it. This is all part of my efforts to avoid re-traumatizing my clients. Many trauma clients will over-share, and this is even more likely for clients who have seen many therapists, searching for help. They feel like they need to open their trauma bag and dump it all out for me to see at the start. I do my best to prevent clients from doing this because they have no trust in me at this point and there is, at most, a limited sense of safety. They have no idea if I’m going to judge them. And, quite honestly, a lot of times when a client is allowed to over-share early on, it feels really awful and they don’t want to go back to that therapist. I want my clients to be able to share only the necessary details of their trauma histories when they are ready and feel safe. And processing of traumas should only occur once the client has the skills to handle the big emotions and the sensations the processing is likely to bring up.
6. Knowledge of Common Trauma Outcomes. Signs of trauma can be easy to miss. Trauma-informed therapy requires the therapist to understand those signs. For instance, dissociation is a very common outcome of trauma and not only is it frequently missed by therapists, they don’t even know what signs to look for. Hypervigilance is another common outcome, and its opposite, hypoarousal, is often misdiagnosed as depression. This matters because if dissociation goes unnoticed, it cannot be addressed. And if a client is misdiagnosed as having depression, they may receive a treatment that does not address the actual root cause of the symptoms. A lack of understanding of trauma is why many professionals still don’t believe DID is a real condition even though it is in the DSM. A lack of understanding of trauma is why so many people are diagnosed as having Borderline Personality Disorder or Bipolar Disorder or Schizophrenia when it’s DID or OSDD.
7. Coordination of Care. Ideally, your therapy should be coordinated with the other medical care you are receiving. In reality, however, it can be challenging to get time with your doctors and psychiatrist to do this; they are often too busy.
8. Therapist Self-Care. Your therapist should be taking care of themselves so that they are able to continue to be there for you. Trauma therapists are at risk of what is called secondary or vicarious trauma. This means, listening to details of horrible traumas, empathizing with clients, and seeing the impacts of those traumas on clients, can begin to affect therapists. It can cause therapists second-hand trauma. They have an obligation to take care of themselves so they can be able to be present with you as you work through your issues.
You can see how these eight principles work together and support each other and the client. One thing not specifically mentioned that is also important in trauma therapy is dealing with shame. Trauma survivors typically have lots of shame pertaining to the trauma. In the case of DID and OSDD, shame may be from things you were made to do by your abuser or from the thousands of times you were told and made to feel that you were worthless. Shame is easy to trigger and while it is likely to still happen even in trauma-informed therapy, the practices of trauma-informed therapy will reduce the frequency of shame and position you and your therapist to deal with the shame more effectively.
I would be very interested to hear in the comments examples of trauma-informed therapy you have experienced and why it was so helpful to you. By sharing, you can help others see what they should expect.
Frequently Asked Questions
What does ‘trauma-informed therapy’ mean?
Trauma-informed therapy goes beyond general counseling. It focuses on safety, trust, client autonomy, cultural sensitivity, and practices that reduce the risk of re-traumatization. For survivors of DID, OSDD, or complex PTSD, this approach can make therapy safer and more effective.
Why is avoiding re-traumatization important in trauma therapy?
If a client is pressured to share too many trauma details too soon, it can feel overwhelming and unsafe. Trauma-informed therapy allows survivors to share at their own pace, focusing on safety first and processing details only once coping skills are in place.
What are common outcomes of trauma that therapists need to recognize?
Trauma can lead to dissociation, hypervigilance, or hypoarousal. Unfortunately, these signs are often missed or misdiagnosed as depression, bipolar disorder, or schizophrenia. Recognizing trauma outcomes ensures the treatment matches the actual cause.
Why is therapist self-care part of trauma-informed practice?
Working with trauma survivors can expose therapists to secondary trauma. To remain present and supportive, trauma-informed therapists must take care of their own well-being. This allows them to show up fully for clients without burning out.