Trauma-informed care principles guide therapists and counselors in creating environments where clients feel safe, respected, and empowered.  For many, trauma is part of their story—and they may show up guarded, unsure, or overwhelmed seeking treatment. Sometimes, just walking through the door is an act of courage. That’s why minimizing the risk of re-traumatization isn’t just best practice—it’s the foundation of safe, effective care. 

Trauma is incredibly common among individuals seeking mental and behavioral health support, and it’s essential to approach care with intentionality and compassion. Research shows that 30–50% of individuals seeking mental health treatment meet the criteria for lifetime PTSD, and two-thirds of Americans have experienced at least one Adverse Childhood Experience (ACE). These experiences increase the odds of high-risk adult behaviors and can negatively shape lifelong behavioral and emotional patterns. 

To support healing, counselors need to care with intention and compassion. 

In this blog, we’ll explore the role of trauma-informed care (TIC) in counseling and discuss key care principles. We will also share trauma-informed care training resources and implementation strategies to help counselors support recovery, build trust, and create healing-centered environments. 

What is Trauma-Informed Care?

Clients often carry trauma that is both diagnosed and unspoken—experiences that can deeply influence how they engage with you, your team, and the treatment process itself. That’s why it’s important to ask: What is trauma-informed care? It’s an approach that recognizes the widespread impact of trauma and actively works to create environments where healing can begin safely and intentionally. 

Trauma-informed care isn’t just about cautious assessments or one-time interventions—it’s a cultural shift in how your organization operates. It involves embedding awareness of trauma into every touchpoint of the client experience. 

SAMHSA defines trauma-informed care through the four “Rs”: 

• Realize the prevalence and impact of trauma. 
• Recognize the signs and symptoms. 
• Respond by integrating trauma knowledge into care. 
• Resist re-traumatization at all levels of interaction. 

SAMHSA also outlines six guiding trauma informed care principles that should shape your work: 

• Safety – Prioritize physical and emotional safety. 
• Trustworthiness & Transparency – Build trust through clear, open communication. 
• Peer Support – Encourage healing through shared experiences. 
• Collaboration & Mutuality – Emphasize partnership in treatment. 
• Empowerment, Voice, & Choice – Support autonomy and individual agency. 
• Cultural, Historical, & Gender Sensitivity – Provide care that respects identity and diverse experiences. 

While you may be thinking about trauma-informed care in terms of long-term recovery, it’s equally important to remember the client’s perspective. As Dr. Elise Snipes shares in her podcast episode “Introduction to Trauma-Informed Care,” providers are not just helping clients reach goals—they’re also helping them “survive this moment.” This balance between long-term vision and immediate emotional safety is at the heart of every trauma-informed interaction. 

Make Trauma-Informed Care Part of Your Practice Culture

Creating a safe, supportive environment isn’t a solo effort—it takes a shared mindset across your entire organization. Trauma-informed care (TIC) works best when it’s not just something you do in the therapy room, but something that lives in your culture, policies, and everyday interactions. 

One framework for building this kind of environment is Sandra Bloom’s Sanctuary Model, which weaves the best-practices of trauma-informed care into the fabric of organizational culture. 

The Sanctuary Model prioritizes not just client safety, but also staff wellbeing. Because when your team feels supported and empowered, they’re better equipped to support healing for others. 

When trauma-informed care becomes embedded into how your organization communicates, collaborates, and cares, it creates more meaningful outcomes for everyone involved. 

Trauma-Informed Care Training: A Critical Piece of the Puzzle

Trauma-informed care shapes every part of your organization. It requires a certain level of understanding, recognition, and cultural competency from everyone on your team—from the front desk staff to clinicians. That’s where trauma-informed care training comes in. 

With staff turnover and evolving best practices, regular training is critical. Here are a few reputable options for keeping your team informed and prepared:  

• TIC Training Center (Colorado): Offers three-day intensive in-person certification. 
• University of Buffalo: Online trauma-informed self-study certificate programs. 
• California Trauma-Informed Care Academy: Free online modules on the neurobiology of trauma tailored for multidisciplinary professionals.
• The Ecumenical Center: Free training with two levels of certification for organizations. 

How to Apply Trauma-Informed Care Principles in Counseling

It’s time to implement the four Rs of trauma-informed care. Make sure trauma-informed care is embedded into every part of the therapy experience—from assessments to how your team talks to clients. 

Recognize Trauma in Clients

Trauma can manifest psychologically, physically, behaviorally, emotionally, and even somatically. Recognizing these signs is an important first step for every trauma-informed care therapist because clients might not say “I’ve experienced trauma,” but they may be living with the effects every day. Here’s what to look for: 

Emotional and Psychological Signs of Trauma: 

• Intense fear, anxiety, or panic when discussing specific topics or situations 
• Dissociation or emotional numbness  
• Depression, hopelessness, or feelings of worthlessness 
• Hypervigilance  
• Difficulty trusting others 
• Intrusive thoughts, flashbacks, or nightmares related to past events 
    

Behavioral Signs Trauma: 

• Avoidance of people, places, or situations that may trigger trauma-related memories 
• Self-destructive behaviors  
• Difficulty forming or maintaining relationships 
• Aggression or irritability without a clear cause 
• Compulsions or ritualistic behaviors 
   

Cognitive and Developmental Signs of Trauma: 

• Memory problems or difficulty concentrating 
• Feeling detached or disconnected from reality 
• Negative self-perception or persistent guilt/shame 
• Difficulty regulating emotions  
    

Signs of trauma can also be somatic, impacting clients’ overall physical health and ability to function. 
 
Somatic Signs of Trauma Include: 

• Fatigue 
• Nausea 
• Diarrhea/constipation 
• Joint or muscle pain 
• Headaches 
• Heart palpitations 

You can read more about somatic complaints commonly linked to prior trauma on the Penn Medicine website. 

Incorporate Trauma-Informed Care Into Treatment Plans

To successfully integrate trauma-informed care into your therapeutic setting, you’ll want to embrace targeted strategies that create a safe, empowering experience—one that meets clients where they are and helps them move forward without re-traumatization. 

Use Trauma-Sensitive Screening & Assessments 

• Use validated trauma screening tools (e.g., ACE Questionnaire, PCL-5) while ensuring assessments are framed as optional and conducted in a non-triggering way. 
• Avoid forcing disclosure of traumatic experiences; instead, focus on how trauma may impact treatment and recovery. 
    

Integrate Safety & Stabilization Strategies 

• Teach grounding techniques (deep breathing, mindfulness, progressive muscle relaxation) to help clients manage triggers. 
• Establish predictable routines and provide clear expectations to reduce anxiety. 
    

Modify Treatment Approaches to Reduce Re-traumatization 

• Offer choice in treatment modalities (e.g., cognitive-behavioral therapy (CBT), somatic therapy, or EMDR). 
• Avoid confrontational approaches that may trigger past trauma responses. 
• Focus on what’s strong, not what’s wrong. Help clients see their strengths, even when they’re struggling. 
    

Encourage Peer Support & Client Collaboration 

• Foster a sense of connection through peer-led groups or trauma-informed 12-step alternatives (e.g., Seeking Safety program). 
• Involve clients in treatment planning, allowing them to set goals at their own pace. 
    

Educate & Support Staff 

• Ensure all team members understand how trauma affects recovery and practice empathy-driven communication. 
• Build systems for staff self-care and secondary trauma support to reduce burnout and improve client interactions.  more details, take a look at this CMS infographic. 

Speaking Like a Trauma-Informed Care Therapist

Your words can heal—or harm. For clients with trauma, language has the power to either build trust or shut them down. Even well-meaning comments can unintentionally trigger shame, fear, or withdrawal. 

A trauma-informed care therapist avoids language that pressures, shames, or overwhelms. By speaking the language of a trauma-informed care therapist, you center care on the client and use strategies of empowerment. The goal isn’t just to avoid harm—it’s to create safety through language that affirms, empowers, and meets clients where they are. Here are some examples:  

Reframe Trauma as Strength 

• Old way: “Your past trauma has made dealing with stress difficult.” 
• Reframe: “You’ve been through a lot, and it’s incredible that you’re here seeking support. What strengths have helped you cope during tough times?” 

Let Clients Set the Pace for Goal Setting 

• Old way: “Your treatment plan will only work if you follow it to the letter.” 
• Reframe: “What does success look like for you? Let’s put together a plan that fits your needs and feels doable right now.” 

Build Coping Tools 

• Teach grounding exercises (e.g., deep breathing, sensory grounding)  
• Encourage creative coping mechanisms (e.g., journaling, art, movement therapy). 

Use motivational interviewing to help clients identify their own “why” for thoughts and behaviors. 

 

Applying Trauma-Informed Care Across Counseling Settings

It’s important to implement TIC consistently, across therapy contexts and modalities, to reduce the potential for harm. Here are some strategies for group and one-on-one counseling contexts.  

Group Therapy 
In group therapy, emotional safety is foundational. Beginning with individual check-ins is key. This gives participants a chance to share their current emotional state, creating a space for vulnerability and connection. It’s also important to set clear guidelines for sharing, so everyone understands the importance of confidentiality and respect. Make sure every member knows what’s expected—and what’s safe.  Peer support can be incredibly healing. When participants share their insights and coping strategies, it fosters a sense of community and collective healing.  

One-on-One Counseling 
Start with a check-in on your client’s emotional state and discuss any recent triggers or stressors. This creates a grounded starting point—and reinforces that the client sets the tone. Use strengths-based language to empower your client, focusing on their resilience and coping skills. If discussing past trauma gets overwhelming, let your client hit ‘pause’ or redirect the conversation to topics that feel safer. Giving permission to redirect puts power back in their hands—something many trauma survivors have had taken away. 

How Radicle Health Supports Behavioral Health Organizations

For many healthcare providers, tracking Z codes and SDoH data feels like just one more administrative burden. But with the right Electronic Health ReAt Radicle Health, we design technology that supports therapists, counselors, and organizations working to improve client outcomes. 

We empower behavioral health providers through our flexible, cloud-based EHR software, offering you the capability to: 

• Build customizable treatment plans that include trauma-informed screenings and assessments 
• Track progress with secure, compliant documentation making care coordination easier and more effective 
• Streamline integrated billing and reporting for services 

Our systems also support e-prescribing and medication-assisted treatment (MAT) through eMAR functionality, med tracking, and batch administration tools. 

Whether you’re running a small practice or a multi-site agency, our tools are built to support  care from intake to recovery. 

Creating Safe Spaces for Healing

At Radicle Health, we understand the complexities of tracking and addressing social determinants of health. With over 14,000 organizations Incorporating trauma-informed care principles into your practice is a powerful way to support resilience, promote healing, and improve treatment outcomes. Whether you’re an experienced trauma-informed care therapist or new to the approach, investing in trauma-informed care training and implementation helps you create environments where clients feel truly supported. 

Ready to update your operations? 
Visit Radicle-Health.com to learn how our tools can support your team and the clients you serve.