Structural racism has been identified as a major source of medical vulnerability for urban populations. Police brutality is a consequence of structural racism and a critical social determinant of urban health that is associated with both physical and psychological injury. However, the presence of law enforcement agents is common in the healthcare setting, especially in the emergency department. The emergency department occupies a critical social role as a major source of healthcare for vulnerable urban populations, yet very little is known about patients’ opinions regarding police activity in the ED. This study contributes to the growing body of literature on the pathogenic effects of structural racism by designing trauma informed methodology to investigate patient perceptions of police presence in the emergency room. / Urban Bioethics

My study examines trauma informed practice (TIP) policies in BC, Canada. My chosen methodology, what is the problem represented to be (WPR) (Bacchi 2009), makes politics visible in policies. I am interested in the effects of trauma policies on women who experience male violence. How does discourse produce certain effects and constitute specific subjects within these texts? I extend a politicized analysis of TIP policies, specifically, an in-depth feminist post structural analysis. I advance an understanding of the effects of policy, particularly for women who have experienced male violence and who receive services under the TIP guidelines. I note the absence of an intersectional analysis and the lack of attention paid to power relations, specifically associated with the provision of care within the health care system, the construction of the traumatized female subject and the absence of a social justice lens in TIP policies. My study addresses the meanings, and resulting practices arising from the TIP policy and its impacts on women's lived experiences. My feminist post structural analysis provides a critique of TIP policies glaringly absent from the literature. I examine available literature, which evaluates TIP. My analysis deepens the understanding of the policy's inherent assumptions by revealing the problem of trauma, as represented in TIP policies. I explore the emergence of the dominant concept of trauma in the completion of a genealogy of trauma. I uncover the commonly accepted trauma ethos, a set of principles and beliefs about violence against women that has set the path for a trauma discourse in BC's guidelines, policies, and programs. I explore my interest in iv the ontology of trauma, the nature of trauma itself and the way of being when trauma has occurred. While exploring this interest through a genealogy of trauma, I identify five historical figures; the traumatized female figure, the assaulted woman figure, the wounded veteran figure, the colonized Indigenous woman figure and the emancipated woman figure. My study explores how women are obscured and invisible in policies intended to address violence against women. I demonstrate that this invisibility results in gender-neutral policies-if there is no gender-based violence- we, therefore, do not have to think of gender-based treatment. The patriarchal erasure of women from trauma policies continually repositions what the problem is represented to be. These policies constitute women as the less valued subjects, fundamentally damaged and flawed. Trauma policies shape women as people who can damage staff; assuming they are a source of trauma infection; they can infect staff with their trauma resulting in vicarious traumatization of staff. Trauma policies characterize the traumatized female subject as fundamentally different from the staff or the professional expert. Only certain kinds of women can be traumatized, the mentally ill and substance-using women. My study exposes the presupposition embedded in policies that only certain women are violated, and other women are unlike them. This trauma discourse is grounded in racism, colonialism and sexism, built on stereotypical patriarchal representations of women, resulting in the stigmatization of women who experience male violence. / Graduate / 2022-08-25

Abstract available through the Annals of Behavioral Medicine.

This thesis evaluated the Trauma-Informed Child Advocacy Certificate (TICA) at Mississippi State University which is hosted in the School of Human Sciences, specifically in the area of Human Development and Family Science (HDFS). HDFS students (N = 94) enrolled in coursework during Spring 2021 participated in the evaluation. Students were grouped by enrollment in TICA courses, with 43 students having participated in TICA coursework and 51 students having only participated in general HDFS courses. Assessments included a perceived knowledge survey and 10 application-based scenarios. Independent samples T-tests indicated TICA students perceived themselves to have more trauma-informed knowledge, and frequency analyses showed they were more effective at applying that knowledge than HDFS students who have not taken any TICA courses. Data were used to highlight strengths of the TICA program and make recommendations on ways to enhance the TICA coursework to promote knowledge of trauma-informed professional practices.

This editorial chapter addresses the problem of burnout in academic libraries by introducing a fusion of principles from trauma-informed care (TIC) and Constructive Living (CL) to offer unique, easy-to-incorporate plans of action to identify and mitigate symptoms of burnout. These two action-based philosophies, which may be new to most readers, provide strategies for considering, practicing, and adopting perspectives and behaviors that may give those suffering from burnout new ways of thinking about their professional and personal lives. We identify accessible opportunities to connect mind and body in self-care to neutralize negative self-talk, regain perspective and balance, and foster lifelong resiliency at a pace wholly determined by the individual and without formal training or expense.

Child and Adolescent caregivers are rarely the focus of research and/or trauma-focused or informed models when working with traumatized children (Baynard, Englund, & Rozelle, 2001; Chapman, Dube, & Anda, 2007). It has been shown that use of caregivers in the treatment of children who have suffered trauma can have a significant impact on not only the child, but also reduce the trauma symptoms of the caregivers themselves (Cohen, Mannarino, & Staron, 2006). The purpose of this study is to critically review the empirical research of trauma-focused and trauma-informed trainings and treatment models for children who have suffered some form of trauma and whose caregiver is included in the treatment. The outcomes of trauma-focused models will be examined in terms of its purpose, intervention, facilitation, adaptability and modification. Implications for further research and application are drawn.

Psykiskt trauma är vanligt hos patienter inom rättspsykiatrisk vård. Det finns idag effektiva metoder som traumamedveten omvårdnad för att vårda trauma. Det saknas forskning om hur sjuksköterskor inom denna vårdkontext upplever arbetet med trauma. Huvudsyftet med studien var att utforska sjuksköterskans arbete med trauma inom rättspsykiatrisk vård. Sju semistrukturerade intervjuer genomfördes med sjuksköterskor som arbetade inom rättspsykiatrisk vård. Intervjuerna transkriberades och analyserades med konventionell innehållsanalys med induktiv ansats. Resultatet var tre huvudteman: Sjuksköterskans arbete med trauma, Hinder i att arbeta med patientens trauma och Utvecklingsmöjligheter inom vården. Sjuksköterskor använder olika sätt att identifiera trauma och önskar mer kunskap i ämnet. Sjuksköterskor erfar hinder såsom patientens egna svårigheter och organisatoriska brister. Som slutsats konstateras att sjuksköterskor beskriver svårigheter med att arbeta omvårdnadsmässigt med trauma hos patienter inom rättspsykiatrisk vård, som bristande kunskap, bristande rutiner och bristande avdelningskulturer. Sjuksköterskorna har en vilja att upptäcka, förebygga och vårda trauma genom att förändra rutiner och lära sig mer om evidensbaserade behandlingsmetoder i vårdandet av trauma. Vidare beskrivs att den finns en medvetenhet om att delar av den rättspsykiatriska vården kan vara potentiellt traumatiserande eller retraumatiserande. Sjuksköterskorna beskriver att de har metoder för att förebygga denna risk genom att till exempel arbeta med tydlig information och lugn. / Mental trauma is common among patients in forensic psychiatric care. Today, there are such as Trauma-informed Care to There is a lack ofresearch on how nurses within forensic psychiatry experience their work with trauma. The main purpose of the study was to explore how nurses describe their work with trauma in forensic psychiatric care. Seven semi-structured interviews were conducted with nurses working in forensic psychiatric care. The interviews were transcribed and analyzed with a conventional content analysis with inductive approach. The result ended up in three main themes: How the nurse works with trauma, The difficulties in working with the patients’ trauma and Opportunities for Development in Care. Nurses use different ways to identify effective methods nurture trauma. trauma and want more knowledge of the subject. Nurses experience obstacles such as the patient's own difficulties and organizational shortcomings. In conclusion, it is stated that nurses describe difficulties in working with nursing the trauma of patients in forensic psychiatric care, such as lack of knowledge, lack of routines and lack of ward cultures. Nurses have a desire to detect, prevent and nurture trauma by changing routines and learning more about evidence-based treatment methods in the care of trauma. It is further described that there is an awareness that parts of forensic psychiatric care can be potentially traumatic or retraumatizing. The nurses describe that they have methods for preventing this risk by, for example, working with clear information and being calm.

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. A two hour, Delphi reviewed, evidenced based educational session was developed for licensed nurses in two health care facilities. After the educational session is completed, an anonymous survey will be distributed to determine the licensed nurses’ awareness of trauma informed care. A second anonymous survey will be sent four weeks later to assess changes in clinical practice based on trauma informed care education. One educational session for eleven licensed nurses working in a psychiatric facility has been completed. Two preliminary themes emerged from the first survey. The first theme was more intentional focus on integrating trauma informed care principles into practice. The second theme was an increased need for self-care. Two more educational sessions are planned for licensed nurses in an acute care hospital. Keywords: trauma informed care, nursing, education, KTA Cycle, health care, policy

Intimate partner violence (IPV), substance use, and HIV are syndemic and have compounding risks that contribute to the collective physical and mental health burden among women in the United States. These syndemic factors may contribute to the significant gender-related disparities in substance use disorder (SUD) treatment. IPV is a source of stress and trauma for women, with known interactions with SUD; however, SUD services generally lack trauma-informed treatment modalities to address IPV-related health impacts. The goal of this dissertation was to improve the understanding of the associations between IPV, substance use behaviors, and SUD treatment utilization, and to inform the response to women’s needs related to IPV experiences and substance use within healthcare settings. We employed a mixed-methods approach to understand the interplay of IPV with subsequent substance use behaviors and utilization of SUD services, along with identifying differences by HIV status. We used quantitative methods to evaluate the association of specific forms of IPV (psychological, physical, and sexual) with subsequent substance use (Chapter 2) and SUD service utilization (Chapter 3), and qualitative methods to explore women’s perspectives on how IPV experiences influenced their substance use behaviors and SUD treatment and recovery (Chapter 4). The study in Chapter 2 found that incident IPV experiences were associated with increased risk of subsequent substance use, with physical IPV being more consistently associated than other IPV forms. The study in Chapter 3 found recent IPV experiences to be associated with increased SUD service utilization, whereas lifetime IPV experiences were associated with decreased utilization. Both quantitative studies highlight the complex relationship between IPV and substance use and SUD service utilization. This relationship varies by IPV form, with the syndemic interaction of IPV and HIV exacerbating adverse outcomes. In Chapter 4, qualitative findings explained mechanisms of IPV’s contribution to substance use behaviors and impediment of SUD service engagement and recovery. The interviews also highlighted the value of mental health and IPV supportive services, along with SUD treatment, for a successful SUD recovery. Overall, the findings of this dissertation emphasize the importance of using a trauma-informed approach to address IPV to facilitate women’s SUD recovery. / 2026-05-16T00:00:00Z

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