The COVID-19 pandemic has prompted a rapid expansion of telehealth use in the U.S.\u00a0While articles have been published on telehealth and best practices for patient-centered communication during the crisis, none have focused on applying principles of trauma-informed care until now.<\/p>\n
COVID-19 is traumatizing for many and has a disproportionate\u00a0impact on those who have prior trauma exposure and mental health conditions. Catastrophic events, such\u00a0as natural disasters and pandemics, may serve as both newly traumatic and as potential\u00a0triggers for survivors who have endured prior trauma. Social distancing\u00a0serves to protect communities, but may amplify isolation and danger in abusive relationships or\u00a0exacerbate underlying mental illness.<\/p>\n
The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed six principles of trauma-informed care: safety, trustworthiness and transparency, peer support,\u00a0collaboration and mutuality, empowerment, voice and choice, and sensitivity to cultural,\u00a0historical and gender issues. BUSM researcher describe ways in which these concepts can be used during telehealth encounters in primary care and other specialties to help mitigate the isolating, traumatic effects of COVID-19.<\/p>\n
The researchers, experienced primary care and mental health clinicians at the Veteran\u2019s Health Administration, share their experience with telehealth and discuss the case for applying the principles of trauma-informed care to all telehealth encounters.\u00a0Their article takes a practical, skills-based approach including a case study.<\/p>\n
![\"\"](\"\/camed\/files\/2015\/06\/Megan-Gerber-1.jpg\")
\u201cTrauma-informed care is a global, \u201cuniversal precautions\u201d\u00a0approach to providing quality care that can be applied to all aspects of\u00a0healthcare and to all patients,\u201d explained corresponding author Megan R. Gerber, MD, MPH, medical director of women\u2019s health at VA Boston Healthcare System.<\/p>\n
According to the researchers, trauma-informed virtual care during the COVID-19 pandemic has the\u00a0potential to ensure and even expand continuity of medical care, offer connection and\u00a0support to trauma survivors, and enhance patient and clinician resilience in this time of need. \u201c<\/strong>Clinicians have a unique opportunity during this pandemic to apply trauma-informed care principles\u00a0early on and to envision how telehealth may contribute to a more meaningful care experience for all and a more equitable future for those we care for,\u201d said Dr. Gerber, associate professor of medicine.<\/p>\n The researchers believe it is critical for clinicians to be\u00a0mindful that the public health approach to the pandemic may actually result in trauma and\u00a0retraumatization for patients, which in turn can impact both access and response to care.\u00a0\u201cBecause trauma may be unseen, unmeasured and unnamed, it is\u00a0important to deliver all medical care with sensitivity to its potential presence. All clinicians have a unique opportunity in the setting of COVID-19 to apply a trauma-informed lens to our telehealth encounters which may promote connection, equity and healing-centered engagement in care.\u201d<\/p>\n