How to Make Your Practice Trauma-Informed

By: Anita Ashton, Deputy Registrar & Chief Regulatory Officer 

Each patient you see as a physiotherapist carries a lifetime of experiences with them into the appointment.  

Maybe they’re a survivor of abuse who struggles with being touched or someone who has previously faced discrimination in health-care settings. 

Past experiences and traumas shape how we react in the present. They influence everything from how easily we trust others to what kinds of touch or treatment we’re comfortable with. 

Trauma-informed care is about seeing your patient as an individual and putting their needs first.  

What is trauma? 

Trauma is a personal reaction to a distressing experience. That experience could include (but is not limited to) sexual, physical or verbal abuse, neglect, exposure to war, violence or accidents, stress, social isolation, loss, receiving a difficult medical diagnosis, or experiencing racism or bias.  

Trauma can impact our physical and mental health, relationships, sense of safety, trust, confidence and the way that we respond to certain situations. 

How can physiotherapists provide trauma-informed care? 

As a physiotherapist, you will have insight into a patient’s health challenges and diagnoses, but you likely won’t know their personal history. This history will have an impact on what they are expecting from you, along with how your words and your touch affect them. 

Providing trauma-informed care shifts the conversation away from “What’s wrong with you?” to “What happened to you?”  

It focuses on creating a safe space built on patient empowerment, respect, compassion, collaboration and trust. 

Here are some ways physiotherapists can provide trauma-informed care: 

• Ask for a patient’s pronouns on an intake form 

• Slow down; ask the patient if there is anything you can do to make them feel safe and comfortable while you work together; listen to their response 

• Never use language that could be interpreted as blaming the patient 

• Ask the patient if they would like to have someone else with them during the assessment or treatment 

• Take intentional steps to ensure that a patient understands what to expect during the assessment/treatment 

• Never touch a patient without telling them in advance what you are doing and why; ask them if they are OK with the touch before you proceed 

• Look for physical signs of discomfort even if the patient is not verbalizing anything 

• Consider why a patient is responding or acting in a certain way and approach them with curiosity and empathy 

• Use barriers and draping appropriately when treating sensitive areas of the body 

• Use patient centred communication 

• Remember that English or French may be your patient’s second, third or fourth language; avoid using jargon and be prepared to explain something a different way if they don’t understand 

• Learn more about how you can minimize the potential for harm and re-traumatization 

• If you practice pelvic health care, make sure you’re aware of how your treatment approaches may impact sexual abuse survivors 

Each patient’s lived experiences are unique, how you respond to them should be just as individual. 

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