Michelle Acra
November 13, 2012 — 2,652 views  
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Being aware of abuse, trauma and Dissociative Identify Disorder triggers is crucial for receiving necessary healthcare services.   Self-advocating can build the bridge for trauma informed care.

The most common situation potentially triggering symptoms involves physical examinations.   However, other services such as physical therapy, occupational therapy, dental care, sleep studies, chiropractic and massage therapy may also trigger perceived trauma re-victimization responses.  Unfortunately, it may appear that the patient is difficult to work with, non-compliant or non-adherent when in fact these reactions are the obstacle.  When ongoing healthcare treatments are required, patients may forgo them instead of feeling overwhelmed.

Self-advocacy skills may include: asking the provider about their experience working with patients who have a trauma or abuse history, suggesting the provider include a question about trauma and abuse issues during their initial screening, or briefly sharing that oneself has a history of trauma and/or abuse.

Advocating increases provider awareness (don’t assume the provider knows about triggers), aids in receiving needed and timely care (patients may suffer needlessly for years), and creates an opening for future patients to receive trauma informed care.  As patients self-advocate, these small steps build a new history of accomplishments.  Patients become an active participant in their care (by having a voice) and shift dynamics from victim to thriver.

While processing self-advocacy skills with clients, also prepare them for potential positive, neutral and negative provider responses.

Overall concepts of self-advocacy skills involve:

  1. Trigger awareness    
  2. Educating and informing others about personal issues     
  3. Reframing treatment experiences in a more positive light with self-talk: “I am brave, I choose this healthcare as part of my healing, or I am in this present moment”
  4. Assertiveness skills to verbalize needs to one’s provider by requesting a brief pause/ break during treatment, or if the process may be modified to accommodate patient sensitivities, or that the patient will be informed about each step of the treatment.

Michelle Acra

Central Ohio Mental Health Center

I have provided therapy services to all ages in a community mental health setting for many years. My specialty areas include trauma recovery. This article is dedicated to the clients who have inspired me.