Today, professionals and service providers of all kinds outside the mental health field are adopting a trauma-informed mindset. Lawyers, yoga teachers, photographers, career coaches, and tattoo artists are learning about the effects of trauma, approaching their work with this new knowledge in mind, and calling their businesses “trauma-informed.”

Although mental health professionals take courses and receive certification from academic and professional organizations that specialize in trauma-informed training, those outside the field rarely have access to similar training. There is no consensus on how to vet professionals outside the mental health field, nor is there a governing body that regulates trauma-informed programs. This means that non-mental health professionals may receive inadequate training.

Vaile Wright, senior director of healthcare innovation at the American Psychological Association, said the risk this poses is two-fold. “If consumers expect a trauma-informed yoga teacher to heal or treat their trauma, I think you run the risk that that expectation is obviously not met, and therefore a consumer might not ask for help in another way, like [with] a professional. At worst, it could end up being re-traumatizing.

When training is not available, interested professionals such as Rosie Valentine, a photographer from central North Carolina who trauma labels their services, create their own curriculum.

“I really care about my clients’ emotional experience and their safety. I recognize that I cannot create a 100% safe space all the time. It’s just not humanly possible,” Valentine said. “I don’t know people’s individual triggers to the nuanced extent that they exist as living, complex people, and their lived experience.”

Valentine’s trauma-informed approach involves consent, communication and boundaries. For portrait clients in particular, Valentine makes herself available for hours of pre-shoot consultation, where they agree on the types of poses, interaction and language the client is comfortable with, when and where to shoot. will take place, and how Valentine can make the experience positive. Valentine said photoshoots often begin with a moment of silence. “It’s usually a pretty tender and vulnerable experience for the people being photographed. … It’s a pretty vulnerable space together.

As the growing interest in providing trauma-informed care suggests, trauma is common. Investigation of 2,900 participants found that up to 89.7% of adults in the United States have experienced at least one traumatic event, and exposure to more than one is the norm. According to the Substance Abuse and Mental Health Services Administration, childhood trauma is common: At age 16, more than two-thirds of children report at least one traumatic event.

Traumatic events can include community, school, racial, and domestic violence, physical or sexual assault, emotional abuse, loss of a loved one, neglect, natural disasters, and refugee or war experiences, although this list is far from exhaustive.

The effects of these events can be profound and long-lasting and can manifest in many ways, including anxiety, depression, inability to concentrate, self-harm, violent behavior, suicidal thoughts, intense memories and traumatic event, dissociation, sleep disturbances and avoidance of emotions and sensations associated with the traumatic event.

To be trauma-informed, said Carol Tosone, a professor of social work at New York University who co-directs its trauma-informed clinical practice program, is to assume “that trauma is pretty pervasive, that it’s is prevalent, that anyone could experience it, and you have to be sensitive to the fact that anyone could experience it. She also noted that what a person registers as trauma, a another may not be.

Aaron Skinner-Spain, a licensed clinical social worker who co-directs NYU’s trauma-informed program with Tosone, characterized the approach as one that asks, “What happened to you?” not “What’s wrong with you?”

Trauma awareness is particularly appropriate in settings where physical contact may occur, such as a yoga class, Tosone said. “You go to the studio, you do your poses. The instructor can come and correct your pose to help you deepen it. For someone who has experienced trauma, she says, being touched can cause a deeply painful or unpleasant reaction. “Now, considering the trauma, what the instructor would say is, ‘Can I approach you? Can I lay hands on you?

Jenn Turner, a Boston-based licensed mental health counselor, founded the Trauma Center Trauma-Sensitive Yoga, a program to train yoga instructors in trauma awareness. The 300-hour certification course includes classroom work, mentoring, observation, assessment, and research, and it requires participants to pursue ongoing training and annual supervision to maintain their degree.

For professionals like Valentine, the photographer, finding trauma-friendly training can be difficult. There are no licenses or certifications for photographers, so they must create their own curriculum. Valentine said they draw on their previous work at a domestic violence agency and their undergraduate courses in subjects such as sociology, human rights and colonialism, in addition to keep abreast of current research. “I am constantly working to learn and grow in this area. I think this is the thing I will always learn and grow in. I feel confident doing trauma-informed work at this point, but I also recognize that there is so much room to grow.

Professionals who seek to incorporate trauma into their work often do so for deeply personal reasons. “As someone who’s been through a lot of trauma in my body and mind in life, it’s really important to me to support others with trauma services,” Valentine said, “and I’m really passionate about it. affirmation from people, especially other people in the LGBTQIA community.

Ruby Gore is a tattoo artist from Philadelphia who learns about trauma. Like everyone in his field, Gore spends a lot of time in close physical contact with others, which can be difficult for someone who has been through a traumatic experience. She said that when several clients began asking her to cover up scars, often the result of a traumatic event or its long-term effects, she recognized that she needed a specialist approach.

“I was like, you know, I’ve never done this before. It’s something that’s important to me. I’d like to learn. Gore said she started by having a more experienced tattoo artist supervise and by doing her own research online.Now she is working with a friend in social work to figure out how she can help clients feel safe during the tattooing process.

Like Valentine, Gore’s motivation is personal. As someone who has experienced trauma themselves, “seeing how [scar coverups] brought so much hope and light to the person I had tattooed was…so gratifying on another level that I couldn’t even explain it.

Because there are few formal educational opportunities in trauma, not everyone receives adequate training. Skinner-Spain, with NYU, said the risk of someone outside of mental health educating themselves and labeling their work as trauma is that they may not be ready to deal with trauma responses or to hear about traumatic experiences. “Listening to stories of hurt is difficult both for the practitioner, if you are not equipped and experienced enough to handle it, and also for the person, if you cannot contain the emotional charge and intervene appropriately. “

How professionals represent themselves matters, said New York-based psychotherapist Jennifer Benetato, who specializes in trauma and addiction recovery. It’s a good sign if they’ve been trained by a mental health practitioner, but it doesn’t mean that person is qualified to say, “Please tell me all your traumas, let’s heal everything.” this,” she said.

One of the most popular texts for those seeking to develop trauma awareness is “Body Keeps Score: Brain, Mind, and Body in Trauma Healingwhich documents and explores the effects of trauma. Author, psychiatrist and trauma researcher Bessel van der Kolk said he was encouraged by the “quite significant and quite revolutionary” growing awareness of trauma and its effects. He nevertheless expressed reservations about using the trauma-informed label outside of mental health.

“I like to think I know something about trauma,” he said. “I would never call myself a trauma-informed practitioner because I know people have their own reactions and you can get some very unexpected responses.” He also noted that the term trauma can be over-applied.

Van der Kolk worries that some practitioners are hiding behind the label, using it as a buzzword. If someone wants to claim trauma awareness, he said, there has to be a demonstrable change in the way they work with and relate to clients. “I would say, ‘What do you mean? What have you learned? How do you do things differently? »

“I think the label doesn’t really tell me how good you are, but your results [do].”

Emily McCrary-Ruiz-Esparza is a Richmond-based freelance writer who covers workplace culture, politics and issues facing women. Find her @emilymccrary.