How trauma-informed care is spreading beyond therapy offices

Trauma is an event or series of events experienced by an individual or group that has lasting effects on a person’s well-being. The primary goal of the trauma-informed approach is to avoid re-traumatizing a person. While there have been great strides in social research and trauma research in the past few decades, only in recent years have we seen trauma-informed care gain traction in mainstream areas and in many different professional spaces.

What is Trauma informed care?

Trauma-informed care (TIC) according to The Institute on Trauma and Trauma-Informed Care (ITTIC) at the Buffalo center for Social Research, is an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma. Trauma-Informed Care recognizes the presence of trauma symptoms and acknowledges the role trauma may play in an individual’s life- including service staff.

Key principles of trauma-informed care that should be taken into consideration when assessing services for trauma-informed adequacy and how it may look structurally in practice include:

  1. Safety- Ensuring physical and emotional safety
    1. It can be incorporated through welcoming common areas and respected spaces for privacy as needed 
  2. Choice- individuals are granted choice and control
    1. Informed consent is provided clearly, and concisely as well individual rights and responsibility is made known
  3. Collaboration- making decisions with individual and sharing power
    1. Emphasis on individual role in planning and evaluation of services
  4. Trustworthiness- Clarity and consistency in practice 
    1. Respectful and effective interpersonal boundaries are maintained
  5. Empowerment- Prioritizing individual empowerment and skill building
    1. Can be incorporated through providing an environment where individual is met with validation and affirmation when contacting anyone throughout the agency.

Re-traumatization is the potential risk of not utilizing trauma-informed care in many instances. Re-traumatization is any situation or environment that resembles an individual’s trauma literally or symbolically, which then triggers difficult feelings and reactions associated with the original trauma. Re-traumatization may also occur when interfacing with individuals who have history of historical, inter-generational and/or a cultural trauma experience- which is why intersectional considerations are highly recommended.

Ways that re-traumatization can occur are:

  • Violation of trust 
  • Having and individual retelling events of trauma repeatedly 
  • No opportunity for individual to offer feedback
  • Lack of boundaries 
  • Non-consensual touching 
  • Being treated as a number 

What are effective ways to incorporate these principles in an organizational structure?

  • Incorporating the approach to every aspect of the organization, creating a genuine culture change.
  • Demonstrating greater awareness of the impact of trauma on all individuals served by the program, organization, or system, including its own workforce.
  • An acceptance that trauma influence the effectiveness of all human services (care coordination, medical care, criminal justice, etc.) (SAMSHA, 2015).
  • Solution-based service approach.
  • Recognizing the pervasiveness of trauma.
  • Changing the thinking from “What is wrong with this individual?” to “What happened to this individual?”
  • “Involves vigilance in anticipating and avoiding institutional processes and individual practices
  • that are likely to retraumatize individuals who already have a trauma history”.
  • Staff at all levels change their behaviors, actions, and policies in keeping with a TIC approach

Aside from therapy offices, where else has trauma informed care been incorporated?

A 2013 survey of 2,900 participants in the U.S. found that 89.7 percent of adults have been exposed to at least one traumatic event if not multiple. One can only imagine that finding has increased steadily in the past decade or even remained consistent. With trauma being so prevalent many other professionals such as Lawyers, yoga teachers, photographers, career coaches and tattoo artists are educating themselves about the effects of trauma, approaching their work with this new knowledge in mind and labeling their businesses “trauma-informed.” Some are self-educating and creating their own curriculums and practices while others are enlisting mental health professionals such as psychiatrists, psychologists, social workers and mental health counselors to provide workshops and trainings at corporate and organizational levels.

To further explore real world implementation of trauma informed care we connected with Jessica Valentine the owner of Haven Tattoo studio in Brooklyn who has gained a following across many platforms for her work with marginalized communities in the tattoo industry for a brief overview on how she implements these values in her practice.

Q: Tell us a little about yourself and career journey as a tattoo artist.

JV: “My name is Jessica Valentine. I’m a tattoo artist and owner of Haven studio in Brooklyn, NYC. I have been in the tattoo industry for just over 15 years, tattooing for 10. I started as a shop assistant 15 years ago, slowly moving up and eventually opened Haven in 2019 which started out as a private studio and has grown into an appointment only shop with multiple artists.”

Q: What was a major factor to wanting to create a safe space for tattooing?

JV: “Tattooing can be a very intimidating experience. It’s very intimate as well. I remember being 18 walking into a shop and the artists laughing at my tattoo idea. It definitely set the tone for me on just how scary of a place a tattoo parlor can be. Even as a heavily tattooed person I still can feel as if I am being judged when walking into the door of a new shop. For many tattoos you’re undressing a bit and spending hours in extremely close proximity to a person who is stabbing you over and over again. The process is bad enough, the experience should be the pleasant part. The more I spoke to my clients, who are predominantly women, the more I heard it’s not just me who has had negative experiences. It’s 99% of my clientele as well. That’s when I decided if I wanted to see a change in the industry, I had to do it myself.”

Q: What ways do you offer a safe accommodating space for women, LGBTQIA+, and other marginalized folks?

JV: “I only tattoo women and LGBTQIA+ now. I want my clients to know there will be absolutely no one creeping on them in my space. I want them to feel as comfortable as possible. One way I do this is by being a private space. No one can walk in off the street. The address is not public. We keep it small and comfortable. We ask clients to come alone, so there are no extra bodies lingering, watching (also, Covid precautions). We really try our best to cater to our clients and let them know they have our complete undivided attention, and they are safe in our hands.”

Q: These are the Key principles of trauma informed care and trauma informed organizations:

1. Safety- Ensuring physical and emotional safety

2. Choice- individuals are granted choice and control

3. Collaboration- making decisions with individual and sharing power

4. Trustworthiness- Clarity and consistency in practice

5. Empowerment- Prioritizing individual empowerment and skill building 

What ways do you feel your business adheres to these practices?

JV: “I find that a lot of my client’s stories involved not feeling like they had a voice in the process. Some ways I work with my clients are different than how your average tattooer may work. When a client comes in, I chat with them a little, making sure they are getting comfortable. Once settled I show them my drawing. I have them take it in and ask if they would like to see any changes be made. If so it’s a collaboration. Once design is finalized, I discuss how the whole process will go so there are no surprises. I remind them multiple times I can change the placement or size of the stencil. Many people feel nervous to ask for these changes due to previous experiences, so I reiterate it’s important they voice their wants/needs. One small thing I think that makes a huge difference in overall experience is asking consent. I ask consent before I do most things “may I roll your sleeve up?” For example. It sounds so simple, but you’d be surprised how infrequent this is in the industry. I like to check in with my clients often, possibly too often lol. I am constantly asking how they are doing; offering breaks If needed. I empathize often, I communicate how I know this is painful/difficult to sit through and I remind them how well they are doing. (Even if they aren’t sitting well lol). I always ask my clients if they prefer to chat or not during their session. It’s my job to make them feel as comfortable and respected as possible.”

Q:  What ways do you hope to make a lasting impact for the tattoo industry and what other changes do you hope to see in the future?

JV: “I hope more and more tattooers catch on to simple things such as communication, consent, etc. The tattoo is not the only thing that lasts a lifetime, it’s the whole experience.  I hope some tattooers can drop their egos at the door and remember the client is putting their trust in us. At the end of the day, I know I am doing something right because so many people say their experience getting tattooed with me has been their best tattoo experience. And they keep coming back.”

Jessica has shown us that it does not take a lot to be trauma informed at it can take just the simplest changes to be more accommodating for clientele. You can see Jessica’s work and and follow her across all platforms at, @havenstudiobk, and @jesvalentinetattoos.

Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of traumatic stress26(5), 537–547.

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