Spotlight on Trauma-Informed Inclusion

Trauma is common across the Australian community. Many people accessing assistance animal services have experienced one or more traumatic events during their lives, including childhood abuse or neglect, domestic and family violence, sexual assault, war and conflict, discrimination, racism, bullying, serious accidents, natural disasters, medical trauma, institutional trauma or the loss of loved ones. Others may experience trauma associated with disability, chronic illness, repeated hospitalisation or interactions with service systems.

Trauma affects far more than mental health. It can influence physical health, cognition, communication, relationships, emotional regulation, learning, memory, executive functioning and occupational participation. Trauma may also affect how individuals interact with healthcare professionals, respond to feedback, engage in training or build trust with organisations.

Occupational therapists working within assistance animal organisations should therefore assume that some individuals accessing services have experienced trauma, whether or not it has been disclosed. Trauma-informed practice does not require knowing a person’s trauma history. Rather, it requires creating services that maximise safety, choice, trust and empowerment for everyone.

Importantly, being trauma-informed does not mean lowering professional standards or avoiding difficult conversations. Instead, it means delivering services in ways that minimise unnecessary distress while maintaining ethical practice, public safety and animal welfare.

Understanding Trauma

Trauma occurs when an event, or series of events, overwhelms an individual’s ability to cope.

Traumatic experiences are highly individual.

The same event may be experienced very differently by different people depending upon factors such as:

• previous experiences;
• age;
• support networks;
• resilience;
• culture;
• neurodiversity;
• disability;
• available resources.

Trauma should therefore be understood from the perspective of the individual rather than judged according to the event itself.

Types of Trauma

Individuals may experience many different forms of trauma, including:

• childhood abuse or neglect;
• domestic and family violence;
• sexual violence;
• war or conflict;
• refugee experiences;
• racism and discrimination;
• institutional trauma;
• medical trauma;
• disability-related trauma;
• bullying;
• workplace trauma;
• natural disasters;
• sudden bereavement;
• serious accidents;
• animal attacks;
• occupational trauma.

Many people experience multiple forms of trauma throughout their lives.

Trauma Is Common

Trauma is not rare.

For this reason, occupational therapists should avoid assuming that trauma is exceptional or that only certain groups experience trauma.

Rather than asking:

“What is wrong with this person?”

Trauma-informed practitioners ask:

“What may have happened to this person?”

or

“What experiences might help explain what I am observing?”

This simple shift encourages empathy while avoiding assumptions.

Trauma and Occupational Performance

Trauma may influence many aspects of occupational performance.

Examples include:

• concentration;
• attention;
• memory;
• planning;
• emotional regulation;
• communication;
• trust;
• decision-making;
• sensory processing;
• sleep;
• fatigue;
• community participation.

These changes should not automatically be interpreted as poor motivation, non-compliance or lack of interest.

Understanding trauma helps practitioners develop more appropriate supports.

Trauma Responses

People respond to trauma in many different ways.

Common responses include:

• hypervigilance;
• anxiety;
• panic;
• emotional numbing;
• withdrawal;
• irritability;
• anger;
• dissociation;
• avoidance;
• difficulty trusting others;
• difficulty concentrating;
• heightened startle responses.

Trauma responses may fluctuate depending upon the environment, stress levels and perceived safety.

Occupational therapists should avoid assuming these behaviours are deliberate or manipulative.

Trauma and Assistance Animal Practice

Trauma may influence every stage of the assistance animal journey.

Examples include:

• difficulty trusting professionals;
• anxiety during assessments;
• fear of making mistakes;
• sensitivity to feedback;
• difficulty attending appointments;
• avoidance of public places;
• sensory overload;
• emotional responses during training;
• challenges participating in multidisciplinary meetings.

Recognising these possibilities helps practitioners respond with empathy while maintaining professional boundaries.

Trauma-Informed Principles

Trauma-informed practice is commonly guided by several core principles.

Safety

Individuals should feel physically, emotionally and culturally safe.

Examples include:

• predictable appointments;
• welcoming environments;
• privacy;
• respectful communication;
• clear explanations;
• culturally safe practice.

Trustworthiness and Transparency

Practitioners should clearly explain:

• their role;
• assessment processes;
• documentation;
• confidentiality;
• expectations;
• decision-making processes.

Predictability supports trust.

Choice

Whenever possible, individuals should have genuine choices regarding:

• appointment times;
• communication methods;
• support persons;
• goal setting;
• participation in decision-making.

Choice promotes autonomy and reduces feelings of powerlessness.

Collaboration

Trauma-informed practice involves working with people rather than making decisions for them.

Shared decision-making strengthens engagement and trust.

Empowerment

Practitioners should recognise strengths, resilience and existing coping strategies rather than focusing solely on problems.

Supporting self-efficacy promotes long-term participation.

Avoiding Re-Traumatisation

Healthcare systems can unintentionally recreate feelings associated with previous trauma.

Potential triggers include:

• being ignored;
• being disbelieved;
• lack of privacy;
• coercion;
• unnecessary physical contact;
• unclear expectations;
• inconsistent communication;
• loss of control;
• excessive questioning;
• judgemental language.

Occupational therapists should continually consider whether aspects of service delivery could be modified to reduce unnecessary distress.

Trauma and Assistance Animals

For many individuals, assistance animals contribute significantly to emotional regulation, confidence, safety and occupational participation.

However, practitioners should avoid assuming that assistance animals replace psychological treatment or resolve trauma.

Assistance animals should be considered one component of a broader, multidisciplinary support plan where appropriate.

Similarly, practitioners should ensure that assistance animals are not exposed to situations that compromise their own welfare through unrealistic expectations or repeated exposure to highly distressing circumstances.

The wellbeing of both members of the partnership remains equally important.

Trauma and Professional Boundaries

Being trauma-informed does not mean becoming a trauma counsellor.

Occupational therapists should remain within their professional scope of practice.

This includes recognising when referral to appropriately qualified professionals is required.

Examples may include referral to:

• psychologists;
• psychiatrists;
• mental health occupational therapists;
• counsellors;
• general practitioners;
• domestic violence services;
• specialist trauma services.

Working collaboratively promotes comprehensive care.

Secondary Trauma and Compassion Fatigue

Professionals working with trauma may themselves experience emotional impacts.

Repeated exposure to distressing stories or situations may contribute to:

• compassion fatigue;
• secondary traumatic stress;
• burnout;
• moral distress.

Occupational therapists should:

• seek supervision;
• engage in reflective practice;
• maintain professional boundaries;
• access peer support;
• prioritise self-care;
• recognise early warning signs.

Healthy practitioners are better able to provide safe and effective care.

Trauma-Informed Organisations

Trauma-informed practice extends beyond individual clinicians.

Organisations should consider whether their policies, procedures and environments promote:

• safety;
• dignity;
• accessibility;
• transparency;
• collaboration;
• cultural safety;
• inclusion;
• staff wellbeing.

Trauma-informed organisations continually review systems through the perspective of both service users and staff.

Practical Strategies

Occupational therapists can support trauma-informed inclusion by:

• introducing themselves clearly;
• explaining what will happen before assessments;
• seeking consent throughout interactions;
• respecting privacy;
• allowing additional time when needed;
• offering choices where possible;
• avoiding unnecessary judgement;
• recognising strengths;
• maintaining predictable communication;
• referring appropriately when specialist support is required.

Small changes in practice often have a significant impact on how safe and respected individuals feel.

The Role of Occupational Therapists

Occupational therapists are well placed to integrate trauma-informed principles into every stage of assistance animal practice.

This includes:

• creating psychologically safe environments;
• adapting communication;
• promoting occupational participation;
• recognising trauma responses;
• supporting informed choice;
• collaborating with multidisciplinary teams;
• advocating for trauma-informed organisational policies;
• balancing the wellbeing of both handlers and assistance animals.

Trauma-informed care complements person-centred, culturally safe and neurodiversity-affirming practice and should be viewed as an integral component of inclusive service delivery.

Reflective Questions

As part of reflective practice, consider:

• How might trauma influence the person’s participation?
• Have I created an environment that promotes safety and trust?
• Have I offered genuine choice wherever possible?
• Am I interpreting behaviour through a trauma-informed lens rather than making assumptions?
• Could aspects of my communication unintentionally increase distress?
• Have I recognised the individual’s strengths as well as their support needs?

Key Message

Trauma-informed inclusion recognises that trauma is common, that its impacts are diverse and that services should be designed to promote safety, trust, choice, collaboration and empowerment for everyone. Occupational therapists do not need to know an individual’s trauma history to provide trauma-informed care. Instead, they should create environments where people feel respected, listened to and supported while maintaining professional standards, appropriate boundaries, animal welfare and public safety.

By integrating trauma-informed principles into assistance animal organisations, practitioners strengthen participation, improve therapeutic relationships and contribute to services that are compassionate, inclusive and responsive to the diverse experiences of the communities they serve.