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Karen Johnson

Senior Director, Trauma-Informed Services, National Council for Behavioral Health

4 Ways to Make Patients with Traumatic Histories Feel Safe in Primary Care

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“Doctor, your 3:00 is in Room 12.”

You may have heard your receptionist refer to a patient by an appointment time rather than by name. You may think nothing of it. However, for people who already feel unsafe and insecure at the doctor’s office, this unintentionally dehumanizing remark may hinder their ability to build a trusting relationship with you.

So, what makes patients feel unsafe and uncomfortable in the doctor’s office? How can your organization train staff members to help them feel safe and calm in an environment that traditionally makes them feel uncomfortable? And why does it matter?

For example, disrobing at a doctor’s office is a common, yet uncomfortable, task for anyone. However, those who have experienced trauma in their lives may have an even more difficult time feeling secure in an environment that involves uncomfortable processes.

Here are four ways that providers can help ensure safe and secure environments for their patients and, ultimately, develop trusting relationships with patients through trauma-informed primary care practices:

  1. Set the tone. Patients who have experienced trauma may not feel they can verbalize their fears. Initiating a conversation about what makes your patient feel unsafe or uncomfortable, or explaining what is next, may help a patient share their fears and problem-solve how to address them.  Ask questions like, “Are you uncomfortable being touched?” or explain what’s happening, like “I’m going to take your blood pressure, if that is OK.” Then, respectfully respond to their fear or anxiety while listening for and soliciting solutions.
  2. Take the time.Take the time to tell your patient that your office is a safe place. Before proceeding with any procedures, ensure that your patient feels safe in your care. Language in medical settings can sometimes be off-putting; explain complicated diagnosis codes and jargon.  And, take the time to listen to their responses and problem-solve with them about how you can alleviate their fears.
  3. Be sensitive to change. How and what you say can greatly affect your patient’s ability to feel safe and secure. Receiving news about a provider’s retirement or changes in prescribing policies, for example, can alarm any patient. Those with history of trauma benefit from explanations, especially since many of these individuals are unlikely to assert themselves when they are uncomfortable.
  4. Engage and understand. Make sure your patients feel engaged and secure in your care. Simple things like asking, “What questions do you have?” rather than “Do you have questions?” creates an opportunity for your patients to open up. Other seemingly minor things, like maintaining eye contact, explaining why you may use a laptop or iPad during the visit and sitting down with your patients rather than standing over them will also create a more engaging and safe environment.

Healing from trauma is a non-linear process. It is extremely important for both provider and patient to understand trauma’s impact on a person’s experiences of services and why it matters in primary care. These few tips on how you can help make your patients feel safe and secure are only the first steps in building long-lasting, trusting provider-patient relationships.