Trauma Informed Care in Disability Support: What It Means and Why It Matters

When providing personal care, domestic assistance, or community access support in Melbourne, I regularly work with people who have experienced trauma. This isn't surprising—research consistently shows that people with disability experience trauma at significantly higher rates than the general population, whether from abuse, medical procedures, institutional care, accidents, grief, or countless other sources.

Having completed CHCMHS013 - Implement Trauma Informed Care, I'm trained to provide support that acknowledges trauma's impact without requiring disclosure, creates safety and predictability, and avoids re-traumatisation. Here's what trauma informed care actually means in practice and why it matters for disability support.

What Is Trauma?

Trauma isn't just one type of experience. It can result from single events like accidents, assaults, or natural disasters, ongoing experiences such as abuse, neglect, or chronic illness, medical trauma from painful procedures, hospitalisations, or loss of bodily autonomy, institutional trauma from experiences in care facilities, group homes, or hospitals, vicarious or secondary trauma from witnessing others' trauma, historical and intergenerational trauma affecting communities and families, and grief and loss including loss of health, mobility, independence, or loved ones.

For people with disability, several factors increase trauma exposure: higher rates of abuse and neglect, frequent medical interventions (often from childhood), experiences of institutionalisation, loss of autonomy in care settings, and ongoing experiences of discrimination and exclusion.

The point isn't to assume every person with disability has trauma, or to define people by their trauma experiences. It's to recognise that trauma is common enough that all support should be delivered in ways that are safe for trauma survivors—whether or not their specific history is known.

What Trauma Does to the Brain and Body

Understanding the neuroscience of trauma helps explain why trauma informed approaches matter:

The Stress Response System

When we experience threat, our nervous system activates fight, flight, or freeze responses. For people with trauma, this stress response can become dysregulated—either hyperactive (constantly on alert, easily triggered) or hypoactive (shut down, numb, disconnected).

This means situations that seem minor to others can trigger intense stress responses in trauma survivors. A support worker arriving late, an unexpected touch, a change in routine—these can activate the same alarm systems as the original trauma.

Memory and Triggers

Traumatic memories are stored differently than ordinary memories. They can be fragmented, sensory-based, and easily triggered by reminders of the original trauma. A particular smell, sound, tone of voice, or type of touch might trigger trauma responses even when the current situation is safe.

Triggers aren't always obvious or logical. Someone might be triggered by things that seem unrelated to their trauma because of sensory associations they may not consciously remember.

The Window of Tolerance

Everyone has a "window of tolerance"—a zone where we can manage stress and stay regulated. Trauma often narrows this window, meaning trauma survivors can move more quickly into hyperarousal (anxiety, panic, aggression) or hypoarousal (shutdown, dissociation, numbness).

Trauma informed support aims to keep people within their window of tolerance by minimising unnecessary stressors and providing predictability and safety.

The Principles of Trauma Informed Care

The CHCMHS013 training covers six core principles that guide trauma informed practice:

Safety

Creating physical and emotional safety is foundational. This means ensuring the physical environment is safe and comfortable, being reliable and consistent in behaviour, maintaining appropriate boundaries, being transparent about what will happen during support, and responding calmly to distress rather than escalating.

Safety isn't just about avoiding danger—it's about actively creating conditions where people feel secure.

Trustworthiness and Transparency

Trust is often damaged by trauma, especially when perpetrated by people in caregiving or authority roles. Building trust requires being honest and clear in communication, following through on commitments, being transparent about decisions and processes, acknowledging uncertainty rather than making promises you can't keep, and being consistent over time.

Trust isn't demanded or assumed—it's earned through consistent trustworthy behaviour.

Peer Support

Connection with others who have shared experiences can be powerful for trauma recovery. While peer support isn't always part of direct disability support work, trauma informed workers can encourage connection with peer support networks, disability advocacy groups, and shared interest communities, recognising that professional support isn't the only valuable form of support.

Collaboration and Mutuality

Trauma often involves powerlessness. Trauma informed care actively shares power by involving participants in decisions about their support, respecting expertise participants have about their own needs, working collaboratively rather than directively, and avoiding unnecessary hierarchical dynamics.

This aligns naturally with the NDIS principle of choice and control, but goes deeper—recognising that genuine collaboration helps heal the powerlessness of trauma.

Empowerment, Voice, and Choice

Trauma informed approaches prioritise participant empowerment by maximising choice in all aspects of support, supporting skill development and independence, validating participant perspectives and experiences, and focusing on strengths rather than deficits.

This means asking "what would you like?" rather than telling, offering options rather than directives, and believing participants when they communicate their needs.

Cultural, Historical, and Gender Issues

Trauma must be understood in context. This includes recognising intergenerational trauma affecting Aboriginal and Torres Strait Islander communities, understanding how cultural background affects trauma expression and healing, acknowledging gender-based violence and its impacts, and being aware of how identity factors intersect with trauma experiences.

Trauma informed support isn't one-size-fits-all—it's responsive to each person's cultural and social context.

What Trauma Informed Support Looks Like in Practice

These principles translate into practical approaches throughout disability support work:

Before Sessions

Consistency and predictability: Arriving when expected, communicating about any changes in advance, and following established routines unless the participant wants to change them. Surprises and unpredictability can be triggering.

Clear communication: Letting participants know what to expect from the session, what tasks are planned, and any changes from usual routine.

During Personal Care

Personal care support involves physical proximity, touch, and vulnerable situations—all potential triggers for trauma survivors. Trauma informed approaches include always asking permission before touching, narrating what you're doing ("I'm going to help you with your shirt now"), giving participants control over pace and approach, being attentive to signs of distress and adjusting accordingly, respecting modesty and privacy absolutely, and never rushing intimate care tasks.

Example: Rather than reaching to help someone undress, a trauma informed approach is: "I'm going to help you take your shirt off now. Is that okay? Would you like to start with the buttons yourself, or would you like me to help from the beginning?"

During Community Access

Community access support involves navigating environments that may contain triggers. Trauma informed approaches include discussing the plan before going out, identifying potential stressors in advance, having exit strategies if the participant becomes overwhelmed, checking in about comfort levels during activities, and not pushing participation beyond what feels safe.

Example: Before visiting a crowded market: "Markets can be really busy and loud. How are you feeling about that today? Would you like to plan some quiet spots we can step away to if it feels like too much?"

During Domestic Assistance

Even domestic assistance tasks benefit from trauma informed approaches. Respecting the participant's home as their safe space, asking before rearranging or moving things, being predictable in how tasks are approached, and maintaining appropriate boundaries in private spaces.

When Distress Occurs

Sometimes despite best efforts, participants become distressed or triggered. Trauma informed responses include staying calm and grounded, using a gentle, low tone of voice, not taking distress personally, offering grounding techniques if helpful ("Let's take some slow breaths" or "Can you feel your feet on the floor?"), providing space if that's what the person needs, not requiring explanation or disclosure, and following up with care and without judgment.

What Trauma Informed Care Is NOT

Understanding what trauma informed care isn't helps clarify appropriate practice:

It's Not Therapy

Support workers are not therapists. Trauma informed care doesn't mean providing trauma therapy or processing—it means delivering support in ways that don't cause additional harm. If a participant needs trauma therapy, that's a referral to a psychologist or counsellor, not something the support worker provides.

It Doesn't Require Disclosure

Participants don't need to disclose their trauma history for support to be trauma informed. The whole point is that support is delivered in trauma-sensitive ways regardless of whether specific history is known. I don't need to know what happened to you to provide support that's safe for trauma survivors.

It's Not About Walking on Eggshells

Trauma informed care isn't about being so cautious that support becomes awkward or ineffective. It's about building genuine safety and trust, not treating participants as fragile. With good trauma informed practice, support can be warm, natural, and even playful—safety enables connection.

It's Not Treating Everyone as a Victim

Trauma informed approaches recognise resilience as much as vulnerability. Many trauma survivors are remarkably resilient and don't want to be treated as damaged or fragile. The focus is on creating conditions that support healing and empowerment, not on emphasising victimhood.

Signs Someone May Be Experiencing Trauma Responses

Support workers trained in trauma informed care learn to recognise potential signs of trauma responses:

Hyperarousal signs: Heightened startle response, difficulty sitting still, rapid speech, scanning the environment, sleep disturbances, irritability, or anxiety.

Hypoarousal signs: Flat affect, difficulty engaging, seeming "checked out" or distant, slow responses, difficulty making decisions, or emotional numbness.

Behavioural signs: Avoiding certain topics, places, or activities, strong reactions to seemingly minor events, difficulty trusting, perfectionism or people-pleasing, or difficulty with boundaries.

These signs don't confirm trauma—many have other explanations. But recognising them helps support workers respond appropriately rather than misinterpreting behaviour.

Avoiding Re-traumatisation

One of the most important aspects of trauma informed care is avoiding re-traumatisation—causing additional harm by recreating dynamics similar to original trauma:

Power imbalances: Support relationships inherently involve power differences. Making decisions without input, being directive, or dismissing participant preferences can echo experiences of powerlessness.

Boundary violations: Touching without permission, invading personal space, or being intrusive can echo experiences of physical violation.

Unpredictability: Inconsistent behaviour, broken promises, or chaotic support delivery can echo unstable or neglectful environments.

Dismissal: Not believing participants, minimising their experiences, or invalidating their feelings can echo past experiences of not being believed or taken seriously.

Coercion: Pressuring participation, forcing decisions, or "knowing what's best" can echo experiences of having autonomy removed.

The goal isn't perfection—it's awareness. When support workers understand how trauma works, they can minimise these dynamics and respond appropriately when they accidentally trigger distress.

Working with Trauma and Mental Health Complexity

Many NDIS participants have both disability and mental health conditions, sometimes including conditions directly related to trauma like PTSD, complex PTSD, or dissociative disorders. Trauma informed approaches are especially important for participants with mental health complexity, those who have experienced psychiatric hospitalisation, participants transitioning from institutional to community living, those with histories of abuse in care settings, and participants whose disability resulted from traumatic events.

For these participants, the quality of everyday support relationships can significantly impact mental health and recovery. Consistent, safe, trauma informed support isn't just about task completion—it's therapeutic in itself.

Self-Care for Support Workers

Working with trauma survivors can be challenging. The CHCMHS013 training includes understanding vicarious trauma and secondary traumatic stress that can affect workers, the importance of debriefing and supervision, self-care strategies to maintain wellbeing, and knowing when to seek additional support.

Support workers can't provide trauma informed care if they're burnt out, traumatised themselves, or emotionally depleted. Sustainable practice requires attention to worker wellbeing too.

Why CHCMHS013 Training Matters

The CHCMHS013 - Implement Trauma Informed Care unit provides formal training in everything discussed above: understanding trauma and its impacts, applying trauma informed principles, recognising trauma responses, avoiding re-traumatisation, and responding appropriately to disclosures.

While any support worker can be kind and caring, formal training provides a framework for understanding why certain approaches work, language to communicate about trauma informed practice, strategies for difficult situations, and recognition that this is a professional skill, not just personality.

For participants who have experienced trauma, knowing their support worker has this training can provide additional confidence that their needs will be understood and respected.

Trauma Informed Care and Other Certifications

Trauma informed approaches complement other aspects of qualified support work:

Certificate III in Individual Support: The foundational qualification covers person-centered care, but trauma informed training deepens this with specific understanding of trauma impacts.

Manual handling (HLTWHS005): Physical assistance involves touch and body contact. Trauma informed approaches ensure this is done with full consent and sensitivity to how physical contact can be triggering.

Medication assistance (HLTHPS006): Medication routines can echo institutional experiences. Trauma informed approaches maximise participant autonomy in medication management.

Food safety (HLTFSE001): Food can be connected to trauma (eating disorders, food restriction in institutions, etc.). Trauma informed meal preparation respects participant autonomy around food.

Together, these qualifications create comprehensive capability for safe, skilled, trauma-aware support.

Questions Participants Might Ask About Trauma Informed Care

If you're considering whether a support worker provides trauma informed care, here are useful questions:

"Do you have trauma informed care training?" Look for specific training like CHCMHS013, not just general claims of being "trauma aware."

"How do you approach building trust with new participants?" Good answers involve patience, consistency, letting trust develop naturally, and not expecting immediate trust.

"What would you do if I became distressed during a session?" Good answers involve staying calm, offering support without pressure, giving space if needed, and following up with care.

"How do you ensure I have choice and control in my support?" Good answers involve asking rather than telling, offering options, and respecting decisions even if they disagree.

"Do I need to tell you about my history for you to support me well?" The correct answer is no—trauma informed support doesn't require disclosure.

My Approach to Trauma Informed Support

With my CHCMHS013 - Implement Trauma Informed Care certification, I apply these principles throughout my support work in Melbourne's inner south:

I assume nothing about your history but approach all support as if it needs to be safe for trauma survivors—because for many participants, it does. I prioritise your autonomy and choice in every interaction, ask before touching, explain what I'm doing, and create space for you to set the pace.

If you're a trauma survivor, you don't need to explain your history. You don't need to justify your needs or preferences. You just need support that's predictable, respectful, and safe. That's what trauma informed care means in practice.

And if you're not sure whether you've experienced "trauma" or whether it's relevant to your support—that's fine too. Trauma informed support benefits everyone. Predictability, respect, and genuine collaboration are good support practice regardless of trauma history.

Related Resources

• Personal care services delivered with trauma informed approaches
• CHCMHS013 - Implement Trauma Informed Care unit details
• Blue Knot Foundation - Australia's leading trauma-specific organisation
• Phoenix Australia - Centre for Posttraumatic Mental Health
• FAQ: What is trauma informed care?
• Contact me to discuss trauma informed support