By Tamala Sammons, MA CCC-SLP , Senior Therapy Resource

We have become aware of Requirements for Participation, or ROPs. An area that we might not think about from a rehab perspective is the new Phase 3 requirement of trauma-informed care. This requirement is part of Quality of care:      483.25 Quality of care.

Trauma-informed care: Trauma survivors must receive culturally-competent, trauma-informed care in accordance with professional standards of practice, accounting for residents’ experiences and preferences to eliminate or mitigate triggers that may cause re-traumatization.

Currently, trauma is defined as singular or cumulative experiences that result in adverse effects on functioning and mental, physical, emotional or spiritual well-being. Trauma contributes to mental health and functional difficulties. Individuals with multiple adverse experiences are more likely to engage in health-risk behaviors and are more likely to be obese, and have higher rates of heart disease, stroke, liver disease, lung cancer, chronic obstructive pulmonary disease, and autoimmune disorders than the general population (Oral et al., 2016).

There are five primary principles for trauma-informed care.

  • This includes creating spaces where people feel culturally, emotionally and physically safe as well as an awareness of an individual’s discomfort or unease
  • Transparency and trustworthiness
  • Choice
  • Collaboration and mutuality
  • Empowerment

It is important for us to be aware of any adverse experiences our patients may have encountered and awareness of any triggers so we can work with them in an environment where they feel safe, can make choices and are empowered with their plan of care.

Our Occupational Therapists are essential partners as they can complete an occupational profile as part of their evaluation. According to AOTA, “The occupational profile is a summary of a client’s occupational history and experiences, patterns of daily living, interests, values and needs. The information is obtained from the client’s perspective through both formal interview techniques and casual conversation and leads to an individualized, client-centered approach to intervention.” The profile demonstrates occupational therapy practitioners’ commitment to clients as collaborators in the occupational therapy process and facilitates client-centered practice.

A copy of an occupational profile can be found on AOTA’s site: https://www.aota.org/~/media/Corporate/Files/Practice/Manage/Documentation/AOTA-Occupational-Profile-Template.pdf

Additionally, taking time to obtain the occupational profile is essential to allow care providers to deeply connect and align with the principles of trauma-informed care. Occupational profiles allow therapists to build trust, collaborate with and empower clients, and get to personal issues that are unique to each person they work with.

Occupational therapists are not expected to do this alone, however, as trauma-informed care is an IDT approach. Even though standard occupational therapy interventions that focus on improving function, well-being and health can support individuals with intensive needs, it is essential that practitioners know the limits of their personal knowledge and skills and be ready to refer when needed by maintaining collaborative relationships with colleagues who have advanced trauma-specific skills. Sharing this information with the IDT will help with effective care planning strategies, especially if that means bringing in other professionals to help.

 Additional Resources

  • For a complete description of each component and examples of each, refer to the Occupational Therapy Practice Framework: Domain and Process, 3rd Edition.
  • American Occupational Therapy Association (2014). Occupational therapy practice framework: Domain and process (3rd ed.).
  • American Journal of Occupational Therapy, 68, S1–S48. https://doi.org/10.5014/ajot.2014.682006
  • aota.org