Guidelines to Aid Providers in Inquiring about and Responding to Women’s Trauma

Physician listening to a female patient

In response to the growing recognition of the role of trauma in physical and behavioral health conditions and the need or guidance on how to offer trauma-informed care, a group of trauma experts from multiple disciplines published a commentary in Women’s Health Issues. Edward L. Machtinger, MD, director of the Women's HIV Program and the Center to Advance Trauma-informed Health Care at the University of California, San Francisco, and his co-authors recommend ways for providers and practices “to inquire about and respond to recent and past trauma as a way of more effectively addressing many common health problems.”

The commentary recommends key preparatory steps that providers and practices can take to lay the foundation for trauma inquiry and response. Machtinger and his colleagues offer ways to inquire about past trauma, as well as both immediate and longer-term steps to help patient who disclose trauma experiences. They suggest multiple options for inquiry, including assuming a history of trauma instead of asking and screening for the impacts of past trauma instead of for the trauma itself. They also include examples of language providers can use to respond to trauma disclosures.

This commentary builds on a 2015 commentary by the same group of authors, also published in Women’s Health Issues, that provided a conceptual framework for trauma-informed primary care. Since then, the authors note, it has become clear that trauma affects the experiences and outcomes of care in specialties as well as in primary care, and so the newest publication refers to “trauma-informed care” and can be used in specialties such as obstetrics and gynecology, rheumatology, neurology, infectious disease, geriatrics, and palliative care. 

“Providers and clinics that adopt a trauma-informed approach, inquire about trauma, and provide linkages to trauma-specific services will offer new pathways to support more satisfying and effective relationships for both patients and providers,” write Machtinger and his fellow authors.

“Given high rates of childhood and adult trauma among women, improving provision of trauma-informed care has the potential to greatly improve women’s health and reduce health disparities both in the short term and throughout the life course,” said Women’s Health Issues Editor-in-Chief Amita Vyas, PhD, MHS, an Associate Professor of Prevention and Community Health at the George Washington University Milken Institute School of Public Health. “This commentary makes an important contribution to a rapidly evolving field by offering concrete guidance for providers and practices.”

Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, based in the Department of Health Policy and Management at the George Washington University Milken Institute School of Public Health. The commentary “From Treatment to Healing: Inquiry and Response to Recent and Past Trauma in Adult Health Care” will appear in the March/April issue of Women’s Health Issues