Evidence
References
The tools on this site draw on the research and professional guidance below. Follow your institution's policies and current clinical guidelines.
Frameworks & professional guidance
Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: SAMHSA; 2014.
Source of the Four Rs and the six core principles behind the Four Pillars on this site.
American College of Obstetricians and Gynecologists. Caring for Patients Who Have Experienced Trauma. ACOG Committee Opinion No. 825. Obstet Gynecol. 2021;137(4):e94–e99.
Recommends universal trauma-informed practices in obstetric and gynecologic care.
Research on trauma & health
Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–258.
Foundational evidence that trauma exposure is common and affects lifelong health.
Raja S, Hasnain M, Hoersch M, Gove-Yin S, Rajagopalan C. Trauma informed care in medicine: current knowledge and future research directions. Fam Community Health. 2015;38(3):216–226.
Describes a universal-precautions model of trauma-informed care for clinicians.
Ravi A, Little V. Providing trauma-informed care. Am Fam Physician. 2017;95(10):655–657.
Source for the visit-by-visit clinician actions on the TIC Facts page.
Clinical education
Elisseou S, Puranam S, Nandi M. A novel, trauma-informed physical examination curriculum for first-year medical students. MedEdPORTAL. 2019;15:10799.
Teaches narration, consent, and patient control during the physical exam.
Tillman S. Consent in pelvic care. J Midwifery Womens Health. 2020;65(6):749–758.
A framework for ongoing consent in pelvic care, cited in the DNP project protocol.
Websites
- SAMHSA: Trauma and Violence
Federal resources on trauma, including trauma-informed approaches and programs.
- National Child Traumatic Stress Network
Research, training, and resources on childhood trauma.
- National Council for Mental Wellbeing: Trauma-Informed Care
Training and implementation resources for health organizations.
- Trauma-Informed Care Implementation Resource Center
Practical tools for putting trauma-informed care into practice, from the Center for Health Care Strategies.
- VA National Center for PTSD: Information for Women’s Medical Providers
Guidance on caring for patients who have experienced sexual trauma.
- The Feminist Midwife
Scripts and positioning ideas for empowering gynecologic exams.