Treating Trauma
Best Practices
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Best Practice Parameters for Clinical and Organizational Interventions

ISTSS has formulated Best Practice Parameters for trauma professionals as teachers, clinicians, and scholars. The aim is to stimulate discussion and exchange of information within the traumatic stress community.

Service providers who work with trauma survivors:

  • Refrain from dual relationships with clients/consumers, especially of the sort that would involve exploitation of any sort. In particular, sexual contacts and intimacies between client and trauma professional are especially problematic and are expressly forbidden in perpetuity by many professional organizations. Several forms of trauma specific work (e.g., disaster work, services during combat or civil unrest) may preclude the prevention of contact with clients. In these settings, persons who provide direct client services manage their relationships in such a way as to preclude developing friendships, romantic or business relationships.
  • Have the responsibility to practice within the relevant standard of care. In particular, practitioners are advised to strive to stay current with advances in relevant research and practice activities; they modify practice as needed in response to advances in research, policy, and practice.
  • Approach all assessments, interventions, techniques, and services that do not have research or observational substantiation with caution. If possible, they initiate evaluation efforts in order to assess the effects of their interventions/services.
  • Monitor the progress of interventions or services they provide. If a client appears to be stalemated, not making progress, deteriorating, and/or experiencing dangerous or intolerable risks, the practitioner seeks consultation or supervision to review the intervention/service plan and determine whether it needs to be modified or ended, whether he or she is capable of providing the intervention, and whether the client should be referred to another professional for treatment.
  • Conduct interventions with attention to their cultural, political, demographic, and religious contexts. They strive to provide services that match the needs and the specific context of the client.
  • Are sensitive to issues of trust, power, and boundaries when working with trauma survivors. Since traumatic life events (especially those involving interpersonal violence and exploitation) often affect the capacity to trust others and make choices, practitioners strive to engage clients in a collaborative process that attends to their empowerment. To whatever extent possible, clinicians encourage clients to have a say in their treatment or in the service they receive.
  • Respect the confidentiality of clients in accordance with relevant ethical guidelines and laws. Providers strive to assure that all electronic and paper records are securely maintained. When a violation of confidentiality is dictated by law (e.g., in the case of imminent danger to self or other), the clinician seeks to engage the client's cooperation and participation in the process.
  • Recognize that clinical work with trauma survivors requires attention to their own emotional health and actively seek to manage the impact of trauma work on their own lives (vicarious, secondary or indirect traumatization) through involvement in regular professional and personal renewal efforts and activities. Practitioners who experience personal or professional difficulties that interfere with their ability to function seek support, consultation, supervision, and treatment as needed. Trauma professionals seek to assist colleagues they perceive as having difficulty in their ability to function.

Learn more about the Best Practice Parameters