What is Compassionate Trauma-Informed Healthcare?

Compassionate trauma-informed healthcare brings together compassionate care with trauma-informed principles.   It has compassion at the heart, which changes how individuals, teams, leaders and systems operate.  It’s about creating healthcare systems that support staff and service users, recognise that anyone can be affected by trauma, and support more sustainable healthcare.  While this blog focuses on healthcare, a lot of what’s shared here is equally relevant to social care and other sectors.

In compassionate, trauma-informed working, compassion is not only an individual skill – it’s embodied and enacted at every level of the organisation.  This requires shared responsibility, awareness, and practice, across leadership, teams, and systems.

Compassionate trauma-informed healthcare recognises that both service users and healthcare professionals are human beings with needs, vulnerabilities, strengths and life experiences that shape how they experience healthcare.

It supports us in being present with suffering, understanding people’s experiences and responding wisely.  As relational beings, connection, belonging, and compassionate relationships are fundamental to our health, wellbeing, and collective flourishing.  Trauma-informed principles help ensure this care is delivered in ways that promote safety, trust, collaboration, choice and empowerment.

Together they create conditions where people are more likely to feel heard, respected and supported.  They help to cultivate conditions of safety, trust, collaboration and compassionate care, along with reducing the risk of retraumatisation.

What is Compassion?

To understand compassionate healthcare it’s important to understand what compassion is.  Through the lens of compassion focused therapy (CFT), compassion is the recognition of suffering and the desire or motivation to try and alleviate or prevent it.  It is something we can train and it is innate within us.

In CFT compassion has three core qualities: a caring commitment to engage with suffering and try and alleviate it, the courage to turn towards difficulty, and wisdom which involves recognising the complexities of being human, understanding the root causes of suffering, and responding in ways that are wise and with the intention of being helpful.

CFT also describes a number of attributes and skills that support compassion.  Attributes include sensitivity to suffering, distress tolerance, and care for wellbeing.  Skills include compassionate attention and compassionate behaviour.  Other qualities often associated with compassion include patience, kindness, humility, non-judgement and curiosity.

Compassion can flow in three directions: towards others, from others, and towards ourselves (from ourselves).  Many people find self-compassion the most difficult of these.  Compassion directed towards ourselves is essential in healthcare, and in life more generally.   Without self-compassion, it becomes harder to sustain compassionate attention, behaviour and care over time.

Compassion is both a motivation and an experience.  We can feel compassion, cultivate it intentionally, and strengthen the qualities and skills that support it.  Through practice and embodiment, compassion becomes more than something we do occasionally — it becomes a way of being that influences how we relate to ourselves, others and the wider world.

Compassion is commonly misunderstood as soft and fluffy.  Whilst compassion can have a gentle and nurturing quality, it also requires great courage.  It supports us in leaning into suffering, conflict, challenge and difficulty, rather than turning away or rushing to try and ‘fix’ things.  This includes navigating difficult behaviour and conversations.

Compassion in Healthcare

Compassion in healthcare is more than being kind.  It is reflected in how we listen, relate, communicate and respond to suffering, and how compassion is embodied within teams, organisations and systems.

Compassionate care is a whole person approach to care and involves a variety of aspects like curiosity, non-judgmental listening, presence and being with the person and all of what’s present, awareness of ourselves and others, awareness of what is happening relationally, effective communication, clarity, and respect for individual experiences and values.

I like a term that Professor Michael West uses around presence and being with the other person and their experience, which is attending.  This refers to presence and deep listening and Michael says listening with fascination.

Before trying to help, we first need to attend and be with the person and their challenges or suffering, listening deeply with curiosity and a genuine desire to understand.  We need to acknowledge and validate what is present before moving towards wise action.

What Does Being Trauma-Informed Mean?

Trauma-informed working is not the same as trauma-sensitive or trauma aware, all of these matter.  Trauma-informed working recognises the profound and wide-reaching impact of trauma on individual lives and collectively.   There needs to be an understanding of trauma, the many ways it can present, and the need to prevent retraumatisation or further trauma.  There are 6 key principles of trauma-informed practice:

• Safety
• Trustworthiness and Transparency
• Choice
• Collaboration
• Empowerment
• Cultural, Historical and Gender Awareness

You can read more about Trauma-Informed Practice here: https://unityphysio.co.uk/services/trauma-informed-practice/

Trauma-informed principles are naturally supported when compassion is embodied at individual, team and organisational levels.  Safety, trust, collaboration, empowerment and choice are not separate from compassion; they are expressions of compassion in practice.

Why Does it Matter? 

We face significant challenges across health and social care, including workforce pressures, chronic work overload, high levels of stress and burnout, increasing demand and inequities in access and outcomes; and waiting lists in healthcare are long.  We need to address a variety of issues and better meet the core human needs of staff and the people using healthcare services.  There are some pockets of good compassionate healthcare, within individual practice, teams, and whole organisations and trusts.  This needs to be more the norm than the exception.

Compassionate healthcare has been shown to help decrease the risk of burnout, improve team working, improve job satisfaction, improve service user engagement and outcomes.  It’s also important for sustainability. It values diversity, supports inclusion, and enables organisations to benefit from the collective wisdom, experience and perspectives of their teams.  Compassionate trauma-informed healthcare recognises that sustainable wellbeing requires attention to both individuals and the systems in which they work.

“Compassion is the single most important intervention we have in healthcare” Professor Michael West

The potential benefits for staff include:

• Supports nervous system regulation, trust and a sense of belonging
• Enhances therapeutic relationship and professional relationships
• Improves wellbeing including mental health and overall wellbeing
• Reduces work-related stress
• Lowers the risk of burnout and vicarious trauma
• Increases work satisfaction

Burnout is often framed as an individual problem requiring individual solutions.  While personal wellbeing practices can help, they cannot compensate for systems that repeatedly fail to meet core human needs.  It is not a resilience issue of individuals, it’s largely a systemic issue.

When people have little autonomy, feel disconnected from others, experience chronic overload, lack resources, or feel unable to influence change, stress and burnout rise.   Part of this is core human needs not being met, this increases threat system activation.

It’s also wider than this — it’s a societal issue too.  We have a society that encourages over doing, striving, not resting, and feeling like nothings enough.

It is essential that staff feel understood, valued, trusted, and cared about.  Working within a compassionate culture supports this and creating well structured teams.

There are also a number of potential benefits for the organisation, including:

• Improved effectiveness and sustainability
• Reduced sickness absence and staff turnover
• Supports healthy boundaries and sustainable workloads
• Stronger team dynamics, communication, and collaboration
• Enhances service user experiences and outcomes

It also has a number of potential benefits for service users including:

• Supports nervous system regulation
• Decreases the risk of retraumatisation
• Improves engagement with services
• Enhances satisfaction and care outcomes
• Promotes healing and recovery

When healthcare is not compassionate and trauma-informed, people can leave encounters feeling dismissed, invalidated or blamed. Some avoid seeking support in the future, others disengage from treatment or lose trust in healthcare services altogether.

Creating compassionate, trauma-informed healthcare is about more than improving individual interactions.  It helps create cultures where staff can flourish, service users feel heard and supported, and compassion ripples out into families, communities and wider society.

Summary

Compassionate trauma-informed healthcare is not only about reducing harm and improving service user outcomes.  It’s about creating conditions where people, teams and organisations can work, heal and thrive sustainably over time.

When people feel heard, understood and supported, they are more likely to engage with care, communicate openly, and participate in decision-making.  This can contribute to improved experiences, more effective care and better outcomes.

Creating compassionate, trauma-informed healthcare is about more than improving individual interactions.   It helps create cultures where staff can flourish, service users feel heard and supported, and compassion ripples out into families, communities and wider society.

Part two of this blog explores what can support the cultivation of compassionate trauma-informed healthcare, including compassionate leadership, nervous system regulation, self-compassion, embodiment, reflective practice and collective wisdom.  You can read part two here: https://unityphysio.co.uk/?p=8420&preview=true

You can find out more about my work in this area here: https://unityphysio.co.uk/services/compassionate-trauma-informed-working/