Why Survivor Centered Care

Person Centered, Trauma informed and Survivor Centered 

What do any of these buzzwords mean? In theory, this might depend on who you ask, practitioner, client, type of practitioner etc. As a practitioner specialized in treatment of complex trauma, person centered care is the bare minimum of any care provider. Unfortunately, as many of the clients I assist can attest, finding true person centered care is far and few between. I would go as far to argue that person centered care is in itself, trauma informed care. I state this as to say, placing another human’s experience as the forefront of the therapeutic experience and inherently trusting a client’s experience is integral to the success of and safety within the therapeutic space. As many clinicians will tell you, the quality of the therapeutic relationship between client and therapist is the greatest predictor for therapeutic outcomes (Knobloch-Fedders, 2008.) Trauma informed care has grown in popularity enormously and yet client after client are reporting undo harm from therapists when they’ve sought help for wounds and injuries requiring extreme vulnerability. The way I see it, these approaches are building blocks of the same philosophy. 

Okay, So What is Survivor Centered Care?

Respecting client terminology: e.g. abuse, domestic violence, assault and survivor, victim, person who was abused. 

We are taught to assist clients in moving to a place where they no longer identify themselves as a victim, but rather a survivor. Now, this seems well intentioned, but I think we as practitioners could take pause. I can’t help but call notice to the resistance in the therapy room when we are guiding a client to where we want them to be than where they already are. Ultimately, our comfort as therapists is less important than the client’s current lived experience as a survivor/victim. There is healing in validating and holding space for victimhood given that abuse, trauma and domestic violence are in fact victimizing experiences. This also apples to how clients label their abuse experiences. Clients are not required to utilize clinical terminology and deserve to use language authentic to them. Language provides meaning, but it also provides insight into meeting our clients where they are at without urging them to be elsewhere. 

Non-judgment and safety planning 

You don’t know what you don’t know. By this, I mean, it is incredibly important to consistently assess for client’s contact with current and past abusers in addition to their general safety. The risks of harm only increases with survivors leaving an abuser, making it pertinent to assess and create adequate safety plans throughout treatment. When safety planning, be realistic. Not all survivors/victims are able to create a “go bag” or have a familial or peer support system to stay with or reach out to. Some may label this as “resistance,” a lack of privilege is not resistance. Remain patient if working with a victim/survivor attempting to leave an abuser, the emotional and physical toll of this is incredible and we do not hold the right of judgment for clients who stay with their abusers for many valid reasons such as safety, financial concerns, and custody of their children.

Appropriate Self Disclosure and Patience

Many survivors have encountered harm from practitioners, it is important to assess this harm at the beginning of treatment to have an adequate understanding of the rapport building process you’ll be engaging in. You may notice clients with abuse and complex trauma histories are especially mistrusting. This may make it feel like an uphill battle to build an effective relationship. On the other hand, this puts immense power in the healing and assistance of a positive therapeutic relationship. Effective limited self disclosure can be immensely helpful in allowing a client to know you enough to do the work they need to.

What Survivor Centered Care Means Within My Practice as a Therapist

Survivor centered care allows me to sit with my clients in their pain while building a relationship where their experience is seen, heard and centered. Sometimes this means setting aside what I was taught to honor what I am hearing. The way I see it, we need to set aside the theories, the treatments, the interventions and just be human to human. If we cannot be human to human and create the safety needed for therapy, we cannot utilize our knowledge within treatment or interventions. If we can learn to simply be with our clients, we hold much greater power in assisting them in healing their wounds.