Telehealth, COVID-19, and Social Determinants of Health: Trauma Informed Care and Intimate Partner Violence

In our last post, we discussed the ongoing interest and attention around Social Determinants of Health (SDOH) in primary care, and how telehealth has played an important role during the COVID-19 pandemic in enabling care teams to continue to screen for SDOH and support their patients’ overall health. This week, we will dig deeper into some of the challenges involved with SDOH and provide some suggestions for how telehealth can help address these challenges.

Trauma-Informed Care 

Screening for SDOH can involve discussions of sensitive and potentially stigmatizing topics, such as financial and food insecurity, and has the potential to exacerbate or cause new trauma if not done in an empathetic and patient-centered manner.

Trauma-informed care is an approach to working with patients that seeks to acknowledge the whole picture of their situation, circumstances, and history. This approach recognizes the importance of understanding patients’ lives as a whole, that traumatic experiences can have adverse effects on health and well-being, and that providers and care teams may unintentionally retraumatize or disempower patients if they do not adhere to the principles below. While trauma was once considered an atypical experience, research has shown that a majority of Americans have experienced some form of trauma during their lives. The principles of trauma-informed care include attention to each of the following:

• Ensuring physical and psychological safety for patients and staff
• Building and maintaining trust and transparency
• Peer support from individuals with lived and shared experience
• Acknowledging and reducing power differences to foster true collaboration
• Empowering and recognizing strengths and successes, and building resilience
• Recognizing and addressing biases and historical traumas with humility and responsiveness