Introduction
Jane is a 31 year old female who has been recently admitted in an acute mental health unit; she suffered from childhood trauma and domestic violence. The report will consider case of Jane for undertaking comparative analysis between two important approaches within mental health nursing- Trauma-Informed care (TIC) and Recovery- Oriented Care (ROC). Comparison between these approaches will be undertaken and subsequently, similarity and differences would be highlighted. Furthermore, critical evaluation of the strategies comprehending with TIC and ROC will be done and its implication on Jane’s case would be considered. The prior focus will be integrated on presenting person-centred and safe care approaches for supporting Jane.
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Definitions and Core Principles
Trauma-Informed Care (TIC):
TIC delineated as that framework which focuses on addressing the drastic impacts developed from a traumatic event. This framework is specifically undertaken for supporting patient and subsequently, healthcare providers can improve patient outcomes by identifying the trauma related symptoms (Dowdell & Speck, 2022).The motive of this care is to avoid the chances of re-traumatisation for patient. The key principles are comprises with safety, trustworthiness, choice, collaboration, empowerment and peer support. TIC significantly focuses on assessing the symptoms for instance- In Jane’s case her history of childhood abuse and domestic violence are identified as significant domains and that needs to be focused out for taking corrective measures. Implementation of TIC supports in developing safe and predictable environment that fosters trust and validates emotions of patient (Dowdell & Speck, 2022).
Recovery-Oriented Care (ROC):
ROC is explicated as a person-centred approach which focuses on working with patient in responsive, respectful and collaborative manner. It is merely not limited to assessing symptoms and its reduction; it is a wider concept that focuses on improving quality of life for patient while developing higher self-esteem (McGorry et al, 2022). The core principles of ROC are personalised care, self-determination, collaborative decision making, empowering patient, respecting autonomy and patient engagement. In current case ROC would focus on validating her emotions and empowers setting and achieving goals. Further, this approach improves her decision-making capabilities while prioritising her strengths. (McGorry et al, 2022).)
Key features of Trauma-Informed Care and Recovery-Orientated Care
The core features of TIC and ROC provides consistent guidance within nursing practices whilst; there approaches differs from each other. The features of TIC align with identifying trauma histories, fostering patient safety, reducing chances of re-traumatisation and providing consistent support to patient (Fabricante, 2022). On the other hand, ROC follows a forward approach and develops an environment in which personal recovery goals are developed for patient and collaborative partnership is implemented for supporting patient. It promotes peer involvement and encourages holistic framework that consider past issues and develops future aspirations (Fabricante, 2022).
Similarities between Trauma-Informed Care and Recovery-Orientated Care
Despite distinct approaches both of these framework have certain similarities and this comprises with keeping patient at the forefront of care procedure and providing person-centred care. Furthermore, RIC and TOC encourages collaborative partnership which is important for promoting collaborative decision-making and supports Jane in showing active participation in care procedure (Fabricante, 2022). Two of these approaches lead to empower Jane and build confidence in her; TIC builds confidence by increasing resilience in Jane while ROC implements personalised goals and fosters sense of self-esteem in Jane. Additionally, both of theseframeworks extending beyond managing symptoms and significantly focuses on addressing holistic factors comprises with emotional, social, physical and cultural issues of Jane (Fabricante, 2022). Differences between Trauma-Informed Care and Recovery-Orientated Care
Differences between TIC and ROC depict about their complementary nature; the primary focus of TIC is on addressing the symptoms comprises with past trauma and often neglects the present issues. In Jane’s case integration of TIC complies with assessing the symptoms such as- anxiety and depression and this would be linked with her past experience (Stack et al, 2022). On the other hand, ROC focuses on future development and therefore, strategies that empower Jane will be considered and personalised goals such as- social engagement will be integrated. Furthermore, TIC prioritises safety and ROC focuses on considering optimism and hope. The clinical implication of TIC concerned with fostering protective environment and reducing harm (Stack et al, 2022). Whereas, ROC focuses on developing personalised goals and promoting social inclusion for Jane.
Strategies implemented in clinical practice.
Trauma-Informed Care for Jane:
Developing Therapeutic interaction with Jane-
From the case it has been evident that Jane is unable to trust staff members and this shows that it is important to develop therapeutic alliance with her. Persistent interaction with Jane needs to be developed and subsequently, transparent communication must be followed (Stack et al, 2022). It is important to consider the needs of Jane and accordingly, appropriate actions require to be implemented. Her emotions should be prioritised and her trust needs to be gained; this supports in developing an effective therapeutic interaction with Jane and improves her self-esteem to greater extent.
Acknowledging Experience of Jane-
It is highly important that nurse listen Jane’s experience without being judgemental. It is highly important to show consistent empathy towards patient. This leads to develop sense of belongingness in her and further improves her morals to greater extent (Huo et al, 2023). TIC specifically focuses on developing a non-judgemental environment where patient can share about their issues and concerns without having fear of judgement. Therefore, it is the accountability of nurse that there is need to develop a non-judgemental environment so Jane can open about her past issues and the things that bothers her (Huo et al, 2023).
Creating safe and comfortable environment-Jane feels unsafe in familiar environment and further, her history of trauma has created drastic impact on her mental wellbeing. Therefore, it is crucial to develop a safe and comfortable environment where Jane feels protected and does not have any fear (Stack et al, 2022). In order to integrate this strategy nurses must assure that Jane is feeling safe and environmental triggers should be reduced. In this manner, significant support to Jane can be assured and her trust could be gained (Stack et al, 2022).
Recovery-Oriented Care for Jane:
Collaborative care planning-This strategy complies with supporting Jane in acknowledging her personal identity by developing personal goals. These goals must be aligned with improving his sleep schedule and developing confidence, particularly in group therapy. Collaborative care planning is important for identifying personal needs and preferences of Jane and accordingly, appropriate goals require to be implemented (Davidson et al, 2021).ROC comprehends with setting personalised goals for patient and this leads to improve their quality of life (Davidson et al, 2021). Hence, considering this strategy in current case is essential for improving self-esteem of Jane.
Fostering strength-ROC aligns with focusing on patient’s strength; for instance- connecting Jane with peer support helps in increasing her engagement and further improves her resilience capabilities to greater extent (Davidson et al, 2021).In this manner, persistent support could be assured to Jane and her social isolation can be decreased.
Empowering Jane and encouraging self-determination-This strategy complies with improving Jane’s engagement in daily care decision making. This is important for fostering Jane’s self-determination and higher sense of self-esteem (McGorry et al, 2022). Nurse must ask questions from Jane such as- “What she wants to wear or what she would like to eat” such questions will lead to promote Jane’s independence and encourages self-esteem.
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Contemporary findings
In the views of Porges and McGorry (2024) TIC and ROC both of these approaches creates consistent support for patient and promotes their wellbeing; these approaches are pivotal within mental health nursing as this enables nurses to undertake a holistic approach for supporting patient wellbeing. Integration of these approaches should be done after analysing the past and current situation of patient. On the other hand, Smith and Brown (2024) stated that TIC is widely used for reducing traumas among patients; this approach supports in identifying the cause behind trauma and focuses on empowering patient and therefore, this is widely used in mental health nursing. It is important to integrate TIC framework within nursing practices specifically when any patient is suffering from distressing impacts due to traumatic event.
In the views of Williams, Chan and Roberts (2023) ROC and TIC both approaches are complementary and they should be integrated in combine for supporting patient wellbeing. Both of these frameworks supports patient autonomy, choices and empowers them to greater extent. However, nurses must have knowledge in regards to undertake appropriate implication of these frameworks so that significant support can be assured to patient. Whereas,Melillo et al, (2025) revealed that ROC is important for developing personalised goals for patient and in this manner, their future aspirations could be developed. This contributes in improving patient self-esteem to higher extent and further develops therapeutic alliance which is important for enhancing patient wellbeing.
Conclusion
This assessment has addressed and discussed about the trauma-informed care and recovery-oriented care by considering Jane’s case. Two of these frameworks have their own benefits and drawbacks and it is important that nurses are aware about these domains as it helps in undertaking appropriate implication of practice. The report highlighted that integration of both framework is beneficial for Jane as TIC supports in fostering trust in her and further decreases the drastic impact of trauma. On the other hand, ROC supports in developing personalized goals and accordingly, Jane can be empowered and her quality of life could be improved.
References
- Davidson, L., Rowe, M., DiLeo, P., Bellamy, C., & Delphin-Rittmon, M. (2021). Recovery-oriented systems of care: a perspective on the past, present, and future. Alcohol Research: Current Reviews, 41(1), 09.https://pubmed.ncbi.nlm.nih.gov/34377618/
- Dowdell, E. B., & Speck, P. M. (2022). CE: Trauma-informed care in nursing practice. The American Journal of Nursing (AJN), 122(4), 30-38.https://pubmed.ncbi.nlm.nih.gov/35348516/
- Fabricante, A. M. (2022). Practicing Trauma-Informed Care in Nursing for a Better Outcome in Hospitalized Adolescents with Adverse Childhood Experiences and Trauma.https://scholar.dominican.edu/nursing-senior-theses/51/
- Huo, Y., Couzner, L., Windsor, T., Laver, K., Dissanayaka, N. N., & Cations, M. (2023). Barriers and enablers for the implementation of trauma-informed care in healthcare settings: a systematic review. Implementation Science Communications, 4(1), 49.https://pubmed.ncbi.nlm.nih.gov/37147695/
- McGorry, P. D., Mei, C., Chanen, A., Hodges, C., Alvarez‐Jimenez, M., & Killackey, E. (2022). Designing and scaling up integrated youth mental health care. World Psychiatry, 21(1), 61-76.https://pubmed.ncbi.nlm.nih.gov/35015367/
- Melillo, A., Sansone, N., Allan, J., Gill, N., Herrman, H., Cano, G. M., ... &Galderisi, S. (2025). Recovery-oriented and trauma-informed care for people with mental disorders to promote human rights and quality of mental health care: a scoping review. BMC psychiatry, 25(1), 125. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06473-4
- Porges, A., & McGorry, P. (2024). Integrating trauma-informed care in nursing practice and education. Journal of Psychiatric and Mental Health Nursing, 31(4), 589–598. https://doi.org/10.1016/j.pedn.2024.01.003
- Smith, J., & Brown, L. (2024). Trauma-informed care in acute adult public mental health settings: Implementation challenges and successes. Issues in Mental Health Nursing, 45(7), 585–597. https://doi.org/10.1080/01612840.2024.2308543
- Stack, E., Hildebran, C., Leichtling, G., Waddell, E. N., Leahy, J. M., Martin, E., & Korthuis, P. T. (2022). Peer recovery support services across the continuum: In community, hospital, corrections, and treatment and recovery agency settings–A narrative review. Journal Of Addiction Medicine, 16(1), 93-100.https://pubmed.ncbi.nlm.nih.gov/33560695/
- Williams, T., Chan, K., & Roberts, M. (2023). Carers’ understanding of recovery-oriented practice in mental health: A systematic review. International Journal of Mental Health Nursing,32(5), 1024–1038. https://doi.org/10.1111/inm.70035
