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Trauma-informed care - an approach to grow together

James Heap, a case manager with Forensic Psychiatric Services at the Nanaimo Regional Clinic, has an approach to working with clients that is truly inspirational.
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His approach is one that breaks down the hierarchy, is collaborative, empowering and promotes occupation, purpose and care.

James hosts interested clients for meetings in the community garden – tended to by him and many of his clients. Side by side they dig, plant, weed, water and care for herbs and vegetables.  Sometimes clients show up for appointments at the office reporting they stopped by the garden on the way to water it. James provides trauma-informed care as he fosters a safe environment, is transparent and cultivates trust, provides peer support which results in mutuality and collaboration, provides clients with a voice and choice, and is mindful of any cultural or gender issues. 


Trauma is a part of the human experience.  It can affect anyone at any age.  While many people often associate trauma with an event it is actually how a person experiences a traumatic event that largely determines the impact on their lives in days and years to come.  Traumatic events themselves come in a variety of forms, which is why as humans we are all vulnerable.  When a traumatic experience, however, overwhelms a persons’ ability to cope in an adaptive way, safety is threatened and coping naturally shifts towards survival.  To avoid ever experiencing such fear and horror again, vigilance easily becomes essential to protect oneself against any potential threats.  As you can imagine, such vigilance can become exhaustive and may make functioning in both society and relationships incredibly challenging.  Over time, these survival skills can result in a wide range of secondary physical and psychological health issues. 


Many people who have experienced such intense traumatic experiences may find it very difficult to seek help.  A trauma-informed practice is a compassionate approach to care that understands the potential impact trauma can have on a person’s experience across a lifespan.  It is built upon a foundation that acknowledges a person’s requirement for safety, whether it be in relationship or environment.  A trauma-informed approach seeks to learn ‘what has happened’ in a person’s life so both a caregiver and a person receiving care can better understand what may be required in a journey towards healing. And finally, a trauma-informed approach aims to flatten the hierarchy of power and control in favour of acceptance, flexibility, choice and self-empowerment.  

Last season people grew spinach, beans, cabbage, lettuce and herbs. Clients were able to take grocery bags home as the fruit of their labour. Several clients who showed interest in the project last year have transitioned to volunteering at a local farm. This farm sells vegetables to the general public from a market stand.


A client who has worked with James in the garden shares his experience gardening:  

“It’s a wonderful experience.  There is no pressure to get everything done in a hurry; you go on your own accord…nobody harasses you…it’s a safe zone.”

Clients leave with a sense of accomplishment, community and sometimes a bag full of fresh vegetables.

“To Plant a Garden, is to Believe in Tomorrow”- Audrey Hepburn

BC Mental Health & Substance Use Services; mental health
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