ACA Blog

Nancy White
Mar 06, 2012

Trauma Informed Care: Seeking Safety from PTSD/Substance Abuse

The first woman I met, who worked as a street prostitute, was during my counseling practicum inside the Kansas City, Missouri city jail. (Regional Correctional Center, RCC). I remember her sad eyes, her beautiful but aged face, more importantly her dreams of a satisfying life and future for her and her children. She was a beautiful person, wanting the good life for her family and herself. Her words are as loud today as then when she told me “You don’t understand. The very worst has already happened to me. My father raped me. It does not matter what I do now.”

The prevalence of trauma in the United States mental health population is high. 90% of public mental health clients have been exposed to trauma. (Mueser et al., 2004, Mueser et al., 1998) Most have multiple experiences of trauma. (Mueser et al., 2004, Mueser et al., 1998.) 87% experience this abuse both in childhood and adulthood. (Goodman et al., 1997) Adverse childhood experiences that can cause trauma include recurrent and severe physical or emotional abuse and sexual abuse. Just growing up in a household with alcohol and drug abusers, members being imprisoned, mentally ill family members, seeing Mom being treated violently, biological parents absent and emotional or physical abuse are adverse childhood experiences. (Feim et al, 1998).

What does Trauma Informed Care mean to you? To me, it means behavioral health care treatment must incorporate trauma informed care with an appreciation for the high prevalence of traumatic experiences in persons who receive behavioral health services. The care also has to have a thorough understanding of the profound neurological, biological, psychological and social effects of trauma and violence on the individual. (Jennings, 2004) Treatment should focus on “What has happened to you?” not “What is wrong with you?” What has happened to you is particularly important in the jail or prison setting. For some inmates, realizing what has happened to them might be their first step towards freedom.

The “present-focused therapy” that I use, to help people attain safety from trauma/PTSD and substance abuse is Seeking Safety, by Lisa M. Najavits, Ph.D. As our clients cycle in and out of the city jail the twenty-five topics can be used in any order and are appropriate for group or individual sessions. The sessions help clients attain safety in their relationships, thinking, behavior, and emotions.

Working as a probation officer, with a special caseload called Special Services for Women, a counselor within a jail, and at a community mental health I have met many women who began working as a street prostitute at a very young age. Sadly, I have met some of their children who have followed in their mother and grandmother’s footsteps. More importantly, I know women who have escaped the trauma and substance abuse of their lives and live productively in the community. You can help by practicing trauma informed care!


Nancy White, MA, LPC is a counselor who has spent much of her professional life working in corrections.

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