Understanding Trauma and Violence-Informed Approaches in Building Vaccine Confidence

In the wake of the COVID-19 pandemic, conversations around vaccines have become increasingly prevalent in our day-to-day lives. However, despite the well-established safety and effectiveness of vaccines, vaccine hesitancy remains a significant concern for public health. To address this challenge, it’s essential to integrate principles of trauma and violence-informed approaches into service delivery, particularly when engaging with marginalized populations.  

In the first webinar of our Building Vaccine Confidence series, Families Canada introduces Nadine Wathen, professor and Canada Research Chair at Arthur Labatt Family School of Nursing, and Susan Jack, professor of nursing at McMaster university, who take us through the nature of trauma and violence and how to use trauma and violence-informed approaches as family support practitioners.   

What are Trauma and Violence-Informed Approaches? 

Trauma and Violence-Informed Approaches (TVIA) prioritize understanding individuals’ experiences within a broader context. Practitioners who understand TVIA recognize the complexity of people’s social, political, and personal worlds, including the systems and structures that shape their opportunities and challenges. They avoid individual-level analyses, and instead look at the full picture of their client’s lives, recognizing that traumatic experiences may shape behaviours and reactions. Wathen gives us an example of how trauma affects vaccine confidence in Canada: 

“There are many people in our society who might not be confident about receiving vaccines, because they’ve had really bad experiences in our systems, with health care systems and education systems, certainly in criminal justice and legal systems. 

How Does Trauma Affect Our Lives? 

Traumas are not limited to singular events but can be chronic and pervasive, affecting individuals’ abilities to trust and form connections. Wathen explains that trauma involves the response to events that threaten one’s safety, life, or personal integrity. 

“It’s an overwhelming experience… more than everyday stress.”  

Trauma responses can manifest as physiological changes in the body, releasing stress hormones like cortisol.  

“It’s not just all in your head; it’s brain, body, mind, everything together, and it is grounded in physiology.” 

What About Violence? 

Violence has both interpersonal and structural forms. Structural violence, ingrained in societal systems, perpetuates disparities and limits opportunities for marginalized people and families. Interpersonal violence, such as child maltreatment or intimate partner violence, is also chronic and complex, impacting trust and connections. Wathen describes some examples of how interpersonal forms of violence can affect individuals and families: 

“It’s difficult if you’ve grown up in a very violent home, to not have some of those patterns repeated. People do survive and thrive, but it certainly adds additional burden. 

Types of Trauma and Violence 

Traumatic experiences vary widely, ranging from natural disasters to interpersonal violence. Situational traumas, like job loss or war, are external events that threaten safety, whereas interpersonal traumas affect individuals’ abilities to trust and form attachments. 

Wathen elaborates – “Interpersonal forms of trauma are usually chronic and complex… rarely are they a single event.”

Structural inequalities are another form of violence that are deeply embedded in social systems and institutions, perpetuating disparities, and causing complex traumas for marginalized individuals.  

“Structural violence is not an academic term… poverty, racism, discrimination… cause harm.”  

These inequalities manifest in various forms, such as discriminatory practices in healthcare and disparities in access to education and employment. By using trauma and violence-informed approaches to acknowledge structural inequalities, we can begin to dismantle systemic barriers and address trauma and violence head-on. Here are some considerations for using trauma and violence-informed approaches in service delivery: 

The Importance of Safety 

When working with families, it’s crucial to adopt trauma and violence-informed approaches to create safe and supportive environments. Jack highlights the importance of safety when using trauma and violence-informed approaches in service delivery. 

“Both the provider and the person using the service need to feel safe… and that has to happen both at the organizational level and the individual level” 

Countering Stigma and Discrimination 

Jack goes on to explain that to provide trauma and violence-informed care, service providers must counter stigma and discrimination through self-reflection and a consideration of how personal biases can affect the care provided to Canadian families. 

“…this also means actively countering stigma and discrimination, and starting with your own potentially implicit biases or other judgments and stereotypes that you might bring to an interaction and really being aware of those and how they might play out and be harmful to a person that you’re providing service to. 

Collaboration and Using a Strengths-Based Approach 

Wathen elaborates, emphasizing the value of collaboration and connection, as well as understanding individuals’ concerns and experiences 

“Listening to people… collaboration involves co-creating plans that build on individuals’ strengths and support their decision-making process.”  

As family support practitioners, the ability to recognize and address trauma and violence is essential in providing effective care and support to Canadian families. By understanding the complexities of trauma and violence and integrating trauma and violence-informed practices, practitioners can create environments that promote healing and resilience.  

To learn more about how you can use trauma and violence-informed approaches with the families you serve, check out the full webinar here.