Does the Wide Reach of the “Trauma-informed” Model Exceed its Narrow Grasp?

Compared to the biomedical model of mental suffering, the increasingly influential trauma model has received little critical attention. We examine the discursive practices justifying and promoting the trauma-informed care: a set of assumptions and clinical recommendations presented as universal and uncontested guidelines for mental health practitioners. Critical review of two major guidelines for trauma-informed care - the SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach (2014) and A paradigm shift: relationships in trauma-informed mental health services by Sweeney et al. (2018) - was inspired by critical discourse analysis and the analysis of reification. Trauma-informed care is a diverse set of recommendations combining generally accepted standards with the notion of broadly defined trauma as the primary cause of mental suffering. We have identified mechanisms that (1) present the broad trauma model as an assumption-free description of reality, (2) portray it as superior to other models, and (3) elevate the authority of those who adopt the broad trauma model to interpret the suffering of others. The discursive procedures found in the trauma-informed manuals are similar to those documented in the biomedical-psychiatric literature. Potential risks include iatrogenic harm, politicization of mental health care, and reduction of its diversity and effectiveness. Evaluation of the guidelines from the perspectives of safety, cultural validity, ethics, and cost-effectiveness should precede their implementation into clinical practice.