Integrating trauma informed care and harm reduction philosophies and practices to improve participant health outcomes

Trauma is a common experience among people impacted by homelessness. Because traumatic experiences can have widespread effects on individuals' physical and mental health, their willingness to seek support, and the way they engage in services, it is imperative that homeless service providers utilize a trauma-informed approach in their work. Similarly, social service agencies have increasingly adopted a harm reduction approach, recognizing the pervasiveness of substance use among people experiencing homelessness. While harm reduction is most commonly associated with its applications related to substance use, this approach can be implemented more broadly to reduce other potentially harmful effects of traumatic experiences. At the heart of both philosophies lies an emphasis on developing strong, therapeutic relationships, characterized by a nonjudgmental, client-driven approach. These approaches improve engagement through an emphasis on establishing and maintaining participant safety rather than mandating specific behavioral changes, such as complete abstinence from substance use. Participants are often stigmatized for engaging in risky behaviors, which keeps them disconnected from services, increasing their vulnerability. When providers view such behaviors (e.g., substance use, nonadherence to medical and mental health care, choosing to live on the streets rather than in shelters) as responses to trauma, we are better situated to work patiently and compassionately with participants. This workshop will educate attendees about the concepts of harm reduction and trauma-informed care and the ways that they work together, both in theory and in practice. Through didactic lecture and small group discussions, attendees will identify strategies for incorporating these philosophies at their respective agencies. Attendees will obtain tangible tools for implementing the synergy of trauma-informed care and harm reduction philosophies during client engagement.