Responding to Crisis Moments with a Trauma-Informed Lens

Wajdi Akef Fakhoury, LMFT 148333

Crises can happen at any time—especially for individuals with intellectual and developmental disabilities (IDD) who have experienced trauma. When faced with overwhelming emotions or environmental triggers, they may struggle to regulate their behavior, leading to moments of distress that can escalate quickly. For caregivers and professionals, responding to these moments requires more than just de-escalation techniques. It calls for a trauma-informed approach that prioritizes safety, connection, and understanding.

What Makes a Trauma-Informed Response Different?

Traditional approaches to crisis management often emphasize control, focusing on stopping the “problem behavior” as quickly as possible. While this might seem effective in the short term, it can unintentionally increase fear, confusion, or mistrust for individuals with trauma histories. Trauma-informed responses, in contrast, prioritize helping the individual feel safe, understood, and soothed, which promotes long-term healing and resilience.

This type of approach shifts the question from “How do I stop this behavior?” to “What is this behavior communicating?” and “How can I support this person?”

The Importance of Safety in Crisis

During moments of crisis, the brain’s fight-flight-freeze system takes over, leaving little room for logical thinking or communication. For individuals with IDD, this can manifest in behaviors such as yelling, physical aggression, self-injury, or withdrawal. A trauma-informed response seeks to de-escalate the situation by helping the individual feel physically and emotionally safe.

Key elements of psychological safety include predictable responses, calm interactions, and an environment free from threats or perceived judgment.

Trauma-Informed Strategies for Crisis Moments

Here are practical ways to provide trauma-informed care during crises, designed to help caregivers and professionals de-escalate situations while recognizing and addressing trauma-related needs.

1. Regulate First

Before seeking to resolve or address the cause of the crisis, focus on helping the individual regain a state of calm. Their brain cannot process information or problem-solve while in a heightened state of stress.

How to Apply This:

• Use a calm voice and body language: Adopt a low tone, even pace, open posture, and maintain a non-threatening distance. Avoid abrupt gestures or raised voices, which can escalate fear.

• Engage the senses: Offer sensory tools such as a soft blanket, stress ball, or access to a quiet and low-stimulus space.

• Encourage deep breathing: Guide them through simple breathing exercises, such as inhaling slowly for four seconds, holding for four seconds, and exhaling for four seconds.

2. Validate Their Emotion

Validation helps individuals feel seen and heard, which can reduce feelings of helplessness or frustration. Acknowledge their emotions without focusing on the behavior itself.

How to Apply This:

• Use statements like, “I can see that you’re really upset. I’m here to help,” or “I know this is hard for you right now.”

• Avoid making dismissive comments such as “Calm down” or “There’s no reason to be upset,” as these can increase distress.

3. Adjust Your Expectations in the Moment

Crises often require flexibility. Individuals with IDD and trauma histories might not be capable of following instructions or completing tasks during distress. Focus instead on providing immediate support.

How to Apply This:

• Temporarily pause or reduce demands, such as asking them to follow complex directions or complete multi-step tasks.

• Offer choices to restore a sense of control, like asking, “Would you like to sit here or in the quiet room?”

4. Preserve Dignity with Non-Coercive Methods

Using physical restraint or authoritative commands can feel deeply threatening to individuals with trauma histories, often worsening behaviors and potentially re-traumatizing them. Instead, focus on creating a collaborative and respectful environment.

How to Apply This:

• Offer assistance rather than dictating actions (e.g., “Would you like me to sit with you while we figure this out together?”).

• Provide space if needed but remain available—being nearby can help reduce feelings of abandonment.

5. Debrief Once Calm Has Returned

Once the crisis has passed, it’s essential to process what happened in a way that helps the individual learn and grow without shame or fear.

How to Apply This:

• Revisit the situation together, using accessible language or visuals to explore what happened and why.

• Focus on solutions, such as identifying triggers and brainstorming strategies to handle similar situations in the future.

• Encourage positive reinforcement for calming down, emphasizing their resilience rather than focusing on the crisis behavior.

Example in Practice

Scenario: Jamie, a 15-year-old with IDD, becomes overwhelmed during a loud school assembly. He starts screaming, hitting himself, and running toward the exit.

Trauma-Informed Response:

• Step 1: A staff member calmly approaches and says, “Jamie, I see that this is really loud and upsetting for you. I’ll help you get to a quiet spot.”

• Step 2: They guide Jamie to a sensory room with dim lights, staying nearby as he uses a weighted blanket to calm down.

• Step 3: Once Jamie is calm, they use a visual aid to debrief what happened. They explain, “Sometimes loud noises can feel scary. We can try headphones next time or sit near the exit so it’s easier to leave.”

This response prioritizes Jamie’s safety and emotional regulation, allowing him to regain control without punitive measures or escalation.

The Role of Caregiver Self-Regulation

It’s important to acknowledge the emotional toll crises can have on caregivers and professionals. Staying calm requires self-awareness and a commitment to self-care. Techniques such as mindfulness, grounding exercises, or even stepping back momentarily (while ensuring someone else is available to support the individual) can help caregivers regulate their own emotions.

Moving Forward

Trauma-informed care transforms crisis moments into opportunities for connection and understanding. By meeting individuals with IDD where they are and addressing their needs with compassion, caregivers and professionals can de-escalate immediate challenges while fostering trust and resilience for the future.

Next in this series, we’ll discuss how systems-level collaboration strengthens trauma-informed care and supports individuals with IDD across all areas of their lives.

References

• Fletcher, R. (2011). Psychotherapy for Individuals with Intellectual Disability. Kingston, NY: NADD Press.

• Mevissen, L., & de Jongh, A. (2010). PTSD and its treatment in people with intellectual disabilities: A review of the literature. Clinical Psychology Review, 30(3), 308-316.

• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. U.S. Department of Health and Human Services.