A Full Circle Model of Trauma-Informed Communication for Providers and Patients on the Cancer Journey

By:  Sandeep (Anu) Kaur, George Mason University & Barbara L. Ley, University of Delaware

Images Above Sourced From Polyvagal Flip Chart: Understanding the Science of Safety (Norton Series on Interpersonal Neurobiology) By: Deb Dana

Overview of the Full Circle Model

Our "full circle" approach to patient-provider relationships in cancer care foregrounds the interconnectedness of trauma-informed communication, emotional regulation techniques, and provider self-care and life-care. To explore this three-part model further, check out the presentation references and additional resources listed below:

1.     Trauma-Informed Communication

Given the traumatic nature of the cancer experience, health care providers can approach their communication and interactions with patients through a trauma-informed lens.

 ●      SAMHSA (2023). Practical Guide for Implementing a Trauma-Informed Approach. In SAMHSA Publication No. PEP23-06-05-005. National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration.

●      Gerber, M., ed. (2019). Trauma-Informed Healthcare Approaches: A Guide for Primary Care. Springer Publishing.

●      Davidson, C.A., Kennedy, K., & Jackson, K.T. (2023). Trauma-informed approaches in the context of cancer care in Canada and the United States: a scoping review. Trauma, Violence, & Abuse 24(5), 2983-2996.

●      Dhawan, N., & LeBlanc, T.W. (2022). Lean into the uncomfortable: using trauma informed care to engage in shared decision-making with racial minorities with hematologic malignancies. American Journal of Hospice and Palliative Medicine 39(1), 4-8.

●      Hall, M.F., & Hall, S.E. (2017). Managing the Psychological Impact of Medical Trauma: A Guide for Mental Health and Health Care Professionals. Springer Publishing.

●      Sinko, L., Ghazal, L.V., Fauer, A., & Wheldon, C.W. (2023). It takes more than rainbows: Supporting sexual and gender minority patients with trauma‐informed cancer care. Cancer 130(4), 507-516.

2.     Patient/Provider Attunement and Co-Regulation

A trauma-informed communication approach should address the nervous system dysregulation that can occur during provider-patient interactions, particularly given the stressful nature of the cancer experience.

 ●      Bauer, A., & Teply, M. (2023). How patients cope throughout the course of an incurable cancer. Clinical Colorectal Cancer 22(4), 347-353.

●      Cotter, P., Holden, A., Johnson, C., Noakes, S., Urch, C., & King, A. (2022). Coping with the emotional impact of working in cancer care: The importance of team working and collective processing. Frontiers in Psychology 13, 877938.

●      Porges, S.W. (2022). Polyvagal theory: A science of safety. Frontiers in Integrative Neuroscience 16, 871227. https://doi.org/10.3389/fnint.2022.871227

●      Polyvagal Institute:  https://www.polyvagalinstitute.org/

●      Rhythm of Regulation:  https://www.rhythmofregulation.com/

●      Trauma Geek:  https://www.traumageek.com/

3. A Focus on Healthcare Provider Wellbeing

Providers must nurture their own self-regulation, emotional intelligence, and self-awareness to effectively engage patients in a trauma-informed manner. This self-care and life care work is also necessary for providers to maintain their own wellbeing when working in cancer care settings.

●      Lipsky, L., & Burk, C. (2009). Trauma Stewardship: Caring for Ourselves While Caring for Others. Berrett-Koehler Publishers. (https://traumastewardship.com/)

●      Nagoski, E, & Nagoski, A. (2019). Burnout: The Secret to Unlocking the Stress Cycle.  Ballantine Books. (http://burnoutbook.net)

●      Raheem, O.F. (2022). Pause Rest Be: Stillness Practices for Courage in Times of Change. Shambhala Press. (http://pauserestbe.com)

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