The other TIC (Trauma Informed Care)

Hey all, Ryan here.  Happy 2026!

How many of you have thought to yourselves “I turned out pretty ok despite my upbringing?”

I’ve said this a few times tongue-in-cheek because me turning out “ok” is debatable.  I'm in no position to critique my parents or ANY parents for that matter, but my rose-colored glasses see most parents doing their best even when they don’t have all the tools they may need.

Your childhood home felt normal because it was familiar. It takes time and distance to realize what you thought was normal growing up might be far from it.  I grew up on a farm and remember the first time going to a city friend’s house and asking him where his dad farmed because I assumed ALL dads were farmers. Turns out the world needs mechanics and bankers too. 

Some differences in upbringing are not quite as innocent and can impact you beyond your childhood. A test called Adverse Childhood Experiences (ACEs) was developed that shows a correlation between childhood trauma and adult-life problems. 

This simple 10 question test assesses if abuse, neglect, or household challenges were present in your home growing up. A high score does not automatically mean you’re screwed but it does put you at a higher risk for some significant challenges as an adult.  If you’re curious what you might score, this is your chance to jump to the bottom of this post and take the test.

Two thirds(!) of the general population have a score of at least 1. Where things take a turn South is a score of 4 or higher. Nationally, approximately 1 out of 8 have a score of 4 or more.  In Bexar County, TX, 1 out of 5 scores a 4 or higher. Keep in mind, this doesn’t just apply to the citizens we serve…It’s also the people we ride on the firetrucks and ambulances with. 

So, what does it all mean? 

An ACEs score of 4 means as an adult you are:

·         4x more likely to have heart disease, COPD, and/or cancer

·         4x more likely to suffer from depression

·         5x more likely to use illicit drugs

·         7x more likely to have alcohol dependency

·         12x more likely to attempt suicide

·         12X more likely to be incarcerated

·         Compared to those who score zero, 16-year shorter life span

Can we interrupt this cycle? 

An organizational mindset was developed to do just that. Trauma Informed Care (TIC) started conceptually after the Vietnam war as many soldiers were returning home with PTSD. Systemic changes needed to be made to avoid re-traumatization for these individuals. When this model was expanded and applied to those with high ACE scores, it showed promising results. 

The problem was identifying who needs to be treated with a little more compassion because of past trauma. Afterall, people don’t come with warning labels (man, I wish they did).  If you recall, 67% of gen pop had a score of at least 1, so it becomes easier to just assume EVERYONE has been impacted by some level of childhood trauma. I hope you’ve all heard the phrase “treat everyone kindly, we’re all fighting a battle you can’t see.”  This is the height of compassion for me and the baseline I try to operate from.

So, what is TIC?

Trauma Informed Care has nothing to do with “treating someone with kid gloves” or “handing out participation trophies.” Instead, it simply focuses on compassion and safety. Having compassion for another human being and offering them safety does not mean being “soft” or “touchy-feely".

I spent well over a year working towards this certification which resulted in the SAFD being the first fire department in the Country to become certified as a Trauma Informed organization. A lot of the groundwork was already in place, but there were areas to improve.

In some instances, implementing TIC requires thinking outside the box.  Take the room that Applicant Processing uses for the polygraph testing. It was incredibly stark and the chair itself resembled an electric chair. An applicant, already nervous as hell, would walk into the room and automatically feel like they were about to receive their last rights. The room needed an overhaul. 

Bookshelves with books were added, art was hung on the walls, and the overall comfort level of the room went from institutional to downright welcoming. The result was an improved rate of applicants passing the test. 

We’ve all had shitty days where we just can’t deal, but those hard days don’t define us. The applicants have complex lives just like us and are every bit as susceptible to stress. If your polygraph falls on a day you’re struggling with whatever life has dealt you, your chances of failure increase. 

By creating a safe space for the test, applicants feel more comfortable, so their vital signs are closer to normal, and they are much calmer, which results in a more accurate test. We may have inadvertently eliminated some great applicants who would’ve excelled at the job simply because the polygraph test was administered in a scary room (that may have, in and of itself, triggered trauma) while they were dealing with anything ranging from a death in the family to car problems that almost made them late. 

A note on “kids these days.” Some people (like me) have complained that kids are too soft and disengaged.  After taking a deeper look, I realized kids are kids, and they HAVE NOT changed…It’s parenting that has changed.  Kids are a product of their environment and a reflection of their upbringing, which is out of their control.  So, when that new probie comes to your station and you don’t feel they meet your standards, you have two choices.  1). You can run them off so it’s someone else’s problem or 2). You can take them under your wing and teach them about firefighting and life and possibly break the cycle they were born into. 

ACEs Test-the number of “yes” replies is your score:

1.       Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

2.       Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or ever hit you so hard that you had marks or were injured?

3.       Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or attempt or actually have oral, anal, or vaginal intercourse with you?

4.       Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

5.       Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6.       Were your parents ever separated or divorced?

7.       Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

8.       Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

9.       Was a household member depressed or mentally ill, or did a household member attempt suicide?

10.   Did a household member go to prison?

Peer Supporters and your Behavioral Health team at Wellness are always available to talk or provide guidance. Never hesitate to reach out.