Trauma-Informed Behavior Support: It’s About Quality of Life

Or, “Is it OK to say ‘behavior?’”

Sometimes I’ll hear people say “Trauma-informed behavior support – how does that work? Can you be trauma-informed and still be talking about ‘behavior?’”  

My answers: It works great. And yes, you can.  And yep, I get why that can be an uncomfortable mix.

It’s OK to say “behavior.”  (And it’s OK to disagree. If it doesn’t work for you, we’re still cool.)

The word “behavior” has a lot of baggage.  For some people, talking about behavior automatically means talking about applied behavior analysis.  Or, I’ll hear direct support professionals talk about something as “just a behavior.” (“When he sat down there, could that be from a seizure?”  “No, he just sits down sometimes.  It’s just a behavior.”)  And in the world of person-centered thinking (where I try to live in every moment), using the word “behavior” often has an inherent bad taste to it — so many people talk about “behavior” while missing the human underneath the actions.  I, myself, will sometimes contort a sentence to avoid using the B word.

Oh, I get it.

Here’s the thing . . .

Language exists as a tool to communicate.  If we don’t have a perfectly precise way to say what we mean, sometimes we need to go with what we’ve got.  

When we’re talking about “problem behavior,” we’re generally talking about something that a person does that interferes with their own quality of life, or the quality of life of the people around them, and if the person could stop doing that thing, or find an alternative way to meet that need, they most likely would be a happier version of themselves, according to everything we know about them.  

58 words.  Sometimes it’s an action, sometimes it’s a statement, it’s almost always communicating something, but we don’t have a word in our language that means the exact same thing as those 58 words.  The closest we have is “behavior.”

I try to approach language as “mean what you say; say what you mean.” And as Brené Brown says: “Clear is kind. Unclear is unkind.” 

So until we find a more precise way to convey that particular thing,  I use the word “behavior.” Sometimes.  Almost always with quotes or air quotes.

In the world of professional supports for people with developmental disabilities, applying some specialized know-how to help with those quality-of-life-interfering-things gets many labels; one of the clearest labels is “behavior support.”

So I often use the term “behavior support” for clarity.  (And when I’m talking about the sort of behavior supports that I work with, I’ll call it Trauma Informed Behavior Support, Person-Centered Behavior Support, or Integrated Behavior Support, to specify that we’re talking about a whole bunch of good stuff working together.)

Looking at it from all of those different angles, there is of course nothing mutually exclusive about supporting behavior and supporting/navigating trauma (in fact, to do it well, it’s 100% necessary in my eyes). I go with the SAMHSA definition of “trauma-informed”:

“A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization.”

To apply those 4 R’s or “key assumptions” to the practice of supporting people who are working on problem behaviors is to practice Trauma-Informed Behavior Support.

Inherently, that leads us to a behavior support approach that does everything possible to avoid exerting power over the person being supported.  In some scenarios, it’s still a revolutionary way to approach the work.  And it definitely takes more time, at least at first.  But if we see the “problem behaviors” as ways that the person has adapted to their environment — recognize them as survival strategies — we soon realize that a trauma-informed lens is absolutely necessary if we are to promote an improved quality of life.


Brown, Brené. Dare to Lead: Brave Work, Tough Conversations, Whole Hearts. New York: Random House, 2018.

Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

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