Trauma-Informed Care as Structural Disruption: Social Work at the Frontlines of Systems Transformation.

Abstract

Background: Trauma-Informed Care (TIC) is frequently conceptualized as a clinical intervention targeting individual psychological harm. While valuable in clinical contexts, this framing restricts TIC's broader capacity for systemic and structural transformation.

Objective: This article reframes TIC as a structural disruption strategy-an equity-driven, systems-level intervention that redefines how health is understood, delivered, and governed.

Methods: Drawing from social work's integrative approach across clinical, community, and policy domains, the article situates trauma as a predictable outcome of structural violence rather than an individual pathology. Analysis centers on health system fragmentation, particularly the entrenched separation of behavioral and physical health, as a form of systemic harm.

Results: The article highlights liberatory innovations that demonstrate TIC's transformative potential, including healing-centered schools, trauma-informed telehealth, and peer-based emergency response models. These examples illustrate pathways for addressing systemic inequities while fostering relational accountability and community-centered care.

Conclusion: A paradigm shift is needed-from models of integrated care toward liberatory health systems rooted in justice, equity, and structural transformation. By reframing TIC as a disruption strategy, health and social work can move beyond symptom management to advance structural change.