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BITTEN: An Applied Trauma-Informed Healthcare Model

Author: Chrystal L. Lewis, RN; PhD

Year first published: 2019
© 2020 Chrysal L. Lewis
Major Concepts

Theoretical model


Too often healthcare providers only pay attention to why the patient is seeking healthcare and what the provider thinks the patient’s needs are. BITTEN is grounded in trauma informed care and a way for healthcare providers to begin implementation of trauma informed healthcare. The BITTEN model provides a framework to work holistically WITH patients and families in consideration of a person’s past (Betrayal history), the current situation (Indicator for seeking health care, Trauma Symptoms, and Trust) and the future (the patient and family Expectations and Needs).

Primary Source

Lewis, C. L., Langhinrichsen-Rohling, J., Selwyn, C.N., & Lanthan, E.C. (2019). Once BITTEN, twice shy: An applied trauma-informed healthcare model. Nursing Science Quarterly, 32(4), 291-298.

About the Author

Chrystal L. Lewis

Dr. Lewis is an Assistant Professor of Adult Health Nursing at the University of South Alabama. She earned her BSN (2007) from the University of Alabama at Birmingham. She earned her MSN (2009) in Nursing Education and her PhD (2015) from the University of Missouri – St. Louis. Her clinical background is in Adult Acute Care Medicine and Intensive Care. Informing her science are her own personal experiences having an invisible disability and a rare disease.

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