Which Theoretical Models or Frameworks Are Used to Understand Trauma-Informed Care in Mental Health Settings? A Scoping Review.

This scoping review examines and synthesizes the theoretical foundations underpinning trauma-informed care (TIC) in mental health settings. A systematic search of CINAHL, Scopus, Web of Science, and PubMed yielded 1278 records, of which 23 peer-reviewed studies published between 2010 and 2025 met the inclusion criteria. Reporting followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. Seven overarching theoretical domains were identified: neurobiological and psychophysiological foundations, psychological and relational models, adverse childhood experiences and social determinants frameworks, SAMHSA and Harris & Fallot principles, socio-ecological and intersectional frameworks, organizational and implementation science models, and integrated or hybrid approaches. These frameworks highlight the multidimensional nature of trauma and its implications for mental health nursing practice, interdisciplinary care, organizational change, and policy development. The findings underscore that TIC is not a single model but a pluralistic and evolving concept bridging individual, relational, and structural dimensions of trauma. Theoretical clarity can enhance implementation fidelity, reduce re-traumatization, and support recovery-oriented care. Future research should focus on evaluating hybrid frameworks and linking theoretical models to measurable individual, organizational, and system-level outcomes.